CAJ | 학술논문

目的：探讨氟哌噻吨-美利曲辛片联合非甾体抗炎药对中青年女性乳腺癌保留乳房术后慢性疼痛的疗效。方法纳入2011年3月至2012年9月在本院行乳腺癌保留乳房手术的中青年女性患者120例,患者术后均有不同程度的慢性疼痛,综合医院焦虑抑郁测定表( HAD)评分为8~15分。随机数字表法分为治疗组(n=60)及对照组(n=60),对照组采用非甾体抗炎药布洛芬缓释胶囊(芬必得,0．3 g,每日2次),治疗组采用芬必得联合氟哌噻吨-美利曲辛片(1片,每日2次),疗程8周,分别于入组时、治疗4周和8周后进行疼痛模拟评分( VAS)。采用HAD进行情绪障碍评分以及采用匹茨堡睡眠质量指数( PSQI)进行睡眠质量评分。计量资料的比较采用t检验、重复测量的方差分析,率的比较采用χ2检验。结果治疗4周和8周后治疗组疼痛VAS评分显著降低(F=8．337, P=0．002),有效率高于对照组(38．33%比20．00%,χ2=4．881,P=0．027；70．00%比36．67%,χ2=13．393,P=0．000)；治疗组焦虑及抑郁指数明显降低(F=16．825, P=0．000；F=10．026, P=0．000),且均低于对照组(F=6．074, P=0．033；F=4．221, P=0．172)；治疗组PSQI下降(F=8．681, P=0．001),两组差异无统计学意义(F=3．587, P=0．284)。结论氟哌噻吨-美利曲辛片联合非甾体抗炎药治疗中青年女性乳腺癌保留乳房术后慢性疼痛疗效优于单纯非甾体抗炎药,且伴有情绪及睡眠质量改善。
목적：탐토불고새둔-미리곡신편연합비치체항염약대중청년녀성유선암보류유방술후만성동통적료효。방법납입2011년3월지2012년9월재본원행유선암보류유방수술적중청년녀성환자120례,환자술후균유불동정도적만성동통,종합의원초필억욱측정표( HAD)평분위8~15분。수궤수자표법분위치료조(n=60)급대조조(n=60),대조조채용비치체항염약포락분완석효낭(분필득,0．3 g,매일2차),치료조채용분필득연합불고새둔-미리곡신편(1편,매일2차),료정8주,분별우입조시、치료4주화8주후진행동통모의평분( VAS)。채용HAD진행정서장애평분이급채용필자보수면질량지수( PSQI)진행수면질량평분。계량자료적비교채용t검험、중복측량적방차분석,솔적비교채용χ2검험。결과치료4주화8주후치료조동통VAS평분현저강저(F=8．337, P=0．002),유효솔고우대조조(38．33%비20．00%,χ2=4．881,P=0．027；70．00%비36．67%,χ2=13．393,P=0．000)；치료조초필급억욱지수명현강저(F=16．825, P=0．000；F=10．026, P=0．000),차균저우대조조(F=6．074, P=0．033；F=4．221, P=0．172)；치료조PSQI하강(F=8．681, P=0．001),량조차이무통계학의의(F=3．587, P=0．284)。결론불고새둔-미리곡신편연합비치체항염약치료중청년녀성유선암보류유방술후만성동통료효우우단순비치체항염약,차반유정서급수면질량개선。
Objective To investigate the efficacy of Flupentixol and Melitracen tablets ( Deanxit ) combined with non-steroidal anti-inflammatory drug in young and middle-aged patients with chronic postoperative pain after breast-conserving surgery of breast cancer. Methods Totally 120 patients undergoing breast-conserving surgery in our hospital from March 2011 to September 2012 were enrolled and randomly divided into treatment group ( n=60 ) and control group ( n=60 ) . All patients had chronic pain to different degree, with the scores of 8-15 by the hospital anxiety and depression( HAD) scale. Control group was treated with nonsteroidal anti-inflammatory drug Ibuprofen sustained release capsules ( Fenbid, 0. 3 g, bid ) , while treatment group took Fenbid plus Flupentixol and Melitracen tablets (1 tablet, bid). The treatment lasted for 8 weeks. At 0, 4, 8 weeks after treatment, the postoperative pain, emotional disorder and sleep quality were assessed using visual analogue scale( VAS) , HAD scale, and Pittsburgh sleep quality index ( PSQI) . The t test and repeated analysis of variance were used to compare measurement data, chi-square test was used to compare the rates. Results At 4 weeks and 8 weeks after treatment, in treatment group, VAS showed a significant improvement (F=8. 337, P=0. 002), the effective rate was higher than that in control group (38. 33% vs 20. 00%,χ2=4. 881,P=0. 027;70. 00% vs 36. 67%, χ2=13. 393,P<0. 001); the indexes of anxiety and depression were significantly reduced (F=16. 825, P<0. 001; F=10. 026, P<0. 001), and both were lower than those in control group (F=6. 074, P=0. 033;F=4. 221, P=0. 172);PSQI was decreased (F=8. 681, P=0. 001), but the difference was not statistically significant between two groups (F=3. 587, P=0. 284). Conclusion Flupentixol and Melitracen tablets combined with non-steroidal anti-inflammatory drug show a better efficacy than non-steroidal anti-inflammatory drug used alone in the treatment of chronic pain after breast-conserving surgery in young and middle-aged patients with breast cancer, accompanied by the improvement of emotion and sleep quality.