神经病理性疼痛的发病机制及药物研究进展

神经病理性疼痛是神经系统损伤引起的慢性疼痛。至今尚没有真正治疗神经痛的药物，针对神经痛的机制对病人进行药物治疗被认为是目前开发治疗神经痛药物较为可行的办法。作者就该病的发病机制和药物治疗’的研究进展进行综述，并对神经痛的药物治疗方法进行了展望。     

腰椎间盘摘除术后疼痛发生机制及中医康复程序

为提高腰椎间盘突出症患者术后的生活质量，对其术后疼痛的发生机制及中医康复程序进行探讨，结果表明患者术后早期在卧床休息、骨盆牵引、直腿抬高训练、理疗的基础上应用中医疗法可明显缓解患者的疼痛症状。中后期在腰背四肢肌功能训练的基础上给予有和营通络，补益肝肾的中药治疗，可以减少并发症，缩短康复时间。     

疼痛机制研究对疼痛治疗的推动作用

疼痛医学与康复医学有非常密切的联系。半个世纪以来疼痛医学有了长足的发展 ,这是该学科具有的两个基本特征所决定的 ,即多学科组成和基础与临床密切配合。2 0世纪 60年代 ,英国生理学家Ｐ .Ｄ .Ｗａｌｌ和加拿大心理学家Ｒ .Ｍｅｌｚａｃｋ合作提出了疼痛的“闸门控制学说” ,这是对当时处于统治地位的疼痛特异传导学说的一种挑战。闸控学说认为中枢神经系统在接受伤害性的刺激时 ,并非作出千篇一律的被动的反应 ,而是根据当时中枢神经系统的功能状态 ,作出主动的应答 ;或使疼痛加重 ,或使疼痛减轻。而其最关键部位在于脊髓背角的第ＩＩ层…     

肝硬化腹水的中医发病机制及治疗进展

本文从肝硬化腹水的病因及发病机制,到中医对该病的治疗,纵观从古至今各种中医名家的治疗经验,总结中医药在治疗肝硬化腹水上的特色与优势,为进一步中西医结合治疗肝硬化腹水奠定了理论基础。     

中医外治法治疗骨伤科疼痛性疾病临床疗效观察

目的:观察中医外治法治疗骨伤科疼痛性疾病临床疗效.方法:回顾分析2014年1月至2015年12月期间在我院治疗的80例骨伤科疼痛性疾病患者临床资料,依据就诊时间将其分为对照组和观察组,每组40例患者.对照组患者给予常规治疗,观察组患者采用中医外治法治疗,对比两组患者临床治疗疗效.结果:观察组患者临床治疗有效率明显高于对照组,差异有统计学意义(P＜0.05);观察组患者疼痛缓解时间时间明显短于对照组,差异有统计学意义(P＜0.05);观察组患者疼痛评分明显低于对照组,差异有统计学意义(P＜0.05);随访6个月,观察组复发率明显低于对照组,差异有统计学意义(P＜0.05).结论:采用中医外治法治疗骨伤科疼痛性疾病,疗效确切,可有效减轻患者疼痛,并且无不良反应,具有良好的临床推广意义.     

直接火灸法治疗带状疱疹疼痛

采用将火焰直接燃烧在带状疱疹患部皮肤的直接火灸法，是在传统灸法上的技术方法改进，能达到快速止痛迅速结痂的目的，且无毒副作用。     

神经病理性疼痛的机制及治疗研究进展

现代医学所谓的疼痛,是一种复杂的生理心理活动,是大多数疾病具有的共同症状,是临床上最常见的症状之一.而今,世界卫生组织将疼痛确定为继血压、呼吸、脉搏、体温之后的"第五大生命体征",对疼痛的研究越来越被重视.根据病理学特征,疼痛可以分为伤害感受性疼痛和神经病理性疼痛或两类的混合性疼痛.伤害感受性疼痛是完整的伤害感受器感受到有害刺激引起的反应,疼痛的感知与组织损伤有关.正常情况下,疼痛冲动由神经末梢产生,神经纤维负责传递冲动.当神经纤维受损或神经系统因创伤或疾病发生异常改变时也会产生自发冲动,引起的痛感会投射到神经起源部位,称为神经病理性疼痛(neuropathic pain,NPP).国际疼痛研究协会修改后的神经病理痛定义为由于外周或中枢神经系统结构损伤或功能紊乱所致的病理性疼痛[1].神经病理痛是一种自发性疼痛,它可起源于外周或中枢神经系统损伤(三叉神经痛,脊髓损伤),感染(带状疱疹后神经痛),代谢紊乱(糖尿病性神经痛)和梗塞(中风)等[2-3].     

