鞘内注射帕瑞昔布钠联合吗啡对晚期癌痛患者的效果观察  

Efficacy of intrathecal injection of parecoxib sodium combined with morphine for pain in advanced cancer

作　　者：周文 王妍[2] 朴福顺 杜冰 许兆轶 丛勇滋[1] ZHOU Wen;WANG Yan;PIAO Fu-shun;DU Bing;XU Zhao-yi;CONG Yong-zi(Department of Pain,Dalian Municipal Central Hospital,Dalian 116033,China;Department of operating room,Dalian Municipal Central Hospital,Dalian 116033,China)

机构地区：[1]辽宁大连市中心医院疼痛科,大连116033 [2]辽宁大连市中心医院手术室,大连116033

出　　处：《中国肿瘤临床与康复》2022年第2期146-150,共5页Chinese Journal of Clinical Oncology and Rehabilitation

摘　　要：目的探讨鞘内注射帕瑞昔布钠联合吗啡对晚期癌痛患者的镇痛效果。方法选取2016年1月至2021年1月间大连市中心医院收治的104例晚期癌痛患者,采用随机数字表法分为试验组和对照组,每组52例。试验组患者采用鞘内注射帕瑞昔布钠联合吗啡治疗,对照组患者采用鞘内注射生理盐水联合吗啡治疗,比较两组患者治疗前后视觉模拟评分(VAS)、生活质量评分及不良反应发生率,采用实时荧光定量PCR检测患者治疗前后血清miR-192和miR-200a表达。结果治疗前,两组患者VAS评分比较,差异无统计意义(P>0.05);治疗后,两组患者疼痛情况均得到有效缓解,且试验组各时间点VAS评分均低于对照组,差异均有统计意义(均P<0.05)。治疗前,两组患者QLQ-C30评分比较,差异无统计学意义(P>0.05);治疗后,两组患者QLQ-C30评分均上升,且试验组各项评分改善情况优于对照组,差异均有统计意义(均P<0.05)。治疗后,试验组患者不良反应发生率为15.4%,低于对照组的34.6%,差异有统计学意义(P<0.05)。治疗前,两组患者血清中miR192和miR-200a表达水平比较,差异均无统计学意义(P>0.05)。治疗后,两组患者miR-192均增加,miR-200a均下降,且试验组miR-192表达量高于对照组,差异有统计学意义(P<0.05),两组miR-200a表达量比较,差异无统计学意义(P>0.05)。结论鞘内注射帕瑞昔布钠联合吗啡,有助于缓解晚期癌痛患者的疼痛情况,改善生活质量,不良反应发生率更低,且能增加miR-192表达量,降低miR-200a表达量,可能与抗肿瘤作用有关。Objective To investigate the efficacy of intrathecal injection of parecoxib sodium combined with morphine for pain in advanced cancer. Methods A total of 104 patients with advanced cancer pain were selected at Dalian Municipal Central Hospital from January 2016 to January 2021. They were randomly divided into an experimental group and a control group with 52 patients each. The experimental group received intrathecal injection of parecoxib sodium combined with morphine and the control group received intrathecal injection of normal saline combined with morphine. The visual analogue scale(VAS), quality of life score and the incidence of adverse reactions were compared between the two groups before and after treatment. The relative expressions of serum miR-192 and miR-200 a were detected in the of the two groups by real-time fluorescence quantitative PCR. Results There was significant difference in VAS scores between the two groups before the treatment(P>0.05). After the treatment, pain was relieved in both groups and the VAS scores were lower in the experimental group than in the control group(all P<0.05). There was significant difference in European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core-30(QLQ-C30) between the two groups before the treatment(P>0.05). After treatment, QLQ-C30 scores increased in the two groups, and the improvement in the scores was greater in the experimental group than in the control group(all P<0.05). The incidence of adverse reactions was 15.4% in the experimental group, which was significantly lower than 34.6% of the control group(P<0.05). There was significant difference in miR-192 and miR-200 a between the two groups before the treatment(P>0.05). After the treatment, the expression of serum miR-192 increased and the expression of miR-200 a decreased in the two groups and the expression of miR-192 was significant higher in the experimental group than in the control group(all P<0.05). However, there was no significant difference in the expression of

关 键 词：帕瑞昔布钠 MiR-192 MiR-200a 晚期癌痛 

分 类 号：R730.5[医药卫生—肿瘤]