Multimodal stepped care approach with acupuncture and PPAR-α agonist palmitoylethanolamide in the treatment of a patient with multiple sclerosis and central neuropathic pain
Multimodal stepped care approach with acupuncture and PPAR-α agonist palmitoylethanolamide in the treatment of a patient with multiple sclerosis and central neuropathic pain
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DOI：
10.1136/acupmed-2011-010119
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发表时间：
2012-03-01
影响因子：
2.5
通讯作者：
Hesselink, Jan M. Keppel
中科院分区：
文献类型：
--
作者：
Kopsky, David J.;Hesselink, Jan M. Keppel
中枢神经性疼痛是多发性硬化症患者常见的衰弱症状。镇痛药的副作用往往限制了达到治疗剂量。在这个病例报告，一个61岁的妇女慢性中枢神经性疼痛，由于多发性硬化症是描述。针灸只能部分地、暂时地减轻疼痛。然而，在加入天然化合物棕榈酰乙醇酰胺，一种胶质调节剂和过氧化物酶体增殖激活受体-激动剂后，疼痛减轻更加明显，针灸间隔时间可以增加。一种多模式的阶梯式治疗方法被证明，针灸和棕榈酰乙醇酰胺都影响非神经元细胞，如激活的胶质细胞，这是神经性疼痛发展和维持的关键因素。
Central neuropathic pain is a common debilitating symptom in patients with multiple sclerosis. Side effects of analgesics often limit reaching therapeutic dosages. In this case report, a 61-year-old woman with chronic central neuropathic pain due to multiple sclerosis is described. Acupuncture could only partly and temporarily reduce the pain. However, after adding the natural compound palmitoylethanolamide, a glial modulator and peroxisome proliferator-activated receptor-a agonist, pain reduction was more pronounced and the interval between acupuncture sessions could be increased. A multimodal stepped care approach is demonstrated, with acupuncture and palmitoylethanolamide both influencing non-neuronal cells, such as activated glial cells, which are key factors in the development and maintenance of neuropathic pain.