肌肉萎缩性侧索硬化症(ALS)成人患者疼痛管理策略的疗效:系统综述。

IF 2.7 4区 医学 Q2 CLINICAL NEUROLOGY
Neurological Sciences Pub Date : 2024-12-01 Epub Date: 2024-07-05 DOI:10.1007/s10072-024-07643-0
Juan Camilo Rojas-López, Pablo Isaac Estrada-Gualdron, Sofía Ramírez-Guerrero, Maria J Velásquez-Cárdenas, Jesús Redondo-Escobar, Sofía Vargas-Arenas, Leonardo Palacios-Sánchez, Ximena Palacios-Espinosa
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引用次数: 0

摘要

肌萎缩侧索硬化症(ALS)是一种以进行性肌无力为特征的神经退行性疾病。有关 ALS 患者疼痛的研究报告不尽相同,而且大多在症状量表中代表性不足。本研究旨在评估药物和非药物治疗方法对 ALS 患者疼痛控制的疗效。我们在 PubMed、Scopus、Clinicaltrials.gov 和 Cochrane-Ovid 四个数据库中进行了系统回顾。共纳入了五项随机对照临床试验,内容涉及对确诊为 ALS 的成年患者进行药物和非药物疼痛治疗干预,并对患者的疼痛进行了客观评估。使用 RoB2.0 工具对偏倚风险进行了评估。符合条件的研究报告均为描述性分析。本系统综述的注册号为 PROSPERO ID:CRD42024495009。五项有关 ALS 疼痛管理策略的临床试验符合分析条件。其中两项为非药物疗法,其余三项为药物疗法。其中,麦西来汀能有效缓解疼痛,尤其是在每天 600 至 900 毫克的剂量范围内,而美卡辛在高剂量和低剂量时均不能缓解疼痛。运动和整骨疗法等非药物疗法在疼痛控制方面也缺乏疗效。针对 ALS 患者疼痛管理策略的临床试验非常有限。可以理解的是,医疗专业人员只关注直接威胁生命的方面,可能会无意中忽略 ALS 患者所经历的细微而复杂的疼痛问题。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Efficacy of pain management strategies in adults with Amyotrophic Lateral Sclerosis (ALS): A Systematic Review.

Efficacy of pain management strategies in adults with Amyotrophic Lateral Sclerosis (ALS): A Systematic Review.

Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease characterized by progressive muscle weakness. Presence of pain in ALS patients is heterogeneously reported in studies, and mostly underrepresented in symptom scales. The aim of this study is to evaluate the efficacy of pharmacological and non-pharmacological therapeutic modalities for pain management in patients with ALS. A systematic review was conducted in four databases; PubMed, Scopus, Clinicaltrials.gov, and Cochrane-Ovid. Five randomized controlled clinical trials were included regarding pharmacological and non-pharmacological pain management interventions in adult patients with confirmed diagnosis of ALS in whom pain was objectively evaluated. Risk of bias assessment was evaluated using the RoB2.0 tool. Eligible studies were reported as a descriptive analysis. This systematic review was registered with PROSPERO ID: CRD42024495009. Five clinical trials regarding pain management strategies in ALS were eligible for analysis. Two out of five were non-pharmacological approaches whilst the remaining three provided pharmacological therapies. Of these, Mexiletine was efficient in terms of pain relief, particularly between 600 and 900 mg per day, whereas Mecasin showed no pain relief at both, high and low doses. Non-pharmacological therapies, such as exercise and osteopathic manual treatment also lacked efficacy in regard to pain management. Clinical trials focusing on pain management strategies for ALS patients are limited. Medical professionals, understandably focused on immediate life-threatening aspects, may inadvertently sideline the nuanced and intricate dimension of pain experienced by patients with ALS.

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来源期刊
Neurological Sciences
Neurological Sciences 医学-临床神经学
CiteScore
6.10
自引率
3.00%
发文量
743
审稿时长
4 months
期刊介绍: Neurological Sciences is intended to provide a medium for the communication of results and ideas in the field of neuroscience. The journal welcomes contributions in both the basic and clinical aspects of the neurosciences. The official language of the journal is English. Reports are published in the form of original articles, short communications, editorials, reviews and letters to the editor. Original articles present the results of experimental or clinical studies in the neurosciences, while short communications are succinct reports permitting the rapid publication of novel results. Original contributions may be submitted for the special sections History of Neurology, Health Care and Neurological Digressions - a forum for cultural topics related to the neurosciences. The journal also publishes correspondence book reviews, meeting reports and announcements.
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