身痛逐瘀汤治疗神经病理性疼痛的研究进展
Research Progress of Shentong Zhuyu Decoction in Treating Neuropathic Pain
摘要: 神经病理性疼痛是由神经系统的原发性损害和神经功能障碍所激发或引起的慢性疼痛,其发病机制复杂多样,是临床治疗的难点。身痛逐瘀汤具有行气活血逐瘀,祛风除湿止痛之功效,为治疗痹证尤其是瘀血痹的代表方。现代药理研究证明,全方具有显著的抗炎、镇痛、改善微循环以及抗变态反应作用。本文就身痛逐瘀汤治疗神经病理性疼痛的临床研究现状以及作用机制进行综述,以期能对此类疾病的临床治疗提供借鉴。
Abstract: Neuropathic pain is chronic pain caused by primary damage of the nervous system and neurological dysfunction. Its pathogenesis is complex and diverse, and it is the difficulty of clinical treatment. Shentong Zhuyu decoction has the effect of promoting qi, promoting blood circulation and removing blood stasis, dispelling wind, removing dampness and relieving pain. It is the representative prescription for treating Bi syndrome, especially blood stasis. Modern pharmacological studies have shown that the whole prescription has significant anti-inflammatory, analgesic, microcirculation improvement and anti-allergic effects. This article reviews the clinical research status and mechanism of Shentong Zhuyu Decoction in the treatment of neuropathic pain, in order to provide reference for the clinical treatment of such diseases.
文章引用:李力. 身痛逐瘀汤治疗神经病理性疼痛的研究进展[J]. 中医学, 2022, 11(6): 1200-1205. https://doi.org/10.12677/TCM.2022.116175

参考文献

[1] Jensen, T.S., Baron, R., Haanpää, M., et al. (2011) A New Definition of Neuropathic Pain. Pain, 152, 2204-2205. [Google Scholar] [CrossRef] [PubMed]
[2] Colloca, L., Ludman, T., Bouhassira, D., et al. (2017) Neuro-pathic Pain. Nature Reviews Disease Primers, 3, Article No. 17002. [Google Scholar] [CrossRef] [PubMed]
[3] Haanpää, M., et al. (2011) NeuPSIG Guidelines on Neuropathic Pain Assessment. Pain, 152, 14-27. [Google Scholar] [CrossRef] [PubMed]
[4] Bouhassira, D. (2019) Neuropathic Pain: Definition, Assessment and Epidemiology. Revue Neurologique (Paris), 175, 16-25. [Google Scholar] [CrossRef] [PubMed]
[5] Cepeda, M.S., Berlin, J.A., Gao, C.Y., Wiegand, F. and Wada, D.R. (2012) Placebo Response Changes Depending on the Neuropathic Pain Syndrome: Results of a Systematic Review and Meta-Analysis. Pain Medicine, 13, 575-595. [Google Scholar] [CrossRef] [PubMed]
[6] Fishbain, D.A., Cole, B., Lewis, J.E., et al. (2014) What Is the Evidence That Neuropathic Pain Is Present in Chronic Low Back Pain and Soft Tissue Syndromes: An Evidence-Based Structured Review. Pain Medicine, 15, 4-15. [Google Scholar] [CrossRef] [PubMed]
[7] 康道林. Nav1.8离子通道在SNI大鼠背根神经节及外周神经的表达变化[D]: [硕士学位论文]. 南充: 川北医学院, 2017.
[8] Levinson, S.R., Luo, S. and Henry, M.A. (2012) The Role of Sodium Channels in Chronic Pain. Muscle Nerve, 46, 155-165. [Google Scholar] [CrossRef] [PubMed]
[9] 刘大路. 颈椎根性痛大鼠模型建立及背根节IB4-Aδ类神经元介导机械性痛觉敏化的机制[D]: [博士学位论文]. 西安: 第四军医大学, 2016.
[10] Xie, W., Strong, J.A. and Zhang, J.-M. (2015) Local Knockdown of the NaV1.6 Sodium Channel Reduces Pain Behaviors, Sensory Neuron Excitability, and Sympathetic Sprouting in Rat Models of Neuropathic Pain. Neuroscience, 291, 317-330. [Google Scholar] [CrossRef] [PubMed]
[11] Cohen, S.P. and Mao, J.R. (2014) Neuropathic Pain: Mechanisms and Their Clinical Implications. BMJ, 348, f7656. [Google Scholar] [CrossRef] [PubMed]
[12] 吴志伟, 宋朋飞, 朱清广, 房敏. 神经病理性疼痛机制研究进展[J]. 河北医科大学学报, 2018, 39(9): 1095-1100.
