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目的:探讨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及其对免疫功能的影响。方法:选择2015年6月至2016年7月在我院治疗的癌性神经病理性疼痛患者80例,随机分为两组,每组40例。A组患者接受奥施康定抗痛治疗,B组患者在A组基础上联合加巴喷丁治疗。比较两组患者治疗前后VAS疼痛评分以及癌痛缓解的临床疗效,评价两组患者治疗后的生活质量评分和各项免疫指标的变化情况。结果:两组患者治疗后VAS评分均较治疗前显著降低(P<0.05),且B组患者的VAS评分明显低于A组(P<0.05),B组患者治疗后疼痛总缓解率显著高于A组(P<0.05)。两组患者治疗后的食欲、精神状态、睡眠、日常生活以及人际交往等评分均较治疗前显著降低(P<0.05),且B组患者降低的程度显著高于A组(P<0.05)。两组患者的免疫球蛋白G(IgG)、免疫球蛋白A(IgA)、免疫球蛋白M(IgM)、CD4~+、CD4~+/CD8~+以及循环免疫复合物(CIC)水平均较治疗前显著上升(P<0.05),且B组患者以上指标升高的程度显著高于A组(P<0.05)。结论:奥施康定联合加巴喷丁缓解神经病理性癌痛临床疗效显著,并可改善患者的免疫功能,提高其生活质量。
Objective: To investigate the clinical efficacy of OxyContin and gabapentin in the treatment of malignant neuropathic pain and its effect on immune function. Methods: 80 patients with malignant neuropathic pain who were treated in our hospital from June 2015 to July 2016 were randomly divided into two groups of 40 cases each. A group of patients receiving OxyContin anti-pain treatment, B group of patients in the A group on the basis of gabapentin treatment. The VAS pain scores and the clinical efficacy of pain relief before and after treatment were compared between the two groups, and the quality of life scores and the changes of various immune indexes after treatment were evaluated. Results: The VAS score of both groups after treatment was significantly lower than that before treatment (P <0.05), and the VAS score of group B was significantly lower than that of group A (P <0.05). The total pain relief rate of group B was significantly higher after treatment In group A (P <0.05). The scores of appetite, mental status, sleep, daily life and interpersonal communication after treatment in both groups were significantly lower than those before treatment (P <0.05), and those in group B were significantly lower than those in group A (P <0.05). The levels of IgG, IgA, IgM, CD4 ~ +, CD4 ~ + / CD8 ~ +, and circulating immune complex (CIC) in both groups were significantly higher than those in the control group (P <0.05), and the above indexes in group B were significantly higher than that in group A (P <0.05). Conclusion: Oxaliplatin combined with gabapentin can relieve the neuropathic pain. The clinical curative effect is significant, and it can improve the immune function and improve the quality of life.