改善鼻咽癌放化疗所致口咽疼痛伴焦虑的研究

Relief depression in nasopharyngeal cancer patients by controlling the severe pain in oral cavity caused by chemothery and radiation injury

目的探讨采用芬太尼缓释透皮贴剂控制鼻咽癌放化疗所致的中重度口咽疼痛，来改善患者疼痛所致焦虑的可行性。方法将61例放化疗后出现中重度口咽疼痛伴焦虑症状的鼻咽癌患者，随机分为治疗组和对照组，治疗组采用多瑞吉＋口腔粘膜修复剂，对照组仅用口腔粘膜修复剂，观察两组口腔疼痛的缓解率，并以焦虑自评量表（SAS）评定治疗前后的SAS评分变化，记录多瑞吉的不良反应。结果口咽疼痛缓解率治疗组84．6％，对照组为45．7％，两组疼痛缓解率有统计学差异（P〈0．O5）。治疗后SAS评分：治疗组和对照组分别为：（53．59±8．07），（61．21±9．86），两组治疗后SAS评分有统计学差异（P〈0．05）。多瑞吉的不良反应主要为头昏、恶心等。结论使用多瑞吉可减轻放化疗所致中重度口咽疼痛，且安全性较好，口咽疼痛的控制有助于减轻患者的焦虑症状，为肿瘤合并焦虑症状的治疗提供一种新的尝试。

Objective To study its feasibility of relief depression in nasopharyngeal cancer patients with transdermal fentanyl by controlling the severe pain in oral cavity caused by chemothery and radiation injury. Methods 61 casees nasopharyngeal cancer patients with the severe pain in oral cavity caused by chemothery and radiation injury were devided into two groups：the treatment group were with transdermal fentanyl and mucous renovating drug, the control group were with mucous renovating drug only. Observe the relief of pain in oral cavity, and recorded the change of scores with SAS, and recorded adverse reactions. Results The rate of relief in the treatment group was 84.6%,in the control group was 45.7%,and with statistics difference （P〈0.05）.The scores of SAS in the treatment group and in the control group were （53.59 ± 8.07）,（61.21 ± 9.86）,there were statistics difference （P〈 0. 05）.adverse reactions were dizzy, nausea and so on. Conclusion the severe pain in oral cavity caused by chemothery and radiation injury can be controlled with transdermal fentanyl. And it was safe. lt is helpful to relief depression in nasopharyngeal cancer patients by controlling the severe pain in oral cavity, and worthy to application.