CAJ | 학술논문

目的观察奥施康定联合加巴喷丁治疗癌性神经病理性疼痛的临床疗效.方法 63例癌性神经病理性疼痛患者随机分为A、B、C3组,每组21例.A、B、C组患者分别给予奥施康定、加巴喷丁、奥施康定联合加巴喷丁进行止痛治疗,比较3组患者治疗前后癌痛程度的改变、毒副反应、生活质量和免疫功能各项指标.结果与治疗前相比,A、B、C3组患者的癌痛评分(NRS评分)均有不同程度的下降,生活质量(QOL、KPS评分)有所升高(F组内分别为375.852、154.612、151.838,P组内均＜0.05);3组患者的免疫功能(CD3、CD4、CD4/CD8、NK细胞)均有不同程度的改善(F组内分别为158.935、108.145、366.973、92.090,P组内均＜0.05).治疗后C组患者NRS评分低于A、B组[NRS:(2.00±0.86)分与(3.35±0.67)分、(4.05±0.94)分],C组QOL、KPS评分高于A、B组[QOL:(44.80±6.07)分与(37.35±5.71)分、(35.85±5.90)分,KPS: (84.50±6.05)分与(74.50±10.99)分、(72.00±8.34)分],3组比较差异均有统计学意义(F组间分别为3.25、10.499、3.465,P组间均＜0.05);C组免疫指标CD3、CD4、CD4/CD8、NK值均高于A、B组[CD3:(72.94±5.63)％与(62.84±5.27)％、(62.22±8.10)％,CD4: (41.52±4.19)％与(33.84±5.40)％、(33.19±6.90)％, CD4/CD8: 1.86±0.30与1.35±0.37、1.32±0.41, NK:(27.57±6.86)％与(20.49±6.67)％、(20.32±5.63)％,],3组比较差异均有统计学意义(F组间分别为3.377、3.344、3.352、3.386,P组间均＜0.05).C组副作用轻于A、B组.结论奥施康定联合加巴喷丁治疗癌性神经病理性疼痛疗效显著.
목적 관찰오시강정연합가파분정치료암성신경병이성동통적림상료효.방법 63례암성신경병이성동통환자수궤분위A、B、C3조,매조21례.A、B、C조환자분별급여오시강정、가파분정、오시강정연합가파분정진행지통치료,비교3조환자치료전후암통정도적개변、독부반응、생활질량화면역공능각항지표.결과 여치료전상비,A、B、C3조환자적암통평분(NRS평분)균유불동정도적하강,생활질량(QOL、KPS평분)유소승고(F조내분별위375.852、154.612、151.838,P조내균＜0.05);3조환자적면역공능(CD3、CD4、CD4/CD8、NK세포)균유불동정도적개선(F조내분별위158.935、108.145、366.973、92.090,P조내균＜0.05).치료후C조환자NRS평분저우A、B조[NRS:(2.00±0.86)분여(3.35±0.67)분、(4.05±0.94)분],C조QOL、KPS평분고우A、B조[QOL:(44.80±6.07)분여(37.35±5.71)분、(35.85±5.90)분,KPS: (84.50±6.05)분여(74.50±10.99)분、(72.00±8.34)분],3조비교차이균유통계학의의(F조간분별위3.25、10.499、3.465,P조간균＜0.05);C조면역지표CD3、CD4、CD4/CD8、NK치균고우A、B조[CD3:(72.94±5.63)％여(62.84±5.27)％、(62.22±8.10)％,CD4: (41.52±4.19)％여(33.84±5.40)％、(33.19±6.90)％, CD4/CD8: 1.86±0.30여1.35±0.37、1.32±0.41, NK:(27.57±6.86)％여(20.49±6.67)％、(20.32±5.63)％,],3조비교차이균유통계학의의(F조간분별위3.377、3.344、3.352、3.386,P조간균＜0.05).C조부작용경우A、B조.결론 오시강정연합가파분정치료암성신경병이성동통료효현저.
Objective To observe the effect of Oxycontin combined with Gabapentin for treatment of malignant neuropathic pain.Methods Sixty-three cases of malignant neuropathic pain in Jinshan Hospital Affiliated to Fudan University were randomly divided into group A, B and C.Patients of which were given Oxycontin, Gabapentin, Oxycontin combined with Gabapentin respectively for pain treatment.The analgesic effects, toxic reaction side effects, quality of life, and immune function were all compared in three groups.Results Compared with pretherapy, the cancer pain score (NRS), quality of life (QOL) and karnofsky performance status(KPS) scores in all groups were changed significantly after drugs therapy(F=375.852,154.612, 151.838,P＜0.05).The levels of CD3,CD4, CD4/CD8 and NK cells in all groups were higher than before therapy(F=158.935,108.145,366.973,92.090,P＜0.05).After treatment,the NRS, QOL and KPS scores in group C were 2.00± 0.86,44.80± 6.07, 84.50± 6.05, in group A were 3.35 ± 0.67,37.35 ± 5.71,74.50 ±10.99,and in group B were 4.05±0.94,35.85±5.90,72.00±8.34, and the different were significant (F =3.250,10.499,3.465,P＜0.05).The levels of CD3, CD4, CD4/CD8and NK cells in group C were (72.94 ±5.63)％,(41.52±4.19)％, 1.86±0.30, (27.57±6.86)％,in group A were (62.84±5.27)％, (33.84 ±5.40)％,1.35±0.37, (20.49±6.67) ％,and in group B were (62.22±8.10)％, (33.19±6.90)％, 1.32 ± ±0.41, (20.32±5.63) ％, and the different were significant (F =3.377,3.344,3.352,3.386, P＜ 0.05).The patient in group C had less adverse effects than those in group A and B.Conclusion Oxycontin and Gabapentin in treatment of malignant neuropathic pain is effective.