糖皮质激素在慢性疼痛治疗中应用专家意见（Expert opinion on the use of glucocorticoids in the treatment of chronic pain）.docVIP

糖皮质激素在慢性疼痛治疗中应用专家意见（Expert opinion on the use of glucocorticoids in the treatment of chronic pain） Expert opinion on the application of glucocorticoids in the treatment of chronic pain (2007) Xu Jianguo, Tian Yuke, Wang Guolin, Ge Hengjiang, Huang Yuguang Pain is an unpleasant feeling and emotional experience caused by damage to the body and potential tissue damage. If The pain persists and is moderate to severe, which can not be alleviated in certain circumstances, and may be accompanied by depression and anxiety Such changes become chronic pain. The treatment of chronic pain in the clinic includes nonsteroidal anti-inflammatory drugs The anti-inflammatory and analgesic effects of glucocorticoids (GCS) can not be ignored, but the With the further elucidation of the analgesic mechanism and the development of the new formulation, the application of GCS in the treatment of pain is discussed More and more attention has been paid to it. In 1949, Hench et al found that GCS could relieve symptoms of rheumatoid arthritis. For half a century, The application of GCS in the field of pain treatment has experienced three stages: abuse, timidity and rational use today. close The choice of indications, dosage forms, dosage and methods of administration are the keys to safe and effective use of GCS. First, the pharmacological effects of glucocorticoids Endogenous glucocorticoids are secreted by the adrenal zona tract and mediate gene expression by binding to the receptor So as to exert the pharmacological effect. Glucocorticoids are lipid soluble hormones that go through the cell membrane and are intracellular sugars The sex hormone receptor (GR) binding, the latter is composed of the 90KD heat shock protein (Hsp90) and the P59 protein group Macromolecular complex. Subsequently, Hsp90 dissociates from the complex, whereas the activated GCS-GR complex Rapid entry into the nucleus with two aggregates in response to the GCS component of the target gene promoter Component (GRE) combin