抗抑郁药物治疗慢性疼痛的研究进展

Progress in Research of Antidepressant Drugs for Chronic Pains

慢性疼痛合并抑郁症极为高发,焦虑、抑郁及生活质量的下降会不断恶化疼痛对患者的影响,药物治疗在严格遵守三阶梯治疗方案下,仍有10%的患者疼痛不能良好缓解,而一些微创介入的手段有时因患者的种种顾虑无法实施,目前抗抑郁药已经作为神经病理性疼痛的二线用药,有临床的对照实验证实抗抑郁药治疗疼痛伴发抑郁症状有效,本文对慢性疼痛与抗抑郁药在近年药理学上的基础研究做一综述,试图阐述抗抑郁药在慢性疼痛治疗上的可行性与必要性,对顽固性疼痛患者应用传统镇痛药物效果不佳时,抗抑郁药的联合使用可能会有不错的效果,尤其伴有负性情感体验的患者更是联合应用的适应证。

The incidence of chronic pains with depression is extremely high. Various anxieties and depression and unceasing decline of life - quality aggravates the effects of pains on patients. Although drug treatments are performed in strict accordance with the three - step programmes, pains can not be well relieved in 10% patients. And some minimally invasive interventions are impossible to be performed because of patients＇ concerns. Antidepressants, a secondary -line choice for medication, have now been proved effective in clinical controlled experiments in other - type pains with depression. This paper makes a review of the relationship between chronic pains and antidepressants on the basis of pharmacological researches in recent years, to explain the feasibility and necessity of antidepressants in therapy of chronic pains. Combine use of antidepressants may be well effective against intractable pains when traditional analgesic drugs do not work, especially for patients with negative emotional experience.