题名

外陰疼痛的藥物和手術治療

DOI

10.6666/ClinMed.202008_86(2).0089

作者

李耀泰；陳福民；郭宗正

关键词

外陰疼痛（vulvodynia） ； 增生療法（prolotherapy） ； 外陰前庭切除（vestibulectomy）

期刊名称

臨床醫學月刊

卷期/出版年月

86卷2期（2020 / 08 / 28）

页次

498 - 501

内容语文

繁體中文
中文摘要

外陰疼痛乃指外陰持續疼痛逾3個月、但無明顯的原因。它是一種慢性、困擾的疾病，患者常敘述有灼痛、刺痛和性交疼痛，因常治癒無效，婦產科醫師束手無策，患者常出現憂鬱症狀者達8－15%。患者求診時，醫師又不熟稔此疾病，從外觀陰唇並無異常，故給予一些止痛藥並不會有效果。首先可考慮合併使用gabapentin、抗憂鬱藥物、局部止痛藥膏或局部注射；但對局部性外陰疼痛則應考慮手術切除治療。同時要了解，達到完全無痛是不容易的，只要能舒緩患者不適，恢復日常作息便已達成目標。
主题分类 醫藥衛生 > 基礎醫學
醫藥衛生 > 社會醫學
参考文献
  1. Covey, CJ,Sineath, MH,Penta, JF(2015).Prolotherapy: can it help your patient?.J Fam Pract,64,763-768.
  2. Farajun, Y,Zarfati, D,Abramov, L(2012).Enoxaperin treatment for vulvodynia. A randomized controlled trial.Obstet Gynecol,120,565-572.
  3. Hansen, TH,Guldberg, R,Meinert, M(2019).Botulinum toxin-treatment of localized provoked vulvodynia refractory to conventional treatment.Eur J Obstet Gynecol Reprod Biol,234,6-9.
  4. Hauser, RA,Lackner, JB,Steilen-Matias, D(2016).A systematic review of dextrose prolotherapy for chronic musculosketal pain.Clin Med Insights Arthritis Musculosket Disord,9,139-159.
  5. Kim, R,Kelly, KL,Olson, M(2018).Early experience with topical meloxicam and lidocaine combination for the treatment of vulvodynia.Can Urol Assoc J,12,252-255.
  6. Kliethermes, CJ,Shah, M,Hoffstetter, S(2016).Effect of vestibulectomy for intractable vulvodynia.J Minim Invasive Gynecol,23,1152-1157.
  7. Murina, F,Felice, R,Francesco, SD(2018).Vaginal diazepam plus transcutaneous electrical nerve stimulation to treat vestibulodynia: a randomized control trial.Eur J Obstet Gynecol Reprod Biol,148-153.
  8. Pereira, GMV,Marcolino, MS,Reis, ZSN(2018).A systematic review of drug treatment of vulvodynia: evidence of a strong placebo effect.BJOG,125,1216-1224.
  9. Reeves, KD,Sit, RWS,Rabago, DP(2016).Dextrose prolotherapy. A narrative review of basic science, clinical research, and best treatment recommendations.Phys Med Rehabil Clin N Am,27,783-823.
  10. Rosen, NO,Dawson, S,Brooks, M(2019).Treatment of vulvodynia: pharmacological and nonpharmacological approaches.Drugs,79,483-493.
  11. Steinberg, AC,Oyama, IA,Rejba, AE(2005).Capsaicin for the treatment of vulvar vestibulitis.Am J Obstet Gynecol,192,1549-1553.
  12. Stenson, AL., Vulvodynia(2017).Diagnosis and management.Obstet Gynecol Clin N Am,44,493-508.
  13. Tommola, P,Unkila-Kallio, L,Paavonen, J(2010).Surgical treatment of vulvar vestibulitis: a review.Acta Obstet Gynecol Scand,89,1385-1395.
  14. van Beekhuizen, HJ,Oost, J,van der Meijden, WI(2018).Generalized uprovoked vulvodynia: a retrospective study on the efficacy of treatment with amitriptyline, gabapentin or pregabalin.Eur J Obstet Gynecol Reprod Biol,220,118-121.
print cancel