糖皮质激素在慢性疼痛治疗中应用专家意见（The application of glucocorticoid in chronic pain therapy is an expert opinion）.doc

糖皮质激素在慢性疼痛治疗中应用专家意见（The application of glucocorticoid in chronic pain therapy is an expert opinion） Expert advice on the application of glucocorticoid in chronic pain therapy (2007) Xu jianguo (pen), tian yuke, wang guolin, ge hengjiang, huang yuguang Pain is an unpleasant sensation and emotional experience caused by damage to the body and potential tissue damage. if Pain persists, to a level of moderate to severe, which can not be alleviated in certain circumstances, and may be associated with depression and anxiety Change, then, becomes chronic pain. The treatment of chronic pain in clinic includes non-steroidal anti-inflammatory drugs The anti-inflammatory and analgesic of glucocorticoid (GCS) can not be ignored With the further clarification of the analgesic mechanism and the development of new preparation, GCS is used in the treatment of pain Its getting more and more attention. In 1949, Hench found that GCS can alleviate the symptoms of rheumatoid arthritis. Half a century ago, The application of GCS in the field of pain therapy has experienced three stages: abuse, timidity and rational application of today. us The key to the safe and effective use of GCS is to choose the adaption, drug dosage form, dosage and method of drug administration. The pharmacological action of glucocorticoid Endogenous glucocorticoids are secreted by cortical bundles of adrenal cortical cells, which are mediated by binding to the receptor Thus the pharmacological effect is played. Glucocorticoid is a lipid soluble hormone that passes through the membrane of the membrane and the sugar skin inside the cytoplasm The hormone receptor (GR) binds, the latter is the 90KD heat shock protein (hsp90) and the p59 protein group A large molecular complex. The hsp90 then dissolves from the complex and the activated GCS - GR complex Rapid entry into the nucleus of the nucleus, the GCS reaction component or reverse of the target gene promoter A combination of the component (GRE), which promotes or i