奥氮平辅助治疗肺癌骨转移重度疼痛及相关性焦虑、抑郁的临床观察  

Clinical Observation of Olanzapine Auxiliary Treatment of Severe Pain and Related Anxiety and Depression for Lung Cancer Bone Metastases

作　　者：彭雷[1] 戚焕鹏[1] 翟西菊[1] PENG Lei QI Huanpeng ZHAI Xiju(Taian City Tumor Hospital, Taian 271000, China)

机构地区：[1]泰安市肿瘤防治院,山东泰安271000

出　　处：《肿瘤基础与临床》2017年第1期46-48,共3页journal of basic and clinical oncology

摘　　要：目的探讨奥氮平辅助盐酸羟考酮缓释片治疗肺癌骨转移患者的重度疼痛及其改善癌痛相关性焦虑与抑郁的疗效及不良反应。方法将本院收治的85例肺癌骨转移重度疼痛患者随机分为观察组(43例)和对照组(42例),观察组口服奥氮平(5 mg·d-1,连用2周)同时给予盐酸羟考酮缓释片(开始剂量10~20 mg,q12 h,根据疼痛缓解程度,对剂量进行滴定调整,最大剂量100 mg/次);对照组则单纯口服盐酸羟考酮缓释片(用法用量同观察组)。于治疗前后分别应用数字疼痛强度量表(NRS)、焦虑自评量表(SAS)及抑郁自评量表(SDS)评价疼痛程度、焦虑、抑郁标准分及其变化和治疗有效率。结果观察组治疗后NRS、SAS、SDS评分均低于对照组,差异均有统计学意义(P均<0.05);观察组疼痛、焦虑、抑郁的治疗有效率均高于对照组,差异均有统计学意义(P均<0.05);观察组口服奥氮平后的主要不良反应为便秘、嗜睡、恶心、呕吐、头晕、乏力。结论奥氮平能够辅助盐酸羟考酮缓释片治疗肺癌骨转移重度疼痛患者,并且能够改善癌痛相关性焦虑与抑郁,疗效显著,不良反应轻,患者耐受性好。Objective To explore the effect and adverse reaction of olanzapine auxiliary oxycodone hydrochloride zyban in the treatment of severe pain and related anxiety and depression in patients with lung cancer bone metastases. Methods All the 85 cases of lung cancer bone metastases with severe pain were randomly divided into the observation group （43 cases） and the control group （42 cases）. Patients in the observation group oraled olanzapine （5 mg · d- 1,2 weeks） and oxycodone hydrochloride zyban （starting 10-20 rag, q12 h, adjust the dose depending on the degree of pain relief,the maximum dose 100 mg） at the same time; patients in the control group oraled oxycodone hydrochloride zyban （ same to the observation group）. The numerical rating scale （NRS） , Zung seff-rating anxiety scale （ SAS） and self-rating depression scale （SDS） were used to evaluate the degree of pain,depression , anxiety before and after treatment, and the treatment efficiency were compared. Results NRS, SAS,SDS scores of the observation group were lower than the control group after treatment （ P 〈 0.05 ）. The treatment efficiency of NRS, SAS, SDS of the observation group were higher than the control group （P 〈 0.05 ）. The main adverse reactions of olanzapine included constipation, drowsiness, nausea, vomiting, dizziness and fatigue. Conclusion Olanzapine auxiliary oxycodone hydrochloride zyban is safe and effect in the treatment of severe pain and related anxiety and depression in patients with lung cancer bone metastases.

关 键 词：奥氮平 肺癌 骨转移 癌痛 焦虑 抑郁 

分 类 号：R730.6[医药卫生—肿瘤]