当前位置: X-MOL 学术Pain Pract. › 论文详情
Our official English website, www.x-mol.net, welcomes your feedback! (Note: you will need to create a separate account there.)
Non-drug pain relievers active on non-opioid pain mechanisms
Pain Practice ( IF 2.6 ) Pub Date : 2021-09-09 , DOI: 10.1111/papr.13073
Nicoletta Marchesi 1 , Stefano Govoni 1 , Massimo Allegri 2, 3
Affiliation  

This review is aimed to summarize the pain-relieving effect of non-drug substances, mostly prescribed as integrators in treatment of pain, including especially in chronic postoperative pain (CPSP) and in chronic back pain after acute episodes. Their use reflects the fact that the current treatments for these syndromes continue to pose problems of unsatisfactory responses in a significant portion of patients and/or of an excess of side effects like those noted in the present opioid crisis. As integrators are frequently introduced into the market without adequate clinical testing, this review is aimed to collect the present scientific evidence either preclinical or clinical for their effectiveness. In particular, we reviewed the data on the use of: B vitamins; vitamin C; vitamin D; alpha lipoic acid (ALA); N-acetylcysteine; acetyl L-carnitine; curcumin; boswellia serrata; magnesium; coenzyme Q10, and palmitoylethanolamide. The combination of preclinical findings and clinical observations strongly indicate that these compounds deserve more careful attention, some of them having interesting clinical potentials also in preventing chronic pain after an acute episode. In particular, examining their putative mechanisms of action it emerges that combinations of few of them may exert an extraordinary spectrum of activities on a large variety of pain-associated pathways and may be eventually used in combination with more traditional pain killers in order to extend the duration of the effect and to lower the doses. Convincing examples of effective combinations against pain are vitamin B complex plus gabapentin for CPSP, including neuropathic pain; vitamin B complex plus diclofenac against low back pain and also in association with gabapentin, and ALA for burning mouth syndrome. These as well as other examples need, however, careful controlled independent clinical studies confirming their role in therapy.

中文翻译:

对非阿片类药物疼痛机制起作用的非药物止痛药

本综述旨在总结非药物物质的镇痛作用,主要作为治疗疼痛的综合剂,尤其是慢性术后疼痛 (CPSP) 和急性发作后的慢性背痛。它们的使用反映了这样一个事实,即当前对这些综合征的治疗继续在很大一部分患者中产生不令人满意的反应和/或像当前阿片类药物危机中所指出的那样的副作用过多的问题。由于集成商经常在没有充分临床测试的情况下进入市场,因此本综述旨在收集临床前或临床的现有科学证据以证明其有效性。特别是,我们审查了以下使用的数据: B 族维生素;维生素C; 维生素D; α硫辛酸(ALA);N-乙酰半胱氨酸;乙酰左旋肉碱;姜黄素;齿叶乳香;镁; 辅酶 Q10 和棕榈酰乙醇酰胺。临床前发现和临床观察的结合强烈表明,这些化合物值得更加关注,其中一些化合物在预防急性发作后的慢性疼痛方面也具有有趣的临床潜力。特别是,检查它们推定的作用机制,发现它们中的少数组合可能在多种疼痛相关途径上发挥非凡的活性,最终可能与更传统的止痛药组合使用,以扩展作用的持续时间并降低剂量。有效抗疼痛组合的令人信服的例子是维生素 B 复合物加巴喷丁治疗 CPSP,包括神经性疼痛;维生素 B 复合物加双氯芬酸可治疗腰痛,还与加巴喷丁和 ALA 联合治疗灼口综合征。然而,这些以及其他例子需要仔细对照的独立临床研究来确认它们在治疗中的作用。
更新日期:2021-09-09
down
wechat
bug