[13] Miletic, G. and Miletic, V. (2000) Long-Term Changes in Scia-tic-Evoked a Fiber Dorsal Horn Field Potentials Accompany Loose Ligation of the Sciatic Nerve in Rats. Pain, 84, 353-359. [Google Scholar] [CrossRef
[14] 神经病理性疼痛诊疗专家组. 神经病理性疼痛诊疗专家共识[J]. 中国疼痛医学杂志, 2013, 19(12): 705-710.
[15] 白惠萍. p38丝裂原活化蛋白激酶信号传导通路在神经病理性疼痛形成机制中的研究进展[J]. 河北医科大学学报, 2014, 35(1): 118-121.
[16] 陈文佳, 孟晓文, 王丽娜, 詹英. 脊髓胶质细胞在RTX诱导的神经病理性疼痛大鼠的作用[J]. 江苏医药, 2017, 43(12): 829-832.
[17] 徐天乐. 脊髓背角神经元GABA A和甘氨酸受体不对称性交互抑制作用[J]. 皖南医学院学报, 2003, 22(Z2): 43-44.
[18] 伍磊, 林洪, 沙漠. 神经病理性疼痛的发病机制研究进展[J]. 中国临床神经外科杂志, 2014, 19(3): 186-188.
[19] Vallejo, R., Tilley, D.M., Vogel, L., et al. (2010) The Role of Glia and the Immune System in the Development and Maintenance of Neuropathic Pain. Pain Practice, 10, 167-184. [Google Scholar] [CrossRef] [PubMed]
[20] Li, F., Fang, L., Huang, S., et al. (2011) Hyperbaric Oxygenation Therapy Alleviates Chronic Constrictive Injury Induced Neuropathic Pain and Reduces Tumor Necrosis Factor Alpha Production. Anesthesia & Analgesia, 113, 626-633. [Google Scholar] [CrossRef
[21] 张瑛, 王韵. TRPV1: 一种同时参与慢性痛外周敏化和疼痛中枢调制的重要分子[J]. 生理学报, 2017, 69(5): 677-684.
[22] 黄振俊. 身痛逐瘀汤加减治疗腰椎间盘突出症60例[J] 人民军医, 2007, 50(11): 704.
[23] 金弘, 刘婷婷, 刘树民, 陈英华, 孙晓伟, 祝鹏宇. 电针联合身痛逐瘀汤对坐骨神经痛患者疼痛症状及神经传导速度的影响[J]. 针灸临床杂志, 2017, 33(6): 4-7.
[24] 罗秋, 唐梅. 加味身痛逐瘀汤配合普瑞巴林对马尾神经损害亚急性期神经病理性疼痛13例疗效观察[J]. 云南中医中药杂志, 2016, 37(10): 51-52.
[25] 樊海元, 林砚铭, 巫斌. 川芎茶调散合身痛逐瘀汤加减配合针灸治疗坐骨神经痛疗效研究[J]. 陕西中医, 2020, 41(2): 206-209.
[26] 严张仁, 谌莉媚, 邢宏青, 龚丽萍. 益气养阴通络汤配合刺络拔罐治疗老年带状疱疹后遗神经痛的临床研究[J]. 辽宁中医杂志, 2012, 39(5): 864-865.
[27] 牛明珍, 李玉芬. 莪术油葡萄糖注射液治疗带状疱疹后遗神经痛120例疗效观察[J]. 中国实验方剂学杂志, 2009, 15(7): 64.
[28] 赵永见, 牛凯, 唐德志, 梁倩倩, 舒冰, 李晨光, 卢盛, 王拥军, 郑为超. 桃仁药理作用研究近况[J]. 辽宁中医杂志, 2015, 42(4): 888-890.
[29] 易善勇, 官丽莉, 杨晶, 李海燕, 李校堃, 姜潮, 黄建. 红花药理作用及其开发与应用研究进展[J]. 北方园艺, 2015(5): 191-195.
[30] 张翠英, 章洪, 戚琼华. 川芎的有效成分及药理研究进展[J]. 辽宁中医杂志, 2014, 41(10): 2264-2266.
[31] 蔡秋生, 张志红, 高慧琴. 秦艽药理作用及临床应用研究进展[J]. 甘肃中医学院学报, 2010, 27(6): 55-58.
[32] 陈智煌, 廖华军, 刘晨, 邱颂平. 羌活挥发油的GC-MS分析及其抗炎镇痛的药理作用初探[J]. 海峡药学, 2015, 27(8): 20-23.
[33] 钟义. 基于RNA-seq探究身痛逐瘀汤对神经病理性疼痛的潜在作用靶点[D]: [硕士学位论文]. 武汉: 湖北中医药大学, 2020.
[34] 王志福, 俞向梅, 龚德贵, 林心君, 王彦青, 吴根诚. 身痛逐瘀汤对大鼠神经病理性疼痛及脊髓p38MAPK蛋白表达的影响[J]. 江西中医药大学学报, 2015, 27(2): 87-90.