摘要： 痛性周围神经病以神经病理性疼痛为突出表现，可伴运动、感觉及自主神经功能异常，主要累及小纤维（Aδ和C 纤维），根据病因可以分为遗传性和获得性。可为独立性疾病亦可为其他疾病表现的一部分，前者指特发性小纤维神经病。疼痛包括自发性和诱发性疼痛，表现为长度依赖性，呈现“手套-袜套”样分布。痛性周围神经病的主要辅助检查包括定量感觉检测、表皮内神经纤维密度、皮肤交感反应等。治疗原发病和控制疼痛是主要治疗手段，常用药物包括卡马西平、普瑞巴林、阿米替林等。

关键词: 周围神经系统疾病, 神经痛, 疼痛测定, 药物疗法, 综述

Abstract: Painful peripheral neuropathy (PPN) is characterized by neuropathic pain (NP), which is accompanied by dysfunction of motor, sensory and autonomic nervous system. It always involves small nerve fibers, including A δ and C fibers. PPN can be classified into two types according to etiology: hereditary and acquired. Pain of PPN can manifest as spontaneous pain and stimulus-evoked pain (allodynia, hyperalgesia and hyperpathia). The manifestation of typical cases is length-dependent, which firstly involves the feet, and then progresses proximally and to the hands, presenting a glove-stock pattern. PPN can be either an isolated disease entity or part of other diseases. The former indicates idiopathic small fiber neuropathy (SFN), while the latter contains various diseases involving peripheral nerve fibers, including systemic diseases such as diabetes mellitus and peripheral neuropathy with other causes. The accessory examinations of PPN include quantitative sensory testing (QST), intraepidermal nerve fiber density (IENFD), sympathetic skin response (SSR), etc. Among them, IENFD is the "golden standard" for SFN. The major therapeutic methods are to control primary diseases and relieve pain. Medications alleviating neuropathic pain consist of carbamazepine, pregabalin, gabapentin and amitriptyline, etc.

Key words: Peripheral nervous system diseases, Neuralgia, Pain measurement, Drug therapy, Review