����ؽڼ��������ʹ������

疼痛治疗分为药物治疗和非药物治疗。药物治疗包括非甾体类抗炎药、阿司匹林和扑热息痛等非阿片类镇痛药、阿片类镇痛药、"辅助"药物如抗抑郁药阿米替林和抗惊厥药卡马西平等。非药物治疗包括神经刺激疗法、神经阻滞疗法、外科手术、物理治疗、心理-行为疗法等。本文介绍我们临床上常见的颞下颌关节骨关节炎、肌筋膜疼痛、神经病理性疼痛(非典型牙痛、治疗后神经痛、三叉神经痛)及复合性局部疼痛综合征的主要临床用药和理论基础,如非甾体类抗炎药特异性COX-2抑制剂、改善骨关节炎症状和关节结构的药物硫酸氨基葡萄糖、阿片类药物曲马多、三环类抗抑郁药阿米替林、新一代抗惊厥药加巴喷丁等。

Treatment for pain in temporomandibular joint and orofacial pain

Pain management includes pharmacotherapy and non-pharmacotherapy. Medications for pain treatment are nonsteroidal anti-inflammatory drugs，non-opioid analgesics such as aspirin and acetaminophen，opioid analgesics，and adjuvant drugs including antidepressants amitriptyline and anticonvulsants carbamazepine. There are many non-pharmacotherapies for example nerve stimulating therapy，nerve block，surgery，physical therapy，and psycho-behaviour therapy. Here we will introduce drug pain control indications and pharmacology in the management of the most common pain conditions such as temporomandibular joint osteoarthritis，myofacial pain，neuropathic pain （atypical oral and facial pain，neuropathic pain after surgery，and trigeminal neuralgia），and complex regional pain syndrome，focusing on nonsteroidal anti-inflammatory drug specific cyclooxygenase-2 inhibitors，disease modifying anti-rheumatism drug glucosamine sulfate，opioid analgesic tramadol，antidepressants amitriptyline，and a new generation of anticonvulsants gabapentin.