富血小板血浆在神经病理性疼痛中的应用

Application of platelet-rich plasma in neuropathic pain

背景:神经病理性疼痛目前尚无特效治疗方案,患者长期忍受慢性疼痛困扰,严重影响生活质量。富血小板血浆通过释放多种生物活性因子,具有神经修复和缓解疼痛的作用,在神经病理性疼痛应用中具有巨大潜力。目的:探讨富血小板血浆治疗神经病理性疼痛的原理,阐述富血小板血浆在不同类别神经病理性疼痛中的应用效果,以期为临床治疗提供新的思路与方法。方法:中文以“富血小板血浆,神经病理性疼痛,神经损伤,神经痛”为检索词,在维普、中国知网、万方数据库检索相关文献;英文以“platelet rich plasma,neuropathic pain,nerve injury,neuralgia”为检索词,在Web of Science和PubMed数据库检索相关文献;检索时间为1954年至2021年2月。根据纳入和排除标准,共选取107篇文献进行综述。结果与结论:①富血小板血浆具有促进愈合和抗炎特性,既能修复受损神经组织,还能有效缓解疼痛,是治疗神经病理性疼痛的重要治疗手段,具有光明的前景;②富血小板血浆的制备方法仍存在争议,呼吁建立规范的制备方法和统一的成分评价标准;③富血小板血浆在脊髓损伤、周围神经损伤、神经卡压所致的神经病理性疼痛中的研究较多,在其他类别神经病理性疼痛中的作用机制和临床疗效尚需进一步研究。

BACKGROUND:There is no specific treatment method for neuropathic pain.Patients suffer from chronic pain for a long time,which seriously affects the quality of life of patients.Platelet-rich plasma releases a variety of biologically active factors,has nerve repair and pain relief effects,and has great potential in neuropathic pain applications.OBJECTIVE:To discuss the principles of neuropathic pain and the theoretical basis of platelet-rich plasma in the treatment of neuropathic pain,expound the application of platelet-rich plasma in different types of neuropathic pain,in order to provide new ideas and methods for clinical treatment of neuropathic pain.METHODS:Using“platelet rich plasma,neuropathic pain,nerve injury,neuralgia”as search terms,VIP,WanFang,CNKI,Web of Science and PubMed databases were retrieved for relevant articles published from 1954 to February 2021.Finally,107 articles eligible for the inclusion and exclusion criteria were included for result analysis.RESULTS AND CONCLUSION:Platelet-rich plasma has the potential to promote healing and anti-inflammation.It can repair damaged nerve tissues and effectively relieve pain.Platelet-rich plasma is an important treatment for neuropathic pain and has a bright future.The preparation method of platelet-rich plasma is still controversial,and there is a call for the establishment of standardized preparation methods and unified ingredient evaluation standards.Increasing studies on platelet-rich plasma has been made in the fields of spinal cord injury,peripheral nerve injury,and nerve compression.Further exploration is still needed on the application of platelet-rich plasma in the mechanism and clinical efficacy of other types of neuropathic pain.