非阿片类镇痛药治疗慢性疼痛病中国指南

Chinese guidelines for the treatment of chronic pain disorders with non-opioid analgesics

非阿片类镇痛药物是慢性疼痛病重要的临床治疗药物之一,主要包括非甾体抗炎镇痛药、离子通道药物、抗抑郁药、糖皮质激素、神经营养药、肌肉松驰药、α_(2)肾上腺素能受体激动剂、调节骨代谢药物、N-甲基-D-天冬氨酸受体拮抗剂和中成药等。基于《国际疾病分类(第11版)》(ICD-11)中慢性疼痛病非阿片类镇痛药物治疗的指南尚未见报道。本指南由中国国家卫生健康委能力建设和继续教育中心疼痛病诊疗专项能力提升项目专家组(以下简称专家组)牵头制订。专家组系统检索和评价了ICD-11七大类慢性疼痛病的非阿片类镇痛药物治疗的适应证、禁忌证、注意事项等问题涉及的有效性证据,并针对特殊的慢性疼痛病患者如老年、妇女和儿童以及肝肾功能受损患者等提出了非阿片类镇痛药物治疗指南的推荐意见,旨在为临床合理应用非阿片类镇痛药治疗慢性疼痛病提供参考。

Non-opioid analgesics are one of the important clinical treatment drugs for chronic pain disorders,which mainly include non-steroidal anti-inflammatory analgesics,ion channel drugs,antidepressants,glucocorticoids,neurotrophic drugs,muscle relaxants,α_(2)adrenergic receptor agonists,bone metabolism regulating drugs,N-methyl-D-aspartate receptor antagonists and traditional Chinese patent medicines.The guidelines for the treatment of chronic pain disorders based on international classification of diseases(ICD)-11 with non-opioid analgesics have not been reported.This guideline was formulated under the leadership of expert group on Pain Disease Diagnosis and Treatment Special Ability Training Project of National Health Commission Capacity Building and Continuing Education Center(hereinafter referred to as the expert group).The expert group systematically searches and evaluates the effectiveness evidence related to the indications,contraindications,precautions,and other issues of non-opioid analgesics treatment for the seven major categories of chronic pain diseases in ICD-11.It also recommends non-opioid analgesic drug treatment for special chronic pain patients such as the elderly,women and children,as well as patients with liver and kidney dysfunction.This guide aims to provide reference for the application of non-opioid analgesics in the treatment of chronic pain disorders in different disciplines.