帕瑞昔布钠给药方式对晚期癌痛患者镇痛效果及相关激素水平的影响

Effects of parecoxib sodium administration on analgesic efficacy and relevant hormone levels in patients with advanced cancer pain

目的 探讨帕瑞昔布钠给药方式对晚期癌痛患者镇痛效果及疼痛相关激素水平的影响分析。方法 选取2018年3月至2021年3月辽宁省大连市中心医院收治的行常规抗癌治疗的98例晚期癌痛患者为研究对象,采用随机数表法分为研究组和对照组,每组49例。对照组患者给予常规静脉注射帕瑞昔布钠治疗,研究组给予鞘内注射帕瑞昔布钠给药治疗。比较两组患者治疗前后视觉模拟评分(VAS)、卡氏评分(KPS)差异,检测血清5-羟色胺(5-HT)、前列腺素E_(2)(PGE_(2))、一氧化氮(NO)、皮质醇(Cor)、泌乳素(PRL)及生长激素(GH)等应激激素水平,统计治疗期间并发症发生情况,综合分析临床疗效。结果 研究组VAS评分总有效率为93.9%显著高于对照组79.6%,差异有统计学意义(P<0.05)。研究组KPS评分总有效率为95.9%显著高于对照组83.7%,差异有统计学意义(P<0.05)。治疗2个月后,两组患者的各项血清水平均明显降低,且研究组较对照组更低,差异均有统计学意义(均P<0.05)。研究组不良反应总发生率为12.2%较对照组38.8%明显偏低,差异有统计学意义(P<0.05)。结论 通过鞘内注射帕瑞昔布钠给药方式治疗晚期癌痛患者的临床疗效显著,较常规静脉注射给药镇痛效果更佳,可有效降低疼痛相关激素水平,值得推广。

Objective To explore the effects of parecoxib sodium administration on analgesic efficacy and the level of pain related hormones in patients with advanced cancer pain. Methods A total of 98 patients with advanced cancer pain who received routine anti-cancer treatment were included at Dalian Central Hospital from March 2018 to March 2021. They were divided into an experimental group and a control group using the random number table with 49 patients in each group. Patients in the experimental group received intrathecal parecoxib sodium injection and the control group received routine intravenous parecoxib sodium. The visual analogue scale(VAS) and Karnofsky performance status(KPS) scores were compared between the two groups before and after the treatment. The serum levels of 5-hydroxytryptamine(5-HT), prostaglandin E_(2)(PGE_(2)), nitric oxide(NO), cortisol(Cor), prolactin(PRL), growth hormone(GH) and other stress hormones were detected. The complications during the treatment were estimated and the clinical efficacy was comprehensively analyzed. Results The overall efficacy rate of VAS score was 93.9% in the experimental group, which was higher than 79.6% of the control group(P<0.05). The overall efficacy rate of KPS score was 95.9%in the experimental group, which was significantly higher than 83.7% of the control group(P<0.05). At 2 months after the treatment, serum levels were significantly low in both groups and lower in the experimental group than in the control group(all P<0.05). The overall incidence rate of adverse reactions was 12.2% in the experimental group, which was significantly lower than 38.8% of the control group(P<0.05). Conclusion Intrathecal parecoxib sodium injection shows significant clinical efficacy in the treatment of advanced cancer pain, and has a better analgesic efficacy than conventional intravenous administration. It can effectively reduce the levels of pain related hormones, and is worthy of promotion.