1)宁波大学医学部,浙江省病理生理学重点实验室,宁波 315211;2)宁波市海曙区横街镇卫生院,宁波 315181;3)宁波市第二医院,宁波 315010;4)宁波大学附属第一医院神经内科,宁波 315020
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浙江省自然科学基金(LY23H090005),宁波市重点研发计划 (2023Z173, 2022Z147), 宁波市自然科学基金(2022J118, 2022J250,2021J250) 和宁波大学王宽诚幸福基金资助项目。
1)Zhejiang Provincial Key Laboratory of Pathophysiology, Health Science Center, Ningbo University, Ningbo 315211, China;2)Hengjie Township Hospital in Haishu District of Ningbo City, Ningbo 315181, China;3)Ningbo No.2 Hospital, Ningbo 315010, China;4)Department of Neurology, The First Affiliated Hospital of Ningbo University, Ningbo 315020, China
This work was supported by grants from Natural Science Foundation of Zhejiang Province (LY23H090005), Ningbo Key Research and Development Plan Project (2023Z173, 2022Z147), Natural Science Foundation of Ningbo (2022J118, 2022J250, 2021J250), and the K. C. Wong Magna Fund in Ningbo University.
神经性疼痛(neuropathic pain,NP)是由外周或中枢躯体感觉系统的损伤或疾病导致的疼痛。药物治疗在镇痛中占据重要地位,但是过量药物治疗往往会引起严重的副作用,或在可耐受剂量下仅提供了部分的疼痛缓解。认知行为疗法(cognitive-behavioral therapy,CBT)和虚拟现实(virtual reality,VR)干预作为新的、非侵入性的,以及更为安全的疼痛替代治疗方法引起了广泛的关注。CBT和VR疗法可通过转移注意力、改变神经可塑性和神经环路,以及调节促炎和抗炎因子水平缓解神经性疼痛。本文旨在对神经性疼痛的发病机制以及CBT和VR疗法的镇痛效果和机制做出解析,从而为神经性疼痛的治疗干预提供重要的理论指导。
Neuropathic pain (NP) is caused by lesion or disease of peripheral or central somatosensory system, accompanied by a certain degree of functional loss and cognitive impairment. Pharmacological treatment makes vital contributions to analgesia, but excessive pharmacological treatment often causes serious side effects, or only provides partial pain relief at tolerable doses. Cognitive-behavioral therapy (CBT) and virtual reality (VR) intervention, as new, non-invasive and safer alternative treatment methods for pain, alleviate neuropathic pain by diverting attention, altering neuroplasticity and neural circuits, and regulating the expression of proinflammatory and anti-inflammatory cytokines. This article analyzed the underlying pathogenesis of neuropathic pain, as well as the analgesic effects and mechanisms of CBT and VR therapy, so as to provide important theoretical guidance for the treatment and intervention of neuropathic pain.
阮婷婷,翁明奇,吴璨,鲍晓明,牛艳芳,徐淑君.综述与专论: 认知行为疗法和虚拟现实疗法干预神经性疼痛的作用及机制[J].生物化学与生物物理进展,2023,50(10):2396-2405
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