盐酸羟考酮控释片联合普瑞巴林治疗癌性神经病理性疼痛的临床研究

Clinical study of oxycodone hydrochloride controlled-release tablets combined with pregabalin inthe treatment of malignant neuropathic pain

目的：观察盐酸羟考酮控释片联合普瑞巴林治疗癌性神经病理性疼痛的临床疗效及不良反应。方法选择疼痛门诊治疗的癌性疼痛患者87例，口服盐酸羟考酮控释片1周，并进行随访调查。接受治疗患者第8天11点数字分级法评定（ NRS）﹤4入A组，继续给予羟考酮治疗2周；NRS≥4随机入B1、B2组，B1组继续服用羟考酮2周， B2组联合普瑞巴林治疗2周。观察三组患者的疼痛评分及不良反应情况。结果84例（96.55%）完成第一阶段治疗。在第二阶段A组、B1组、B2组分别有28、27、26例患者。三组疼痛评分第15天均降低，第22天无改善，B2组比B1组第22天疼痛评分降低，但差异无统计学意义（P﹥0.05）。B2组羟考酮用量比B1组明显减少（P﹤0.05）。三组不良反应观察中便秘发生率最高，分别为17.9%、29.6%、34.6%。结论盐酸羟考酮控释片联合普瑞巴林治疗癌性神经病理性疼痛疗效明确，能够减少盐酸羟考酮控释片用量，是治疗癌性疼痛性价比较高的方案。

Objective To observe the clinical effect and adverse reactions of oxycodone hydrochloride controlled-release tablets combined with pregabalin in the treatment of malignant neuropathic pain. Methods Eighty-seven patients with cancer pain admitted in pain clinic were chose,oxycodone hydrochloride controlled-release tablets were orally given for 1 week,and the patients were followed-up. On the eighth day,patients with numeric rating scale（ NRS）﹤4 were enrolled in group A,and were given oxycodone treatment for another 2 weeks. Patients with NRS≥4 were randomly divided into group B1 and group B2,the patients in group B1 were given oxycodone for another 2 weeks,and patients in group B2 were given combined treatment of oxycodone and pregabal for 2 weeks. The pain scores and adverse reactions were observed among the three groups. Results Eighty-four patients（ 96. 55%）completed the first phase treatment. In the second stage of treatment,there were 28 cases,27 cases,26 cases in group A,group B1 and group B2,respectively. All of the pain scores reduced on the 15th day of treatment,and without improvement on the 22th day,the pain score was lower in group B2 than that in group B1 on the 22th day of treatment,but there was no significant difference（P﹥0. 05）. The dosage of oxycodone was lower in group B2 than that in group B1（ P﹤0. 05 ）. The incidence of constipation was the highest in the side effects of the three groups,which was 17. 9%,29. 6% and 34. 6%,respectively. Conclusions The effect of oxycodone hydrochloride controlled-release tablets combined with pregabalin on malignant neuropathic pain is good, can reduce the dosage of oxycodone hydrochloride controlled-release tablets.