【摘要】 目的观察加巴喷丁对顽固性癌痛患者的镇痛效果。方法 46例癌症患者分别采用吗啡(M组,22例)和吗啡联合加巴喷丁(MG组,24例)镇痛。M组患者根据疼痛VAS评分递加吗啡镇痛;MG组口服加巴喷丁900mg/d的同时再根据镇痛情况服用吗啡。给药1、2、4周时进行VAS疼痛评分及镇痛效果评定,记录吗啡使用剂量及服药4周后的镇痛相关不良反应。结果镇痛期间,两组VAS疼痛评分均低于治疗前(P<0.01),镇痛优良率达79.17%~90.91%。随着治疗时间的延长,M组吗啡用量明显增加(P<0.05或P<0.01),MG组吗啡用量与初始量仅稍有增加(P>0.05)。治疗的第2、4周,MG组吗啡使用量小于M组(P<0.05)。两组治疗相关主要不良反应为便秘、尿潴留、恶心呕吐、皮肤瘙痒和嗜睡等;两组近期不良反应发生率相仿(59.09%vs.62.50%)(P>0.05)。结论复合应用加巴喷丁和吗啡能有效缓解顽固性癌痛,并可以明显减少吗啡需要量。更多还原

【Abstract】 Objective To observe the analgesic effect of gabapentin combined with morphine on the patients with intractable cancer pain.Methods Forty-six patients with intractable cancer pain were randomly divided into two groups and treated with oral morphine tablet（group M,22 cases）and morphine plus gabapentin 900mg/d orally（group MG,24cases）.Analgesia was evaluated by VAS pain score in the 1^st,2^nd and 4^th week during treatment.The consumption of morphine was calculated and adverse effects were recorded after 4 weeks treatment.Results The VAS scores were significantly lower during analgesia than those before（P<0.01）with the excellence rates of analgesia79.17%⁹0.91%in both groups.The consumption of morphine in group M was increased as the time of treatment went on（P<0.05 or P<0.01）,which in group MG was not and was less than that in group M in the 2^nd and 4^th week of treatment（P<0.05）.The main adverse effects included constipation,urinary retention,nausea and vomiting,skin itching,and lethargy.The incidence rates of adverse effects in two groups were similar（59.09% vs.62.50%）（P>0.05）.Conclusion Combind use of gabapentin and morphine can effectively attenuate intractable cancer pain and reduce the dose of morphine needed for analgesia.更多还原