Neuropathic pain
Neuropathic pain
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DOI：
10.1038/nrdp.2017.2
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发表时间：
2017-02-16
影响因子：
81.5
通讯作者：
Raja, Srinivasa N.
中科院分区：
文献类型：
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作者：
Colloca, Luana;Ludman, Taylor;Raja, Srinivasa N.
神经性疼痛是由躯体感觉系统（包括外周纤维（A β、A δ和C纤维）和中枢神经元）的病变或疾病引起的，并且影响7 - 10%的一般人群。已经描述了神经性疼痛的多种原因，并且由于全球人口老龄化、糖尿病发病率增加和化疗后癌症存活率提高，其发病率可能会增加。事实上，兴奋性和抑制性躯体感觉信号之间的不平衡，离子通道的改变以及中枢神经系统中疼痛信息调节方式的变化都与神经性疼痛有关。慢性神经性疼痛的负担似乎与神经性症状的复杂性、不良结局和难以做出治疗决定有关。重要的是，神经性疼痛患者的生活质量受到损害，这是由于药物处方和医疗保健提供者的访问增加，以及疼痛本身和诱发疾病的发病率。尽管存在挑战，但对神经性疼痛的病理生理学的理解正在促进新的诊断程序和个性化干预措施的发展，这强调了对神经性疼痛管理的多学科方法的需求。
Neuropathic pain is caused by a lesion or disease of the somatosensory system, including peripheral fibres (A beta, A delta and C fibres) and central neurons, and affects 7-10% of the general population. Multiple causes of neuropathic pain have been described and its incidence is likely to increase owing to the ageing global population, increased incidence of diabetes mellitus and improved survival from cancer after chemotherapy. Indeed, imbalances between excitatory and inhibitory somatosensory signalling, alterations in ion channels and variability in the way that pain messages are modulated in the central nervous system all have been implicated in neuropathic pain. The burden of chronic neuropathic pain seems to be related to the complexity of neuropathic symptoms, poor outcomes and difficult treatment decisions. Importantly, quality of life is impaired in patients with neuropathic pain owing to increased drug prescriptions and visits to health care providers, as well as the morbidity from the pain itself and the inciting disease. Despite challenges, progress in the understanding of the pathophysiology of neuropathic pain is spurring the development of new diagnostic procedures and personalized interventions, which emphasize the need for a multidisciplinary approach to the management of neuropathic pain.