盐酸氢吗啡酮治疗骨癌痛患者的临床效果及对疼痛相关介质和激素水平的影响  

Clinical effect of Hydromorphone Hydrochloride in the treatment of patients with bone cancer pain and its influence on pain related mediators and hormone levels

作　　者：张生茂 李娜[2] 包娜日素 苏楠 云乐天 赵智慧 ZHANG Shengmao;LI Na;BAO Narisu;SU Nan;YUN Letian;ZHAO Zhihui(Department of Anesthesiology,Inner Mongolia People’s Hospital,Inner Mongolia Autonomous Region,Huhhot010017,China;Department of Pain Treatment,Hohhot First Hospital,Inner Mongolia Autonomous Region,Huhhot010017,China)

机构地区：[1]内蒙古自治区人民医院麻醉科,内蒙古呼和浩特010017 [2]呼和浩特市第一医院疼痛科,内蒙古呼和浩特010017

出　　处：《中国医药导报》2022年第1期119-122,127,共5页China Medical Herald

基　　金：内蒙古自治区自然科学基金面上项目(2021MS 08109)。

摘　　要：目的探讨盐酸氢吗啡酮对骨癌痛患者的镇痛效果及镇痛机制。方法收集2017年1月至2020年3月内蒙古自治区人民医院收治的50例骨癌痛患者。依据随机信封法分为对照组和观察组,每组25例。对照组采用静脉镇痛泵给予帕米磷酸二钠治疗,观察组采用静脉镇痛泵给予盐酸氢吗啡酮治疗。比较两组视觉模拟评分法(VAS)评分和卡氏功能状态(KPS)评分;检测两组治疗前,治疗后1、2、3个月血清疼痛介质[5-羟色胺(5-HT)、一氧化氮(NO)、前列腺素E(PGE_(2))]和应激激素[皮质醇(Cor)、生长激素(GH)、泌乳素(PRL)]表达水平;分析盐酸氢吗啡酮镇痛效果与骨癌痛患者血清疼痛介质及应激激素水平的相关性。结果观察组镇痛效果优于对照组(P<0.05)。治疗1个月后,两组5-HT、NO、PGE_(2)、Cor、GH、PRL水平低于治疗前(P<0.05);治疗后2、3个月,两组5-HT、NO、PGE_(2)、Cor、GH、PRL水平低于治疗后1个月(P<0.05)。治疗后1、2、3个月,观察组5-HT、NO、PGE_(2)、Cor、GH、PRL水平低于对照组(P<0.05)。VAS评分与血清5-HT、NO、PGE_(2)、Cor、GH、PRL水平呈负相关(r=-0.903、-0.675、-0.748、-0.706、-0.901、-0.621,P<0.05);KPS评分与血清5-HT、NO、PGE_(2)、Cor、GH、PRL水平呈负相关(r=-0.801、-0.696、-0.738、-0.629、-0.752、-0.763,P<0.05)。结论盐酸氢吗啡酮对骨癌痛患者治疗效果优于传统镇痛药物,镇痛机制与抑制疼痛介质及应激激素水平有关。Objective To investigate the analgesic effect and mechanism of Hydromorphone Hydrochloride in patients with bone cancer pain.Methods A total of 50 patients with bone cancer pain admitted to Inner Mongolia People’s Hospital from January 2017 to March 2020 were collected.They were divided into control group and observation group by random envelope method,with 25 cases in each group.The control group was treated with Disodium Pamidronate by intravenous analgesia pump,and the observation group was treated with Hydromorphone Hydrochloride by intravenous analgesia pump.Visual analogue scale(VAS)score and Karnofsky performance status(KPS)score were compared between two groups;the expression levels of pain mediators(5-hydroxytryptamine[5-HT],nitric oxide[NO],prostagrandin E2[PGE_(2)])and stress hormones(cortisol[Cor],growth hormone[GH],prolactin[PRL])were detected before treatment and 1,2,and 3 months after treatment;the correlation between analgesic effect of Hydromorphone Hydrochloride and the levels of serum pain mediators and stress hormones in patients with bone cancer pain were analyzed.Results The analgesic effect of observation group was better than control group(P<0.05).After 1 month of treatment,the levels of 5-HT,NO,PGE_(2),Cor,GH,and PRL in both groups were lower than those before treatment(P<0.05);after 2 and 3 months of treatment,the levels of 5-HT,NO,PGE_(2),Cor,GH,and PRL in both groups were lower than those after 1 month of treatment(P<0.05).After 1,2,and 3 months of treatment,the levels of 5-HT,NO,PGE_(2),Cor,GH,and PRL in observation group were lower than those in control group(P<0.05).VAS score was negatively correlated with the levels of serum 5-HT,NO,PGE_(2),Cor,GH,and PRL(r=-0.903,-0.675,-0.748,-0.706,-0.901,-0.621,P<0.05);KPS score was negatively correlated with the levels of serum 5-HT,NO,PGE_(2),Cor,GH,and PRL(r=-0.801,-0.696,-0.738,-0.629,-0.752,-0.763,P<0.05).Conclusion The therapeutic effect of Hydromorphone Hydrochloride on patients with bone cancer pain is better than that of traditional

关 键 词：骨癌痛 盐酸氢吗啡酮 帕米磷酸二钠 疼痛介质 应激激素 

分 类 号：R730.6[医药卫生—肿瘤]