Ambroxol for the treatment of fibromyalgia: science or fiction?
Ambroxol for the treatment of fibromyalgia: science or fiction?
复制标题
Anbroxol用于治疗纤维肌痛：科学还是小说？
DOI：
10.2147/jpr.s139223
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发表时间：
2017
影响因子：
2.7
通讯作者：
Schwickert M
中科院分区：
文献类型：
--
作者：
Kern KU;Schwickert M
纤维肌痛似乎存在于生物疼痛诱导的亚组中，主要是炎症性、神经性/神经变性、交感神经、氧化、亚硝化或肌肉因素和/或中枢致敏。最近的研究还讨论了神经胶质活化或多巴胺能神经传递中断，以及皮肤肥大细胞和线粒体功能障碍增加。治疗是困难的，到目前为止使用的治疗方案大多只有解决这些方面之一的潜力。由于氨溴索以单一物质的形式解决了所有这些问题，而且还降低了内脏高敏感性，因此应为此目的对纤维肌痛（肠易激综合征或慢性膀胱疼痛）进行系统研究。受两个工作组使用局部或口服氨溴索治疗纤维肌痛的首次临床观察的鼓舞，本文通过观察这种复杂疾病的上述各个方面，概述了这种方法的科学依据，并总结了氨溴索的假定作用模式。然而，目前氨溴索的证据基础还不足以作为临床推荐。
Fibromyalgia appears to present in subgroups with regard to biological pain induction, with primarily inflammatory, neuropathic/neurodegenerative, sympathetic, oxidative, nitrosative, or muscular factors and/or central sensitization. Recent research has also discussed glial activation or interrupted dopaminergic neurotransmission, as well as increased skin mast cells and mitochondrial dysfunction. Therapy is difficult, and the treatment options used so far mostly just have the potential to address only one of these aspects. As ambroxol addresses all of them in a single substance and furthermore also reduces visceral hypersensitivity, in fibromyalgia existing as irritable bowel syndrome or chronic bladder pain, it should be systematically investigated for this purpose. Encouraged by first clinical observations of two working groups using topical or oral ambroxol for fibromyalgia treatments, the present paper outlines the scientific argument for this approach by looking at each of the aforementioned aspects of this complex disease and summarizes putative modes of action of ambroxol. Nevertheless, at this point the evidence basis for ambroxol is not strong enough for clinical recommendation.