建立胫骨癌痛模型的理论与实践

Theory and practice of a practice model of tibial cancer pain

目的:骨癌痛动物模型已有报道,但还没有可接受的与人类骨癌痛相一致的模型。综述胫骨癌痛模型的研究进展及相关治疗前景。资料来源:应用计算机检索Medline1996-01/2006-03相关胫骨、癌痛和治疗的文献,检索词“tibial,cancerpain,therapy”,并限定文献语言种类为English。同时检索万方数据库1996-01/2006-05文献,检索词为“胫骨癌痛”,并限定语言种类为中文。资料选择:对资料进行初审,选取包括胫骨、癌痛和治疗的文献,开始查找全文。纳入标准:①胫骨和癌痛。②癌痛和治疗。排除标准:综述文献、重复研究、Meta分析类文章。资料提炼:共收集到51篇关于胫骨、癌痛和治疗的文献,纳入30篇关于胫骨和癌痛,癌痛和治疗的文献。资料综合:①目前认为,胫骨癌痛动物模型的疼痛表现与临床上所见的骨转移症状相似,可视为转移性骨癌痛模型。②恶性肿瘤骨损害的特征性变化是溶骨性骨吸收和恶性肿瘤疼痛本身,随骨质破坏的加剧,疼痛逐渐增强,移动或轻触可以引发急性痛,在到达极度痛之前,常因运动、负重或自发地间断发生突破痛,其发生的程度和频率与骨质破坏和溶骨活性成正相关。③目前从胫骨癌痛的实验研究中发现可供选择的药物主要有阿片类药、5-羟色胺受体阻断剂、抗惊厥药物加巴喷丁、环氧化酶2抑制剂表皮生长因子阻断剂。结论:利用动物胫骨癌痛模型来研究人类骨癌痛是可行的,但其研究有待进一步深入。从胫骨癌痛的实验研究中发现有许多药物可供选择,这展示了药物治疗骨癌痛的应用前景。

OBJECTIVE： Research on animal models of bone cancer pain have been reported, while there are no acdeptable animal models of bone cancer pain that same to human＇s. To review the development in research on model of bone cancer pain and the prospect of relevant treatment, DATA SOURCES： A computer-based search was conducted in Medline for English literatures related to tibial, cancer pain and therapy published between January 1996 and March 2006 by using the key words of ＂tibial, cancer pain, therapy＂.Meanwhile, Wanfang Database was searched for relevant literatures between January 1996 and May 2006 with the key words of ＂tibial, cancer pain＂, and the language was limited to Chinese. STUDY SELECTION： Data were checked in the first trial, and literatures on tibia, cancer pain and therapy were selected and looked for the full-text. Inclusion criteria： ① Tibia and cancer pain, ② Cancer pain and therapy, Exclusion criteria： Reviews, repeated studies and Meta analytical papers, DATA EXTRACTION： A total of 51 literatures on tibia, cancer pain and therapy were collected and 30 papers about the tibia and cancer pain as well as cancer pain and treatment were included DATA SYNTHESIS： ① It is thought presently that the representations of pain in animal models of tibial cancer pain are similar to the symptoms of osseous metastasis in clinic, which can be taken as the models of metastatic bone cancer pain. ② The marked changes of malignant tumor lesion was osteolytic bone resorption and malignant tumor pain. With the aggravation of bone destruction, the pain was gradually severer, and movement or light touch would induce acute pain. There was breakthrough pain before severest pain, which was caused by movement, loading or spontaneous and intermittent pain. The severity and the frequency of pain was positively correlated with the extent of bone destruction and osteolytic activity. ③ It was found from the experiment of tibial cancer pain that selective medicines mainly are opioid, 5- HT receptor blocking pharmacon, anticonvulsant gabapentin and cycloxygenase-Ⅱ inhibitor epidermal growth factor. CONCLUSION： It is feasible to research human bone cancer pain by using animal models of tibial cancer pain. However, more work must be done for further investigation. Experiment of tibial cancer pain suggests that there are many drugs can be choose, which manifests the application prospect of drug treatment of bone cancer pain.