【摘要】 目的:观察硫酸吗啡缓释片联合加巴喷丁胶囊治疗癌性疼痛的临床疗效。方法:采取随机、对照的试验方法,将最终入选的61例伴有重度疼痛的晚期恶性肿瘤患者,随机分为2组:硫酸吗啡缓释片联合加巴喷丁组(A组)30例,单纯硫酸吗啡缓释片组(B组)31例。两组患者根据疼痛程度逐渐增加药物用量,治疗目标为背景痛数字评价量表(numerical rating scale,NRS)≤3分,当出现爆发痛时采用盐酸吗啡片治疗。然后比较两组患者治疗前后疼痛缓解程度、吗啡的日均用量和生活质量评分。结果:(1)疼痛缓解程度:与治疗前相比,两组患者背景痛NRS评分均较治疗前明显降低(P<0.05);在给药后第2、3、7和14天,A组患者平均背景痛NRS评分低于B组,差异具有统计学意义(P<0.05);同时在给药后第2、3、7、14和28天,A组患者24小时爆发痛的平均次数也少于B组(P<0.05)。(2)吗啡的日均用量:综合硫酸吗啡缓释片和盐酸吗啡片的日均总用量,在给药第28天,A组患者日均吗啡用量少于B组,差异具有统计学意义(P<0.05)。(3)生活质量评分:在正规服药后,两组患者在情绪、失眠、恶心等方面均较治疗前有所改善(P<0.05);与B组比较,A组患者在失眠、恶心等方面评分较低,差异具有统计学意义(P<0.05)。结论:硫酸吗啡缓释片联合加巴喷丁胶囊能有效治疗癌性疼痛,减少吗啡的用量及副作用,并能提高患者生活质量。更多还原

【Abstract】 Objective: To evaluate the analgesic effect of substained-release morphine sulphate combined with gabapentin in the treatment of cancer pain.Methods: 61 patients with advanced malignant tumor and cancer pain were randomly assigned into two groups, substained-release morphine sulphate combined with gabapentin group(group A, 30 cases) and the single-agent substained-release morphine sulphate group(group B, 31 cases). The therapeutic goal was to reduce the numerical rating scale(NRS) of background pain to ≤ 3. The numerical rating scale(NRS) of background pain, times of breakthrough pain, the dosage of morphine, and life quality were compared between two groups. Results:(1) Cancer pain(included background pain and breakthrough pain) was relieved well in both groups. The NRS of background pain of group A was lower than that of group B on day 2,3,7 and 14. The average times of breakthrough pain of group A were less than those of group B on day 2,3,7,14 and 28.(2) The average daily dosage of morphine in group A was significantly less than that of group B on day 28(P < 0.05).(3)The score of life quality of patients in group A was lower than that of group B in the domains of insomnia and nausea on day 14 and 28(P < 0.05).Conclusions: Substained-release morphine sulphate combined with gabapentin could effectively relieve cancer pain, reduce morphine dosage and side effects, and improve the life quality of patients.更多还原