CAJ | 학술논문

背景阿米替林(amitriptyline,AMI)是三环类抗抑郁药(tricyclic antidepressants,TCAs)在神经病理性疼痛(neuropathic pain,NPP)中应用最广泛的药物,历年文献分析总结证实TCAs对NPP有效,其中证据最确切的是AMI,并且其镇痛作用独立于抗抑郁作用,尤其适用于慢性疼痛和NPP镇痛治疗,但AMI为多模式镇痛药物,镇痛机制复杂,目前还不十分清楚.目的现对AMI在治疗NPP中作用机制研究和进展进行综述,旨在为NPP的临床治疗提供参考.内容共4部分:①AMI的研究现状与共识.②动物实验研究进展.③AMI在NPP中作用机制研究进展.④临床应用与研究.趋向对于AMI这个多模式镇痛药物机制研究的进展和新的药物靶点的不断发现不仅对药物本身的认识更加深入,并可能使NPP动态的发生发展过程中的多种作用机制浮出水面.
배경 아미체림(amitriptyline,AMI)시삼배류항억욱약(tricyclic antidepressants,TCAs)재신경병이성동통(neuropathic pain,NPP)중응용최엄범적약물,력년문헌분석총결증실TCAs대NPP유효,기중증거최학절적시AMI,병차기진통작용독립우항억욱작용,우기괄용우만성동통화NPP진통치료,단AMI위다모식진통약물,진통궤제복잡,목전환불십분청초.목적 현대AMI재치료NPP중작용궤제연구화진전진행종술,지재위NPP적림상치료제공삼고.내용 공4부분:①AMI적연구현상여공식.②동물실험연구진전.③AMI재NPP중작용궤제연구진전.④림상응용여연구.추향 대우AMI저개다모식진통약물궤제연구적진전화신적약물파점적불단발현불부대약물본신적인식경가심입,병가능사NPP동태적발생발전과정중적다충작용궤제부출수면.
Background Amitriptyline is the most widely used in neuropathic pain therapy. Multiple evidence has confirmed the effect of tricyclic antidepressants in therapy of neuropathic pain, in which amitriptyline is most positively proved. The analgesic effect of amitriptyline is independent of its antidepressant effect, particularly suitable for chronic pain and neuropathic pain. However, amitriptyline is a multi-modal analgesic drug with complex and unclear analgesic mechanisms. Objective This review highlights the advance in mechanism of amitriptyline for neuropathic pain therapy, summarizing current best evidenceing on its clinical application. Content Our review will be divided into four part :The state of the art and consensus in amitriptyline; Study progress of animal experiment; Researches on the mechanism of amitriptyline in the neuropathic pain action; Research to clinical application; Trend Advance in multi-modal analgesic mechanism of amitriptyline implies that investigators should continue to find new drug targets more in-depth knowledge of the drug.