吗啡联合地塞米松对癌性疼痛患者镇痛疗效及其对β-EP、CGRP、PGE2水平的影响

Analgesic Effect of Morphine Combined with Dexamethasone for Cancer-induced Pain and Its Influence on β-EP,CGRP and PGE2 Levels

目的探讨吗啡联合地塞米松对癌性疼痛(CIP)患者镇痛疗效及其对β-内啡肽(β-EP)、含降钙素基因相关肽(CGRP)与前列腺素E-2(PGE2)的影响。方法选取CIP 89例,对照组采用吗啡,观察组采用吗啡联合地塞米松,比较两组镇痛疗效、血浆β-EP、脑脊液CGRP、脑脊液PGE2水平与药物不良反应发生率的差异。结果观察组每日爆发痛次数、NRS-11评分均明显低于对照组,QOL评分明显高于对照组,比较差异具有统计学意义(P<0.05),两组血浆β-EP水平比较差异无统计学意义(P>0.05),而观察组脑脊液CGRP、PGE2水平明显低于对照组,差异具有显著性(P<0.05)。两组患者药物不良反应总发生率比较差异无统计学意义(P>0.05)。结论吗啡联合地塞米松通过显著降低癌性疼痛患者CGRP、PGE2水平,从而显著减少爆发痛次数,改善镇痛疗效与患者生活质量,值得临床推广应用。

Objective To investigate the analgesic effect of morphine combined with dexamethasone for cancer-induced pain and its influence on β-EP,CGRP and PGE2 levels. Methods 89 cases of CIP were selected,the control group were given morphine, the observation group were given morphine combined with dexamethasone, analgesic efficacy, β-EP, CGRP, PGE2 levels and adverse reactions rate were compared between the 2 groups. Results Daily frequency breakthrough pain, NRS-11 score of the observation group were significantly lower than those of the control group, QOL score was significantly higher than that of the con- trol group, the difference had statistical significance （ P 〈 0.05 ）,β-EP between the 2 groups had no statistical significance （ P 〉 0.05 ）, while CGRP and PGE2 levels of the observation group were significantly lower than those of the control group, the differ- ence was significant （ P 〈 0.05 ）. The adverse reactions rate between the 2 groups was not statistical different （ P 〉 0.05 ）. Conclusion Morphine combined with dexamethasone can significantly reduce the frequency breakthrough pain, improve analgesic effect and patients＇ life quality by significantly reducing CGRP, PGE2 levels, it＇ s worthy of clinical application.