10 条评论 发表在“ALLODYNIA和 HEPERALGESIA涵义区别?”上

1. allodynia通常指mechanical sti 诱发的痛，有两种形式：static allodynia和dynamic allodynia。前者指点对点刺激如von-Frey纤维刺激诱发的，故有称为Punctate allodynia，而后者指触刺激诱发的痛（touch-evoked pain）,有 称之为stroking allodynia。此外热刺激亦可诱发allodynia (thermal or heat allodynia)，例如正常不引起疼痛的热刺激（如<45度的热刺激）引起了痛反应。因而如果将其译为触觉痛不妥，个人认为翻译为异常痛觉（有些词典也这么翻译）更妥。
   下面附张最经典的解释Allodynia和Hyperalgesia 的图。

3. HI
   谢谢pain199954 战友的见解和补充,我想,任何理解在某个层面都是正确的,但是,越过这个层面,可能就不对了!
   例如:您提到的经典的那个图示,其实忽略了一个重要的问题:就是的曲线左移的过程中.所有引起Hyperalgesia 的刺激的质没有改变,还是疼痛刺激!
   但是对于allodynia而言,并不是曲线左移的部分,而是二者的重叠,引起allodynia的还是不痛的刺激!
   两者的刺激形式和反应方式都是截然不同的!不知您在讲学和理解的时候有没有认真思考过!
   对于翻译的说明,我也只是一家之辞,欢迎更多的朋友补充和说明!
   谢谢您!
   MARKE72

4. HI
   liujunle11 战友,您好,请参阅我们研究生的实验步骤:
   弗莱探针（NC-12775Touch-TestTM，美国），
   应用弗莱探针对手术右足底进行机械痛阈评定。将大鼠放置一小金属网格笼中，习惯环境后开始测定。测定野紧贴切口周围。弗莱探针的不同机械压力强度为1g, 1.4g, 2g, 4g, 6g, 8g, 10g, 15g, 26g和 50g， 每次的测定均由1g开始逐次增加直到发生缩腿反射或者刺激强度达到50g。每次重复测定三次，取{zd1}值作为机械痛阈。
   两个要点:1′笼子要比较大,大鼠可以有一定的活动范围,具体的尺寸很多文献上都有,好象长是20-25厘米,宽高我记不清楚了!
   2首次测定要等到大鼠在笼中安静后开始,一般是在放置后20分钟后开始.以减少干扰因素.每次测定的间歇期{zh0}为15–20分钟,
   请您再多参阅文献.
   谢谢!
   MARKE72

5. Allodynia 和Hyperalgesia 是疼痛研究中非常重要的两个概念，任何做疼痛研究的人均应彻底理解。很多关于二者的定义和理解主要源于人体实验的Capsaicin model，定义很明确，但实际应用起来有时二者经常混淆，国际上发表的文章经常可见将二者混在一起的。以下是IASP关于这两个词的定义和解释，供各位同仁参考！
   Allodynia
   Pain due to a stimulus which does not normally provoke pain.
   Note: The term allodynia was originally introduced to separate from hyperalgesia and hyperesthesia, the conditions seen in patients with lesions of the nervous system where touch, light pressure, or moderate cold or warmth evoke pain when applied to apparently normal skin. Allo means “other” in Greek and is a common prefix for medical conditions that diverge from the expected. Odynia is derived from the Greek word “odune” or “odyne,” which is used in “pleurodynia” and “coccydynia” and is similar in meaning to the root from which we derive words with -algia or -algesia in them. Allodynia was suggested following discussions with Professor Paul Potter of the Department of the History of Medicine and Science at The University of Western Ontario.
   The words “to normal skin” were used in the original definition but later were omitted in order to remove any suggestion that allodynia applied only to referred pain. Originally, also, the pain-provoking stimulus was described as “non-noxious.” However, a stimulus may be noxious at some times and not at others, for example, with intact skin and sunburned skin, and also, the boundaries of noxious stimulation may be hard to delimit. Since the Committee aimed at providing terms for clinical use, it did not wish to define them by reference to the specific physical characteristics of the stimulation, e.g., pressure in kilopascals per square centimeter. Moreover, even in intact skin there is little evidence one way or the other that a strong painful pinch to a normal person does or does not damage tissue. Accordingly, it was considered to be preferable to define allodynia in terms of the response to clinical stimuli and to point out that the normal response to the stimulus could almost always be tested elsewhere in the body, usually in a corresponding part. Further, allodynia is taken to apply to conditions which may give rise to sensitization of the skin, e.g., sunburn, inflammation, trauma.
   It is important to recognize that allodynia involves a change in the quality of a sensation, whether tactile, thermal, or of any other sort. The original modality is normally non-painful, but the response is painful. There is thus a loss of specificity of a sensory modality. By contrast, hyperalgesia (q.v.) represents an augmented response in a specific mode, viz., pain. With other cutaneous modalities, hyperesthesia is the term which corresponds to hyperalgesia, and as with hyperalgesia, the quality is not altered. In allodynia the stimulus mode and the response mode differ, unlike the situation with hyperalgesia. This distinction should not be confused by the fact that allodynia and hyperalgesia can be plotted with overlap along the same continuum of physical intensity in certain circumstances, for example, with pressure or temperature.
   Hyperalgesia
   An increased response to a stimulus which is normally painful.
   Note: Hyperalgesia reflects increased pain on suprathreshold stimulation. For pain evoked by stimuli that usually are not painful, the term allodynia is preferred, while hyperalgesia is more appropriately used for cases with an increased response at a normal threshold, or at an increased threshold, e.g., in patients with neuropathy. It should also be recognized that with allodynia the stimulus and the response are in different modes, whereas with hyperalgesia they are in the same mode. Current evidence suggests that hyperalgesia is a consequence of perturbation of the nociceptive system with peripheral or central sensitization, or both, but it is important to distinguish between the clinical phenomena, which this definition emphasizes, and the interpretation, which may well change as knowledge advances.

6. hi
   pain199954 您好,您的回帖写道:
   但实际应用起来有时二者经常混淆，国际上发表的文章经常可见将二者混在一起的。
   非常同意您的观点,
   其实那个图最为重大的一点在于:好象Hyperalgesia 包涵了Allodynia ! 不知道您是否常常这样表述:
   当存在Hyperalgesia时,即使是无害的刺激也可以产生疼痛,那么这种现象就是Allodynia!其实不是因为存在Hyperalgesia 才发生Allodynia的!!!!
   两者其实是不同的,xx不同的事件!最起码我一开始就是认为Allodynia就是Hyperalgesia的一种现象或者一部分!!
   请赐教!
   谢谢!
   MARKE72