氨酚羟考酮治疗晚期肺癌骨转移患者爆发性疼痛的疗效及对疼痛介质水平的影响

Efficacy of oxycodone acetaminophen in the treatment of breakthrough pain in patients with bone metastases from advanced lung cancer and its effect on the level of pain mediator

目的探讨氨酚羟考酮治疗晚期肺癌骨转移患者爆发性疼痛的疗效。方法将90例晚期肺癌骨转移患者根据治疗方式的不同分为吗啡组和氨酚羟考酮组,每组45例。吗啡组患者采用吗啡注射液治疗,氨酚羟考酮组患者采用氨酚羟考酮片治疗,两组患者均连续治疗1个月。比较两组患者的疼痛缓解率、疼痛介质水平、炎性因子水平、生活质量以及不良反应发生情况。结果氨酚羟考酮组患者疼痛缓解率高于吗啡组患者,不良反应总发生率低于吗啡组患者,差异均有统计学意义(P<0.05)。治疗后,两组患者血清P物质、前列腺素E_2水平均较治疗前降低,β-内啡肽水平均较治疗前升高,且氨酚羟考酮组患者血清P物质、前列腺素E_2水平均低于吗啡组,β-内啡肽水平高于吗啡组,差异均有统计学意义(P<0.05)。治疗后,两组患者血清肿瘤坏死因子-α和白细胞介素-6水平均较治疗前降低,且氨酚羟考酮组患者血清肿瘤坏死因子-α和白细胞介素-6水平均低于吗啡组,差异均有统计学意义(P<0.05)。治疗后,两组患者生命质量测定量表各维度评分均较治疗前升高,且氨酚羟考酮组患者生命质量测定量表各维度评分均高于吗啡组,差异均有统计学意义(P<0.05)。结论氨酚羟考酮可有效缓解晚期肺癌骨转移患者的爆发性疼痛,调节疼痛介质水平,减轻机体炎症反应,提高生活质量,不良反应较少,安全性较高,值得临床推广应用。

Objective To investigate the efficacy of oxycodone acetaminophen in the treatment of breakthrough pain in patients with bone metastases from advanced lung cancer.Method A total of 90 patients with bone metastases from advanced lung cancer were divided into morphine group and oxycodone acetaminophen group according to different treat-ment methods,with 45 cases in each group.The patients in the morphine group were treated with morphine injection,and the patients in the oxycodone acetaminophen group were treated with oxycodone acetaminophen tablets.Both groups were treated continuously for one month.The pain relief rate,pain mediator levels,inflammatory factor levels,quality of life and adverse events were compared between the two groups.Result The pain relief rate in the oxycodone acetamino-phen group was higher than that in the morphine group,and the total incidence of adverse events was lower than that in the morphine group,and the differences were statistically significant(P<0.05).After the treatment,the levels of serum substance P and prostaglandin E2 in the two groups were lower,and the levels ofβ-endorphin were higher than those be-fore the treatment,moreover,the levels of serum substance P and prostaglandin E2 in the oxycodone acetaminophen group were lower than those in the morphine group,while the level ofβ-endorphin was higher than that in the morphine group,and the differences were statistically significant(P<0.05).After the treatment,the levels of serum tumor necrosis factor-αand interleukin-6 in the two groups were lower than those before the treatment,and the levels of two indicators in the oxy-codone acetaminophen group were lower than those in the morphine group,and the differences were statistically signifi-cant(P<0.05).After the treatment,the scores of each dimension of the quality of life scale in the two groups were higher than those before the treatment,and the above scores in the oxycodone acetaminophen group were higher than those in the morphine group,and the differences were statistically significant(P<0.05).Conclusion Oxycodone acetaminophen could effectively relieve breakthrough pain in patients with bone metastases from advanced lung cancer,regulate the lev-els of pain mediators,reduce the body’s inflammatory response,and improve the quality of life.Moreover,it has less ad-verse events with higher safety,and is worthy of clinical promotion and application.