化疗引起的神经性病理性疼痛：预防与治疗

化疗引起的周围神经病变（CIPN）性疼痛可大大降低患者生活质量，造成或加重抑郁、失眠、疲劳和其他症状，导致化疗剂量的改变，甚至化疗终止。化疗患者发生CIPN性疼痛的比例从40%到70%不等。目前在CIPN的治疗上没有很好的方法。中枢神经系统的药物在治疗CIPN的使用证据尚不充分。治疗CIPN还要依赖于阿片类药物，但效果也不是很理想，且阿片类药物的使用受到诸多限制。度洛西汀是唯一被证明有效的非阿片类药物。通常用于治疗神经性疼痛的药物，如阿米替林、加巴喷丁和普瑞加林，在CIPN治疗中似乎并不比安慰剂好。一些抗抑郁药和抗惊厥剂在某种程度上起作用。

Chemotherapy-Induced Neuropathic Pain: Prevention, and Treatment

Chemotherapy-induced peripheral neuropathy (CIPN) pain can greatly diminish quality of life; create or worsen depression, insomnia, fatigue and other symptom clusters, and lead to unwanted dose modification and even failure of treatment. The proportion of cancer patients experienced neuropathic pain at some point in their survivorship ranges from 40% to 70%. There is no good way to prevent and treat CIPN. The evidence of central nervous system (CNS) drugs for CIPN treatment is insufficient. There are not known preventatives, and for many patients, control of the pain requires opioids. But the effect is not ideal, and the use of opioids has a lot of constraints. Duloxetine is the only nonopioid that has proven to be helpful. The drugs usually used to treat neuropathic pain, such as amitriptyline, gabapentin and pregabalin, do not appear to be better than placebos in CIPN. Some antidepressants and anticonvulsants work to some extent. Here we summarize some of the global attempts at CIPN treatment and prevention for reference to clinical and scientific research.