硫酸吗啡缓释片联合加巴喷丁胶囊治疗癌性疼痛的临床观察  

CLINICAL OBSERVATION OF SUSTAINED-RELEASE MORPHINE SULPHATE COMBINED WITH GABAPENTIN IN THE TREATMENT OF CANCER PAIN

作　　者：陈立平[1] 申文[1] 韩茜[1] 袁燕[1] 梁栋[1] 殷琴[1] 朱雯[1] 许恒[1] 胡学铭[2] 

机构地区：[1]徐州医学院附属医院疼痛科,徐州221002 [2]徐州医学院,徐州221002

出　　处：《中国疼痛医学杂志》2015年第9期679-683,共5页Chinese Journal of Pain Medicine

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。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.

关 键 词：吗啡 加巴喷丁 癌性疼痛 爆发痛 

分 类 号：R730.5[医药卫生—肿瘤]