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目的观察羟考酮联合加巴喷丁用于癌痛患者的镇痛效果及患者满意度。方法选择60例疼痛视觉模拟量表(VAS)评分7分以上的癌痛患者经吗啡滴定后随机分为两组,每组30例。对照组给予羟考酮的基础上加服安慰剂,试验组给予羟考酮的基础上加服加巴喷丁。观察比较患者服药前后VAS评分,及服药后1周和1、3、6个月羟考酮的日剂量、日止痛药费用、生活质量评分。结果 1个月后,两组患者羟考酮日均剂量差异无显著意义(P>0.05);3个月后,对照组羟考酮日均剂量显著高于试验组[(58.0±15.2)mg vs.(33.4±11.0)mg,P<0.001];试验组日均止痛药费用则明显低于对照组[(34.5±10.2)元vs.(52.4±13.7)元,P<0.01];两组患者服药后各时间点生活质量评分均较治疗前增加(P<0.05);试验组3个月后和6个月后生活质量评分均高于对照组(分别为46.8±4.5 vs.43.5±4.6,P=0.007和46.5±4.8 vs.41.4±4.3,P<0.001)。两组患者嗜睡和头晕的发生率相似(P>0.05),而对照组恶心、呕吐(P=0.038)和便秘(P<0.001)的发生率显著高于试验组。结论重度癌痛患者采用羟考酮联合加巴喷丁有利于控制疼痛,降低羟考酮的用量,减少止痛药物费用,并且有利于减少恶心、呕吐和便秘的发生率,改善生活质量。
Objective To observe the analgesic effect and patient satisfaction of oxycodone combined with gabapentin in patients with cancer pain. Methods Sixty patients with cancer pain who score more than 7 points on the pain visual analog scale (VAS) were randomly divided into two groups (n = 30 in each group). The control group was given oxycodone plus placebo, and the test group was given oxycodone plus gabapentin. The VAS scores of patients before and after taking the drug were compared, and the daily dose of oxycodone, the cost of painkillers, and the quality of life score of 1, and 6 months after taking the drugs were compared. Results After 1 month, the average daily dose of oxycodone in both groups had no significant difference (P> 0.05). After 3 months, the average daily dose of oxycodone in the control group was significantly higher than that in the experimental group [(58.0 ± 15.2) mg (33.4 ± 11.0) mg, P <0.001]. The daily pain medication cost in the experimental group was significantly lower than that in the control group [(34.5 ± 10.2) vs. 52.4 ± 13.7 (P <0.01] The quality of life scores of patients at various time points after treatment were significantly higher than those before treatment (P <0.05). The quality of life scores of patients in trial group after 3 months and 6 months were higher than those in control group (46.8 ± 4.5 vs.43.5 ± 4.6 , P = 0.007 and 46.5 ± 4.8 vs.41.4 ± 4.3, P <0.001). The incidence of lethargy and dizziness were similar in both groups (P> 0.05), while the incidence of nausea and vomiting (P = 0.038) and constipation (P <0.001) in the control group was significantly higher than that in the experimental group. Conclusion Oxycodone combined with gabapentin is effective in controlling pain, reducing the dosage of oxycodone, reducing the cost of analgesics, and reducing the incidence of nausea, vomiting and constipation and improving the quality of life.