促进脊髓损伤后神经再生的药物治疗

Drug treatment for promoting nerve regeneration after spinal cord injury

目的:对促进脊髓损伤后神经再生的药物及其作用机制进行分析和总结,为临床应用提供有力的支持。资料来源:应用计算机检索Pubmed1994-01/2005-12关于脊髓损伤药物治疗的相关文章。检索词“spinalcordinjury,drugtreatment”并限定文章语种类为English。同时利用计算机检索中国期刊全文数据库1994-01/2005-12的相关文章,限定文章语言种类为中文,检索词“脊髓损伤,药物治疗”。资料选择:对资料进行初审,纳入标准:促进脊髓损伤后神经再生的药物及其作用机制、临床及实验推荐用量。排除标准:排除重复性研究。资料提炼:共收集到符合上述要求的文献48篇,排除30篇重复性研究。18篇符合纳入标准,其中6篇关于脊髓损伤药物治疗的研究,12篇关于脊髓损伤具体药物治疗的个案研究。资料综合:脊髓损伤后药物治疗包括两个阶段:急性及继发反应期,以及神经再生期。急性及继发反应期的药物治疗包括皮质类固醇类、神经节苷酯、内皮素受体拮抗剂、钙离子通道阻滞剂、兴奋性氨基酸拮抗剂等,神经再生期的药物治疗包括细胞生长因子、褪黑激素等。结论:对促进脊髓损伤后神经再生的药物及其作用机制的研究比较多,但仅少数几种应用于临床,大多数仍处也实验研究阶段,药物治疗脊髓损伤其前途是光明的。

OBJECTIVE： To analyze and summarize the drug and its mechanism of promoting nerve regeneration after spinal cord injury, and provide useful support for clinical application. DATA SOURCES： The relevant articles of drug treatment of spinal cord injury between January 1994 and December 2005 were searched for in Pubmed by imputing the key words of ＂spinal cord injury, drug treatment＂ in English. Similarly, the relevant articles between January 1994 and December 2005 were searched for in China Journal Full-text Database （CJFD） with the key words of ＂spinal cord injury, drug treatment＂ in Chinese. STUDY SELECTION： The literatures were selected primarily. The inelusive criteria were those drugs and its mechanisms of nerve regeneration, and recommending dose of clinic and experiment on spinal cord injury. Exclusive criterion was those articles.of repetitive research. DATA EXTRACTION： There were 48 literatures in accordance with the above standards, and 30 articles with repetitive research were excluded. Totally 18 articles were accorded with the inclusive criteria, of which 6 were reviews of drug treatment after spinal cord injury, 12 were investigation of individual cases of specific drug treatment after spinal cord injury. DATA SYNTHESIS： Drug treatment of spinal cord injury included two stages, one was acute and secondary reaction period, and another was nerve regeneration period. The former included corticosteroid, ganglioside, endothelin receptor antagonist, calcium channel block agent and excitatory amino acids antagonist, etc. The latter included cell growth factor, mela- tonin and so on. CONCLUSION： There are many studies in drug and its mechanism of promoting nerve regeneration after spinal cord injury, but only several of those have been applied in clinic and the others are still carrying out in experiment stage, however, drug treatment of spinal cord injury will have a bright future.