患者，中年，脊椎间盘破裂，髓质流出，严重炎症反应，一侧腿部及臀部疼痛，卧床，行动极为困难，上下床以及行走5米距离都疼痛，很困难。遵医嘱每天服用止疼消炎药。后来病情发展，即使严格卧床休息，患侧大小腿和臀部几乎每天抽筋，难以忍受，服用镁片无效。我提议用尼古丁贴片 (nicotine patch) 缓解抽筋。患者接受建议。取市售尼古丁贴片(Clear NicoDerm, 14mg), 剪成小片，大小尺寸～9mm x 6 mm，每片约含尼古丁~ 0.5mg (注：抽一支烟约吸入1mg 左右的尼古丁)。贴在腿及臀部痉挛部位，每个痉挛部位一小片。通常3～4片/1～2天。一般1分钟以后痉挛开始缓解，约5分钟后痉挛消失，对解除痛苦，和不得不进行的活动有很多帮助。后得知患者用尼古丁贴片处理方法进行了数周，始终有效。无尼古丁上瘾现象。
我认为，根据诸多文献，作用机理在于尼古丁增强交感神经功能，扩张小血管，增加血流，改善局部循环，进而解除痉挛。
参考文献：
- Effects of Nicotine on the Muscles，By Adam Scarano ，http://www.livestrong.com/article/239665-effects-of-nicotine-on-the-muscles/
- Blood Flow in the Human Calf during Tobacco Smoking，By JAY D. et al. http://circ.ahajournals.org/content/28/5/932.full.pdf
- Nicotine and sympathetic neurotransmission. By Haass M, Kubler W, http://www.ncbi.nlm.nih.gov/pubmed/9110108
- Nicotine induced skeletal muscle vasodilation is mediated by release of epinephrine from nerve terminals. By Diane JN et al. http://www.ncbi.nlm.nih.gov/pubmed/1979721
- The effects of nicotine on the blood vessels of skeletal muscle in the cat and investigation of vasomotor axon reflexes，by S. M. Hilton, http://onlinelibrary.wiley.com/doi/10.1113/jphysiol.1954.sp005051/pdf
