普瑞巴林联合盐酸羟考酮缓释片、复方苦参注射液治疗神经病理性癌症疼痛患者临床观察

Clinical Observation of Pregabalin Combined with Oxycodone Hydrochloride Sustained-release Tablets and Compound Matrine Injection in the Treatment of Patients with Neuropathic Cancer Pain

目的评价普瑞巴林与盐酸羟考酮缓释片联合复方苦参注射液在治疗癌性神经病理性疼痛(malignant neuropathic pain,MNP)的疗效及不良反应。方法选取2019年3月—2021年4月66例疼痛评分大于等于4分的MNP患者,根据随机数字排列表方法将其随机分为:A组:盐酸羟考酮缓释片30 mg,q12 h口服,B组:盐酸羟考酮缓释片30 mg,q12 h口服,联合普瑞巴林口服,至最大剂量300 mg/d。C组:盐酸羟考酮缓释片30 mg,q12 h口服,联合普瑞巴林口服,至最大剂量300 mg/d,并配合给予复方苦参注射液20 mL,qd,iv。观察3组患者疼痛控制情况,不良反应情况、生活质量及睡眠改善情况。结果C组疼痛控制比A组明显改善(χ^(2)=7.333,P=0.007),C组的生活质量比A组明显改善(t=13.803,P=0.0001),睡眠质量改善明显(t=8.340,P=0.0001),在不良事件中,C组的不良事件明显少于A组(χ^(2)=7.333,P=0.007)。结论C组疗效优于A组,睡眠质量和生活质量皆有明显改善,且不良事件发生更少。普瑞巴林联合盐酸羟考酮缓释片及复方苦参注射液治疗控制疼痛效果较好,优于单用阿片类药物。

Objective To evaluate the efficacy and adverse reactions of pregabalin,oxycodone hydrochloride sustained-release tablets and compound Matrine injection in the treatment of cancerous neuropathic pain(MNP).Methods A total of 66 MNP patients with pain score greater than or equal to 4 from March 2019 to April 2021 were selected and randomly divided into:Group A:Oxycodone hydrochloride sustained release tablets 30mg,Q12H orally;group B:Oxycodone hydrochloride sustained release tablet 30mg,q12h oral,combined with pregabalin oral,to the maximum dose of 300mg/day.Group C:oxycodone hydrochloride sustained release tablet 30mg,q12h oral,combined with pregabalin oral,to the maximum dose of 300mg/day,and combined with compound matrine injection 20mL,qd,iv.The pain control,adverse reactions,quality of life and sleep improvement of the three groups were observed.Results Pain control was significantly improved in group C(χ^(2)=7.333,P=0.007),quality of life was significantly improved in group C(t=13.803,P=0.0001),and sleep quality was significantly improved in group C(t=8.340,P=0.0001).The adverse events in group C were significantly less than those in group A(χ^(2)=7.333,P=0.007).Conclusion The efficacy of group C is better than that of group A,and the quality of sleep and life are significantly improved,and the occurrence of adverse events is less.Pregabalin combined with oxycodone hydrochloride sustained-release tablets and compound matrine injection has a better effect on pain control than opioids alone.