针刺治疗骨转移癌痛的临床及机制研究进展*

Progress of Clinical and Mechanistic Studies on Acupuncture in the Treatment of Cancer Induced Bone Pain

摘要:

转移癌痛是中重度癌症疼痛最常见的类型。目前治疗主要包括三阶梯止痛药物、双膦酸盐类药物、放射治疗、介入手术等方法，短期止痛效果确切，但长期应用容易产生耐受、成瘾及毒副反应。针刺治疗骨转移癌痛具有安全性高、起效快、操作简便、副作用小等优势，能有效缓解患者疼痛，减少镇痛药物的剂量，减轻药物耐受和副作用，同时改善患者的焦虑、抑郁症状，提高生存质量。针刺可能通过调节神经递质释放、抑制胶质细胞活化以及调节下行抑制和易化系统等途径发挥镇痛效应。本文就骨转移癌痛的发病机制及针刺治疗骨癌痛的临床及基础研究进行综述，以期进一步为针刺镇痛的机制研究及临床应用提供科学依据。

Abstract:

Cancer induced bone pain (CIBP) is the most common kind of moderate and severe cancer pain. Current treatment mainly focuses on three-step analgesics, bisphosphonates, radiotherapy and interventional therapy, which have definite short-term analgesic efficacy, while the long-term use may cause tolerance, addiction, and toxic side events. Acupuncture has the advantages of high safety, rapid analgesia, easy of use and less side effects in treating CIBP. It can effectively relieve pain, reduce drug tolerance and side effects, improve anxiety and depression, reduce the dosage of analgesics, and thus improve the patients’ quality of life. Its mechanisms include regulating the release of neurotransmitters, inhibiting glial cell activation and regulating descending inhibition and facilitation system. This paper reviewed the researches on the pathogenesis of CIBP, as well as the clinical and basic studies on the acupuncture treatment for CIBP, hoping to provide for the further evidence on the clinical application and mechanism researches on acupuncture in relieving pain．