摘要
目的 比较盐酸氢吗啡酮与盐酸吗啡注射液治疗难治性癌痛的效果。方法 将160例难治性癌痛患者按照随机数字表法分为研究组与对照组,各80例,研究组给予盐酸氢吗啡酮治疗,对照组给予盐酸吗啡注射液治疗。治疗前后比较两组血清一氧化氮、β-内啡肽、前列腺素E_(2)、5-羟色胺水平,比较两组Ramesay镇静量表、视觉模拟评分法及舒适度评分量表评分,比较两组疼痛缓解情况及不良反应发生情况。结果 治疗后两组一氧化氮、前列腺素E_(2)、5-羟色胺水平较治疗前显著降低(P<0.01),β-内啡肽水平较治疗前显著升高(P<0.01),研究组较对照组变化更显著(P<0.01);治疗后两组Ramesay镇静量表及舒适度评分量表评分均显著高于治疗前(P<0.01),视觉模拟评分法评分显著低于治疗前(P<0.01),研究组较对照组变化更显著(P<0.01)。研究组疼痛总缓解率显著高于对照组(P<0.01),两组不良反应发生率比较差异无统计学意义(P>0.05)。结论 盐酸氢吗啡酮治疗难治性癌痛的镇静及镇痛效果较盐酸吗啡注射液更好,可以有效调节疼痛指标水平,缓解疼痛,安全性高,值得临床应用。
Objective To compare the effects of hydromorphone hydrochloride and morphine hydrochloride injection in the treatment of refractory cancer pain.Methods A total of 160 patients with refractory cancer pain were divided into study group and control group according to random number table method,with 80 cases in each group.The study group was treated with hydromorphone hydrochloride,and the control group was treated with morphine hydrochloride injection.The levels of serum nitric oxide(NO),beta-endorphin(β-EP),prostaglandin E_(2)(PGE_(2))and serotonin(5-HT)were compared between the two groups before and after treatment.The Ramsay sedation scale,visual analogue scale(VAS)and Bruggrmann comfort scale(BCS)were compared between the two groups,and the pain relief and adverse reactions were compared between the two groups.Results After treatment,the levels of NO,PGE_(2) and 5-HT in the two groups were significantly lower than those before treatment(P<0.01),and the levels ofβ-EP were significantly higher than those before treatment(P<0.01).The changes in the study group were more significant than those in the control group(P<0.01).After treatment,the Ramsay sedation scale and BCS scores of the two groups were significantly higher than those before treatment(P<0.01),and the VAS scores were significantly lower than those before treatment(P<0.01).The changes in the study group were more significant than those in the control group(P<0.01).The total pain relief rate in the study group was significantly higher than that in the control group(P<0.01),and there was no significant difference in the incidence of adverse reactionsbetween the two groups(P>0.05).Conclusions Hydromorphone hydrochloride has better sedative and analgesic effects than morphine hydrochloride injection in the treatment of refractory cancer pain.It can effectively regulate the level of pain indicators, relieve pain, and has high safety. It is worthy of clinical application.
作者
马英梅
苏培培
李明峰
Ma Yingmei;Su Peipei;Li Mingfeng(The First Affiliated Hospital of Henan University,Kaifeng 475001,Henan,China)
出处
《临床心身疾病杂志》
CAS
2022年第5期128-131,共4页
Journal of Clinical Psychosomatic Diseases
基金
开封市科技发展计划项目(编号2103022)。
关键词
难治性癌痛
盐酸氢吗啡酮
盐酸吗啡注射液
镇静
镇痛
refractory cancer pain
hydromorphone hydrochloride
morphine hydrochloride injection
sedation
analgesia
