普瑞巴林联合盐酸吗啡缓释片治疗前列腺癌神经病理性癌痛的临床疗效研究

The Clinical Efficacy of Pregabalin Combined with Morphine Hydrochloride Sustained-release Tablets in the Treatment of MalignantNeuropathic Pain in Prostate Cancer

目的研究普瑞巴林联合盐酸吗啡缓释片治疗前列腺癌神经病理性癌痛的治疗效果以及治疗过程中的安全性。方法选取前列腺癌伴有神经病理性癌痛患者60例,并随机将60例病患分为盐酸吗啡缓释片联合普瑞巴林组(联合组)与单用盐酸吗啡缓释片组(对照组),比较联合组和对照组的患者用药前后疼痛数字评分(NRS)、盐酸吗啡缓释片每日用药剂量、爆发痛每日发作次数、所产生的不良反应和生活质量(QOL)评分等多个方面。结果在采取服用药物治疗后的第2、第4、第8周后,联合组NRS评分低于对照组,差异有统计学意义(P<0.05)。在用药治疗后的第1、第2、第4、第8周,联合组和对照组所表现出的生活质量评分都出现升高情况。同时,对照组生活质量明显逊于联合组,差异有统计学意义(P<0.05)。治疗后4周、8周,联合组盐酸吗啡缓释片人均日剂量低于对照组,差异有统计学意义(P<0.05);治疗后,联合组爆发痛人均日发作次数均少于对照组。联合组所产生的不良反应情况发生率为16.67%(5/30),优于对照组所产生的不良反应情况发生率60.00%(18/30),差异存在统计学意义(P<0.05)。结论联合使用普瑞巴林与盐酸吗啡缓释片可以有效使病患的疼痛评分有所降低,吗啡用量减少,并且抑制了爆发痛次数,患者的生活质量和情绪状态都得到改善,减少不良反应情况的发生。

Objective To study the efficacy and safety of pregabalin combined with morphine hydrochloride sustained-release tablets in the treatment of malignant neuropathic pain in prostate cancer.Methods A total of 60 patients with prostate cancer and malignant neuropathic pain were randomly divided into two groups.The combined group was treated with pregabalin combined with morphine hydrochloride sustained-release tablets,while the control group was treated with morphine hydrochloride sustained-release tablets alone.Numerical pain score(NRS),per-capita daily dose of morphine hydrochloride sustained-release tablets,per-capita daily attack times of fulminant pain,quality of life(QOL)score,and incidence of adverse reactions were compared between the combined and control groups.Results After 2,4 and 8 weeks from the first day of the treatment,NRS score reduced significantly in the combined group and led to a lower score compared with the control group.The variance in NRS score was statistically significant(P<0.05).We also measured QOL score after applying the treatment for 1,2,4 and 8 weeks.In both groups,it increased significantly after treatment,and that of the combined group was higher.The difference of QOL scores between these groups was statistically significant(P<0.05).The per-capita daily dose of morphine hydrochloride sustained-release tablets,after applying the treatment for 4 weeks and 8 weeks in both groups,showed a discrepancy between the combined and control group.That in the combined group was of a much smaller amount than that in the control group(P<0.05).After treatment,the per-capita daily attack times of fulminant pain in the combined group showed an encouraging decrease compared with the control group.The combined group had a 16.67%(5/30)incidence of adverse reactions,which was 2.6 times smaller than the 60.00%(18/30)in the control group(P<0.05).Conclusion The combination of pregabalin and morphine hydrochloride sustained-release tablets can effectively reduce the pain score,the amount of morphine and number of pain episodes,the incidence of adverse reactions,and effectively improve patients’life quality.