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目的探讨氢溴酸高乌甲素联合阿片类药与单独应用阿片药治疗中重度神经病理性癌痛的疗效差别。方法2003年1月至2007年12月间我院肿瘤科收治了63例神经病理性癌疼痛患者,Karnofsky评分50~80分,随机分为两组,其中A组采用氢溴酸高乌甲素联合阿片类镇痛药(32例);B组单用阿片类镇痛药(31例);疼痛评估采用视觉模拟评分法(visual analogue scale,VAS),分析第0、3、10天的变化;评价两组阿片药品的消耗量以及不良反应的发生率。结果A、B组的VAS评分基线值差异无显著性(P=0.452)。从疼痛的缓解程度来看,VAS评分下降程度A组要好于B组,差异有显著性(P<0.05);从阿片类药物的消耗来看,B组明显要多于A组;阿片不良反应B组多于A组(P=0.015)。结论氢溴酸高乌甲素联合阿片类药可以更好地治疗患者神经病理性癌痛,减少了阿片药品的用量,降低了因为阿片药带来的不良反应,是治疗中重度神经病理性癌痛安全有效的办法。
Objective To investigate the difference between the efficacy of lappaconitine hydrobromide combined with opioid and opioid alone in the treatment of moderate-severe neuropathic pain. Methods From January 2003 to December 2007, 63 patients with neuropathic cancer pain were admitted to Department of Oncology in our hospital. Karnofsky score was 50-80, and randomly divided into two groups. Group A was treated with lappaconitine hydrobromide Opioid analgesics (n = 32), opioid analgesics (n = 31) in group B, and visual analogue scale (VAS) Assess both the consumption of opioid drugs and the incidence of adverse reactions. Results There was no significant difference in baseline VAS scores between groups A and B (P = 0.452). From the perspective of the degree of pain relief, the decrease of VAS score in group A was better than that in group B (P <0.05); from the perspective of opioid consumption, group B was significantly more than group A; opioid adverse reactions B group than A group (P = 0.015). Conclusions Lappaconitine hydrobromide combined with opiates can better treat the patients with neuropathic pain, reduce the dosage of opioid, reduce the adverse reaction caused by opioid, and is the treatment of moderate and severe neuropathic pain. Effective way