持续性躯体形式疼痛障碍的发病机制

持续性躯体形式疼痛障碍(persistent somatoform pain disorder, PSPD)是临床较常见且复杂的疾病,是“躯体形式障碍”的一个亚型,病人通常反复就诊、疗效不确定且伴高度焦虑。PSPD的发病机制目前尚不明确,暂无特效药物,临床治疗多以抗抑郁药、抗精神病药等药物治疗为主,并联合心理疗法。本文回顾总结近年来PSPD在神经生理机制方面的研究进展,以期为明确PSPD的发病机制提供参考。     

中医对晚期肺癌的认识及治疗现状

中医学有关肺癌的论述中医学文献中虽无肺癌的病名,但类似肺癌症候的记载不少。《黄帝内经》记载了昔瘤、石瘕癥瘕癖结等多种与某些治疗临床相似的病种,并从外邪侵害、水土不服、起居无常、饮食不适、情志失调等方面,对其发病原因进行了探讨。如《素问》肺咳之状咳而喘息,甚至唾血……而面浮气逆。《难经》称:肺之积,名曰息贲,在右胁下,复大如杯,久不已,令人洒浙寒热,喘咳,发肺壅。宋代一些方书则载有治疗息贲、咳嗽、喘促咳痛、腹胁胀满、咳嗽见血、胸隔壅闷、呕吐痰涎、面黄体瘦等肺癌常见症的方药。金元时期李东垣治疗肺积的息贲丸,所治之证均类似     

疼痛的机制及其控制

作者阐述疼痛发生的病理生理机制及处理方法，提出护士应加强基础理论学习及技能训练，成为疾病处理的重要角色。     

Current understanding of pathogenesis of Graves ophthalmopathy

Graves ophthalmopathy most frequently develops in a patient suffering from Graves disease in which autoantibodies to a target antigen, thyrotropin receptor, activate the autoantigen leading to hyperthyroidism. It is well known that in Graves ophthalmopathy inflammatory cells infiltrate and hydrophobic glycosaminoglycan accumulates in the retro -occular tissues. However, in contrast to Graves disease, little has been known as to how this eye disease develops. Here we review recent advance in understanding of pathogenesis of Graves ophthalmopathy.     

The pathogenesis of muscle pain

Nociceptive nerve endings in muscles and other tissues are equipped with a multitude of receptor molecules for endogenous pain-producing and sensitizing agents. Particularly interesting molecules are the purinergic receptors, which can be activated by adenosine triphosphate (ATP), and the vanilloid receptor, which is sensitive to protons (low pH). The purinergic receptors are activated by tissue damage because cell necrosis is associated with the release of ATP. A low pH is present in many pathologic conditions such as ischemia and inflammation. At the spinal and medullar level, painful muscle lesions induce marked neuroplastic changes that result in hyperexcitability and hyperactivity of nociceptive neurons. This central sensitization is the basis for the spontaneous pain and hyperalgesia of patients. The transition from acute to chronic muscle pain is complete when the initially functional changes are transformed into structural ones. Patients with morphologic alterations in their nociceptive system are difficult to treat because the changes need time to normalize.     

血脂异常的“痰瘀虚”中医病机内涵和临床应用

通过梳理古代文献,并结合临床实践,阐述“痰瘀虚”三种证候要素在血脂异常治疗中的应用原理与方法,提出以下观点:“痰、瘀、虚”为血脂异常的主要证候要素,痰证贯穿动脉粥样硬化病程的始终,瘀证继发于痰证从而痰瘀互结,脾肾亏虚为虚证内涵。另外,血脂异常在生理功能、发病机制方面均与痰湿有关,现代生物标志物的研究客观化地呈现了中医论治血脂异常的本虚标实内涵。标实应燥湿化痰、活血化瘀,本虚则分为两类:气虚阳虚治以参苓白术散、麻黄附子细辛汤,阴虚血虚治以养阴清肺丸和一贯煎。以“痰瘀虚”理论指导血脂异常调护,当以淡泊节欲、顾护脾胃、惜养肾精为要。     

Cytomegalovirus: recent progress in understanding pathogenesis and control

Cytomegalovirus continues to be an important pathogen in a variety of patient groups especially the neonate and the transplant recipient, and has implicated in a range of pathologies including inflammatory disease and in contributing to early death in ageing populations. This review will focus on advances in understanding the virus-host interaction and options for the new therapeutic control measures.     

Alternative pain medicine: Current modalities and principles

Conventional pain medicine does not solve all the problems of chronic pain patients. In this technological era, patients are more demanding and in their frustration may seek alternative modalities for managing their chronic pain. Recent studies have shown that this tendency may in fact expose patients not only to useless therapies but occasionally harmful ones. Many alternative modalities have been studied and found to be effective in managing chronic pain. These modalities include music therapy, religious or spiritual therapies, relaxation therapy, hypnosis, chiropractic therapy, comfort measures, TENS, acupuncture, and various biostimulation techniques (eg, magnetic therapy, low-power laser therapy). The Office of Alternative Medicine was created to facilitate the scientific evaluation of alternative therapies and act as a funding source for some of those studies. It is hoped that with this new development many alternative methods may be properly studied, efficiently implemented, and effective in pain control.     

Children's understanding of the causality of pain

The ideas of 680 Irish schoolchildren aged 5-14 years about the causality of pain were studied as part of a wider investigation of children's understanding of pain. The results indicated an association between pain and 'transgression' consonant with the literature on children's beliefs about the causality of illness, but not reported in previous studies of children's ideas about pain. Developmental patterns were also noted in the data and one significant sex difference consistent with a previously reported trend.     

Another step towards understanding hemophilia A molecular pathogenesis

See also Zimmermann MA, Oldenburg J, Müller CR, Rost S. Characterization of duplication breakpoints in the factor VIII gene. This issue, pp 2696–704.