慢性痛中阿片耐受的研究进展

Research Progress of Opioid Tolerance in Chronic Pain

慢性痛是困扰人类健康的主要疾病之一,慢性痛可因炎症、神经系统损伤或功能失调以及癌症所引起。目前阿片类药物仍是治疗慢性痛的最有效镇痛药,长期或反复应用阿片类药物可导致阿片耐受,表现为用药量增加和痛觉异常,进而造成更大的药物耐受和更为严重的痛觉过敏,最终形成恶性循环,极大限制了阿片类药物在慢性痛的临床应用。为此,本文就阿片类药物在炎性痛、癌症痛以及神经病理性痛治疗中形成耐受的机制进行综述。

Chronic pain is one of the major diseases that plague human health.Chronic pain can be caused by inflammation,nervous system damage,dysfunction,and cancer.Opioid drugs are still the most effective analgesics for chronic pain,but long-term or repeated use of opioid drugs can induce opioid tolerance manifested as increased dosage of medication and paralgesia,which results in greater drug tolerance and more severe hyperalgesia,and ultimately forms a vicious cycle.This greatly limits the clinical application of the opioid drugs in chronic pain.In this paper,the mechanism of the tolerance formation of opioid drugs in inflammatory pain,cancer pain and neuropathic pain therapy is reviewed.