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[目的]观察硫酸吗啡缓释片联合氟哌噻吨美利曲辛片治疗癌性疼痛的效果。[方法]44例晚期癌痛患者随机分为单药组和联合组,每组22例。单药组每12h口服硫酸吗啡缓释片30mg1次;联合组每12h口服硫酸吗啡缓释片30mg1次,每天口服氟哌噻吨美利曲辛片1片。用数字疼痛评估法(NRS)记录疼痛评分,根据综合性医院焦虑抑郁(HAD)情绪测定表评价患者焦虑抑郁情况。观察21d,评价两组患者疼痛缓解率、疼痛评分、硫酸吗啡缓释片使用剂量、不良反应及焦虑抑郁情况。[结果]两组治疗后各级癌痛缓解率、硫酸吗啡缓释片平均使用剂量以及各不良反应发生率均无显著性差异(P>0.05)。治疗后联合组焦虑/抑郁评分分别为8.19±1.94和9.29±2.10,均较单药组的10.80±2.12和11.85±2.28低,均有统计学差异(P<0.01)。[结论]硫酸吗啡缓释片联合氟哌噻吨美利曲辛片能进一步改善癌痛患者焦虑抑郁状况,氟哌噻吨美利曲辛片未减少硫酸吗啡缓释片治疗癌痛的剂量。
[Objective] To observe the effect of morphine sulfate sustained-release tablets combined with flupentixol and melitracen tablets in the treatment of cancer pain. [Method] Forty-four patients with advanced cancer pain were randomly divided into single drug group and combination group, with 22 patients in each group. The monotherapy group was treated with oral morphine sulfate 30mg once every 12h. The combination group was treated with oral morphine sulfate 30mg once daily for 12h, and oral chlorpheniramine hydrochloride 1 tablet daily. Pain scores were recorded using the Digital Nerve Assessment (NRS) and anxiety and depression were assessed according to the General Hospital Anxiety Depression (HAD) Emotional Table. After 21 days of observation, the pain relief rate, pain score, dosage of morphine sulfate sustained-release tablets, adverse reactions and anxiety and depression were evaluated. [Results] The rates of cancer pain relief, the average dosage of morphine sulfate sustained release tablets and the incidence of adverse reactions were not significantly different between the two groups after treatment (P> 0.05). The scores of anxiety and depression in the combined group after treatment were 8.19 ± 1.94 and 9.29 ± 2.10, respectively, which were significantly lower than those in the single drug group (10.80 ± 2.12 and 11.85 ± 2.28, P <0.01). [Conclusion] Morphine sulfate sustained - release tablets combined with flupentixol and melitracen tablet can further improve the anxiety and depression status in patients with cancer pain. Flupenthixol and melitracen tablets did not reduce the dosage of morphine sulfate sustained - release tablets in the treatment of cancer pain.