神经病理性疼痛的药物治疗

Medication for neuropathic pain

通过大量的基础和临床研究，神经病理性疼痛的发生机理渐渐明确。治疗药物也逐渐确定，目前已经有比较确定的一二三线治疗药物，一些新药和新的治疗方法也渐次开发出来。可是，尽管有确定的治疗药物甚至标准的治疗方案，却未必有良好的效果。相比其他慢性疼痛，神经病理性疼痛更难治，有更多的身体和精神不适，对生活质量影响更大，造成社会和整个医疗健康系统的负担更重。本文按照循证医学的证据，对神经病理性疼痛药物治疗的原则、治疗阶梯和常用药物进行了综述。

Following the more clear mechanism of neuropathic pain and the more definitive medication treatments, current treatments for neuropathic pain are greatly developed, for example, the first-line, second-line and third-line dugs has been defined and other new drugs and treatments have been updating and developing. However, the efficacy of current treatments is still variable although some defined even standard treatment protocols are recommended. As compared with other chronic pain, neuropathic pain is more intractable, brings more physical and psychological discomfort and worsens the patients＇ quality of life, thus increasing the burden of society and the health care system. The principle, stepwise of treatment for neuropathic pain and the common drugs used for neuropathic pain are reviewed in＇this paper, according to evidence-based medicine guidelines.