氟哌噻吨-美利曲辛片联合非甾体抗炎药治疗中青年女性乳腺癌保留乳房术后慢性疼痛的疗效观察:一项前瞻、随机、对照临床研究  

Flupentixol and Melitracen plus non-steroidal anti-inflammatory drug to treat chronic postoperative pain after breast-conserving surgery in young and middle-aged patients with breast cancer: a prospective randomized controlled clinical study

作　　者：王宇[1] 崔志超[1] 马杰[1] 张景华[1] 谷峥[1] 张顺礼 

机构地区：[1]唐山市人民医院乳腺外科,063000

出　　处：《中华乳腺病杂志（电子版）》2014年第2期21-24,共4页Chinese Journal of Breast Disease(Electronic Edition)

摘　　要：目的：探讨氟哌噻吨-美利曲辛片联合非甾体抗炎药对中青年女性乳腺癌保留乳房术后慢性疼痛的疗效。方法纳入2011年3月至2012年9月在本院行乳腺癌保留乳房手术的中青年女性患者120例,患者术后均有不同程度的慢性疼痛,综合医院焦虑抑郁测定表（ HAD）评分为8～15分。随机数字表法分为治疗组（n=60）及对照组（n=60）,对照组采用非甾体抗炎药布洛芬缓释胶囊（芬必得,0．3 g,每日2次）,治疗组采用芬必得联合氟哌噻吨-美利曲辛片（1片,每日2次）,疗程8周,分别于入组时、治疗4周和8周后进行疼痛模拟评分（ VAS）。采用HAD进行情绪障碍评分以及采用匹茨堡睡眠质量指数（ PSQI）进行睡眠质量评分。计量资料的比较采用t检验、重复测量的方差分析,率的比较采用χ^2检验。结果治疗4周和8周后治疗组疼痛VAS评分显著降低（F=8．337, P=0．002）,有效率高于对照组（38．33%比20．00%,χ^2=4．881,P=0．027；70．00%比36．67%,χ^2=13．393,P=0．000）；治疗组焦虑及抑郁指数明显降低（F=16．825, P=0．000；F=10．026, P=0．000）,且均低于对照组（F=6．074, P=0．033；F=4．221, P=0．172）；治疗组PSQI下降（F=8．681, P=0．001）,两组差异无统计学意义（F=3．587, P=0．284）。结论氟哌噻吨-美利曲辛片联合非甾体抗炎药治疗中青年女性乳腺癌保留乳房术后慢性疼痛疗效优于单纯非甾体抗炎药,且伴有情绪及睡眠质量改善。Objective To investigate the efficacy of Flupentixol and Melitracen tablets （ Deanxit ） combined with non-steroidal anti-inflammatory drug in young and middle-aged patients with chronic postoperative pain after breast-conserving surgery of breast cancer. Methods Totally 120 patients undergoing breast-conserving surgery in our hospital from March 2011 to September 2012 were enrolled and randomly divided into treatment group （ n=60 ） and control group （ n=60 ） . All patients had chronic pain to different degree, with the scores of 8-15 by the hospital anxiety and depression（ HAD） scale. Control group was treated with nonsteroidal anti-inflammatory drug Ibuprofen sustained release capsules （ Fenbid, 0. 3 g, bid ） , while treatment group took Fenbid plus Flupentixol and Melitracen tablets （1 tablet, bid）. The treatment lasted for 8 weeks. At 0, 4, 8 weeks after treatment, the postoperative pain, emotional disorder and sleep quality were assessed using visual analogue scale（ VAS） , HAD scale, and Pittsburgh sleep quality index （ PSQI） . The t test and repeated analysis of variance were used to compare measurement data, chi-square test was used to compare the rates. Results At 4 weeks and 8 weeks after treatment, in treatment group, VAS showed a significant improvement （F=8. 337, P=0. 002）, the effective rate was higher than that in control group （38. 33% vs 20. 00%,χ^2=4. 881,P=0. 027;70. 00% vs 36. 67%, χ^2=13. 393,P〈0. 001）; the indexes of anxiety and depression were significantly reduced （F=16. 825, P〈0. 001; F=10. 026, P〈0. 001）, and both were lower than those in control group （F=6. 074, P=0. 033;F=4. 221, P=0. 172）;PSQI was decreased （F=8. 681, P=0. 001）, but the difference was not statistically significant between two groups （F=3. 587, P=0. 284）. Conclusion Flupentixol and Melitracen tablets combined with non-steroidal anti-inflammatory drug show a better efficacy than non-steroidal anti-inflammatory drug used alone in the treatment of chronic pain

关 键 词：乳腺肿瘤 抗焦虑药 抗抑郁药 疼痛 手术后 保留乳房手术 药物疗法 

分 类 号：R737.9[医药卫生—肿瘤]