双氯芬酸钠盐酸利多卡因联合山莨菪碱对骨折疼痛患者的镇痛疗效及安全性评价

Pain analgesic efficacy of diclofenac sodium and lidocaine hydrochloride combined with anisodamine in treatment of patients with bone fractures and evaluation of its safety

目的探讨双氯芬酸钠盐酸利多卡因联合山莨菪碱对骨折疼痛患者镇痛疗效及安全性。方法收集海南省海口市人民医院收治的急性骨折患者54例,随机分为对照组和实验组,每组各27例,对照组给予双氯芬酸钠盐酸利多卡因镇痛,实验组在对照组基础上给予山莨菪碱镇痛,治疗前30 min和治疗2 h后,对所有患者的血浆5-羟色胺(5-hydroxytryptamine,5-HT)、前列腺素E2(prostaglandin E2,PGE2)含量、镇痛效果、耐受性及不良反应情况进行检测。结果治疗后,与对照组比较,实验组患者的血浆5-HT含量均明显较低(P<0.05),实验组患者的血浆PGE2含量较低(P<0.05);实验组患者疼痛分级指数(pain rating index,PRI)的总分、感觉分、情绪分及现有疼痛强度(present pain intensity,PPI)、疼痛视觉模拟评分(visual analogue scale,VAS)均明显较低(P<0.05)。实验组患者的不良反应耐受性(92.59%)明显高于对照组(66.67%)(χ2=5.59,P<0.05)。结论双氯芬酸钠盐酸利多卡因联合山莨菪碱能够明显降低骨折疼痛患者血浆5-HT和PGE2,提高镇痛效果,减少不良反应的发生,患者耐受性较好。

Objective To analyse the pain analgesic efficacy and safety evaluation of diclofenac sodium and lidocaine hydrochloride combined with anisodamine in patients with bone fractures.Methods 54 patients who were diagnosed with acute fracture in the hospital were collected and randomly divided into experimental group and control group, 27 cases in each group, control group was treated with diclofenac sodium and lidocaine hydrochloride, and experimental group was treated with anisodamine on the basis of control group.Before 30 min and 2 h after treatment, the effect of 5-hydroxytryptamine ( 5-HT ), prostaglandin E2 ( PGE2 ), analgesic effect, tolerability and adverse reactions were detected in all patients. ResuIts Compared with control group post treatment, the plasma 5-HT content was significantly lower in experimental group ( P<0.05 ); the plasma PGE2 content in experimental group was significantly lower (P<0.05); the pain rating index (PRI) total score,PRI feel score, PRI emotion score, present pain intensity (PPI) and visual analogue scale (VAS) in experimental group was significantly lower (P<0.05).The tolerance of experimental group was 92.59%, which was significantly higher than 66.67% of control group (χ2 =5.59,P<0.05).ConcIusion Diclofenac sodium and lidocaine hydrochloride combined with anisodamine could significantly decrease 5-HT and PGE2 in patients with fracture pain, enhance the analgesic effect, reduce the incidence of adverse reactions, with a good tolerance, which have the guiding significance on clinical therapy.