吗啡联合小剂量阿片受体拮抗剂应用研究进展

吗啡是临床常用的强效阿片类镇痛药，临床应用中出现恶心、呕吐、镇静、瘙痒、便秘、尿潴留、呼吸抑制等副作用，长期应用又出现耐受和依赖。大剂量阿片受体拮抗剂能拮抗吗啡所产生的全部效应，而小剂量的阿片受体拮抗剂不仅能减少或减轻吗啡所致的副作用，还能增强吗啡的镇痛效能。本文就小剂量阿片受体拮抗剂与吗啡的联合应用、小剂量阿片受体拮抗剂增强吗啡镇痛效能、减弱吗啡耐受和依赖的作用机制，以及拮抗副作用等方面的研究进展进行综述。

Progress in the study of combining morphine and low-dose opioid receptor antagonists

Although morphine is the most effective opioid analgesics, the most widely clinical use has been limited by morphine induced adverse effects, such as nausea and vomiting, pruritus，constipation, urinary retention, drowsiness and respiratory depression. Tolerance/dependence liability also appears during chronic opioid administration. Large-dose opioid receptor antagonists can reverse all effects of morphine. Low-dose opioid receptor antagonists not only decrease side-effects induced by morphine, but also enhance the analgesic efficacy of morphine. This article is a review of the progress in the study of potentiation of analgesic effect, attenuation of tolerance/dependence and reversal of sideeffect of morphine induced by low-dose opioid receptor antagonists.