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疼痛是一种复杂的生理和心理活动。疼痛因疾病类型不同而具有不同的节律模式,镇痛药的药效学和药动学也具有昼夜节律性。因不同手术类型引起的疼痛,患者对镇痛药需求亦存在昼夜差异。从时辰药理学角度来讲,疼痛的药物治疗应按其节律模式、类型和起因灵活调整给药方案,从而达到个体化用药。该文主要就疼痛强度的昼夜节律、镇痛药时辰药理学以及手术类型与镇痛药需求的昼夜节律作一综述,以期为临床疼痛治疗提供参考。
Pain is a complex physical and mental activity. Pain varies depending on the type of disease and has a different rhythm pattern, pharmacodynamics and pharmacokinetics of analgesics also have circadian rhythms. Because of the pain caused by different types of surgery, patients also have diurnal differences in the demand for analgesics. From the time of pharmacological point of view, the pain medication should be flexible according to its rhythm pattern, type and cause of dosing regimen, so as to achieve individualized medication. This paper reviews the circadian rhythm of pain intensity, the pharmacology of analgesic hourly radiotherapy and the circadian rhythm of the types of pain and analgesic requirements in order to provide a reference for clinical pain treatment.