阿片受体及阿片类药物治疗癌痛的研究进展

Progress in opioid receptor and opioids for the treatment of cancer pain

癌痛是影响癌症患者生命质量最重要的因素，如何缓解和控制癌痛是疼痛学研究的重点。研究癌痛的机制可以为癌痛治疗提供思路，例如阻断痛觉的发生和传导。在吗啡及阿片肽的研究过程中发现了最早的阿片受体μ、κ及σ，其中μ受体在疼痛治疗中起主导作用。目前临床上用于癌痛治疗的阿片类药物基本都是μ受体激动剂，吗啡作为第三阶梯药物，仍是癌痛治疗的经典药物，新型的药物如芬太尼透皮贴、盐酸羟考酮缓释片等为临床镇痛提供了新思路。阿片类与非阿片类药物联合应用、阿片类药物给药方式的改变及控释剂与缓释剂联合应用等大大减轻了阿片类药物的副作用。

Cancer pain is the most important factor affecting the cancer patients＇ quality of life, and the approach to relieve and control cancer pain is becoming the focus. Pain mechanism research can offer solutions to pain treatment, such as blocking the happening and conduction of analgesia. The earliest μ, κ, σopioid receptors were found in the research of morphine and opioid peptides, especially μ receptor＇s leading role in pain treatment. Currently, μ opioid agonist is basically used in clinical pain treatment. Morphine, the third level drug, is still the classic pain therapy drugs. Novel drugs such as fentanyl transdermal and controlled-release oxycodone provide new ideas for the pain ease. Opioid combined with non-opioid drugs, the change of opioid drugs delivery way and joint application of controlled release drug and relievers, have dramatically reduced opioid drugs＇side effects.