在人體中,每每可以發生一些具災難性質的事故,例如有細菌等外敵入侵。身體對此會有反應,除了馬上進入戒備狀態(所謂「發炎」),亦向大腦發出警報,也就是「痛的感覺」。「痛」好比是自動灑水系統,本來的作用是提出預警及稍作處理,但本身卻已可令人寢食不安,造成傷害。除了「發炎的痛」(Inflammatory Pain),其他的例子尚有燒傷而產生的痛(Thermal Pain)、神經痛(Neuropathic Pain)、月經生理痛(Dysmenorrhoea)和癌細胞擴散入骨的痛(Cancer Bone Pain)等。
當牙肉被細菌感染,守護口腔的巨噬細胞會分泌PGI2(Prostaglandin I2),後者黏在周邊神經「C纖維」(C fiber)上的「PGI2接受體」,從而啟動一個神經訊息,大腦於是收到痛的感覺。阿司匹靈可以有止痛的作用,方法是抑制巨噬細胞的「環加氧酶」(Cyclo-oxygenase),令其沒法製造PGI2。從上述這「痛的過程」看來,若能攔截「C纖維」傳導的神經訊息,應亦可止痛;實驗證明,果真如此(Neuroreport, Vol. 3, pp. 21-24),其中具體的作用,是將「C纖維」上的一個「TRPV1通道」(Transient Receptor Potential Vanilloid Subtype 1 Channel)打開。這個「TRPV1通道」,原來是減低痛感的捷徑,包括炙傷的痛(Brain Res., Vol. 1328, pp. 49-56)、神經痛(J. Periper. Nerv. Syst., Vol. 11, pp. 262-271)、以及癌細胞擴散入骨、刺激破骨細胞(Osteoclast)做出的痛感(Neurosci. Lett, Vol. 393, pp. 70-73)。一組中文大學醫學院學者,發現中藥白鳳丸之可以紓緩月經生理痛,也是透過「TRPV1通道」(Cell Biol. Int., Vol. 36, pp. 63-69)。有一個在東南亞常用到的調味香料,叫香茅(學名Cymbopogon Citratus),它的香氣來自一種叫香茅醇(Citronellol)的物質。這東西也能止痛,功能正正在於它能打開「TRPV1通道」。
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There are several types of pain medication that can be used to relieve pain, including:
Over-the-counter (OTC) pain relievers: These include acetaminophen (Tylenol) and nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil) and naproxen (Aleve). These medications are available without a prescription and can be used to relieve mild to moderate pain.
Prescription pain relievers: These include stronger pain medications, such as opioids (e.g., oxycodone, hydrocodone, fentanyl) and muscle relaxants. These medications are typically prescribed for more severe pain and are used under the close supervision of a healthcare provider.
Topical pain relievers: These include creams, gels, and patches that are applied directly to the skin over the area of pain. They can be used to relieve mild to moderate pain and can be a good option for individuals who are unable to take oral pain medication.
Adjuvant pain medications: These are medications that are typically used to treat other conditions, but can also be used to relieve pain. Examples include tricyclic antidepressants and anticonvulsants.
It is important to discuss the use of pain medication with a healthcare provider to determine the best treatment option for an individual's specific needs. The type of pain medication used, as well as the dose and frequency of use, will depend on several factors, including the cause and severity of the pain, the individual's overall health, and any other medical conditions they may have.
Neuropathic pain is a type of chronic pain that results from damage or injury to the nervous system, including the peripheral and central nervous systems. This type of pain is often described as burning, tingling, shooting, or electric in nature and can be very difficult to manage.
The causes of neuropathic pain can be due to a variety of factors, including injury to the nerves, certain medical conditions (such as diabetes, shingles, and HIV), and certain medications.
Treatment for neuropathic pain typically involves a combination of medications, physical therapy, and lifestyle changes. Medications used to treat neuropathic pain may include anticonvulsants, antidepressants, topical creams and patches, and certain pain-relieving drugs, such as tramadol or gabapentin. In some cases, nerve blocks or spinal cord stimulation may also be recommended.
It is important for individuals with neuropathic pain to work closely with a healthcare provider to develop an individualized treatment plan that addresses their specific needs. In some cases, multiple treatments may need to be tried before finding the most effective therapy. Additionally, it is important to manage stress and maintain a healthy lifestyle to help improve overall well-being and reduce the impact of neuropathic pain.
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