盐酸羟考酮缓释片联合加巴喷丁治疗老年癌性神经病理性疼痛的回顾性研究

Clinical effect of oxycodone hydrochloride sustained-release tablets combined with gabapentin in treatment of cancerous neuropathic pain in elderly cancer patients：A retrospective study

摘要:

目的：观察盐酸羟考酮缓释片联合加巴喷丁治疗老年癌性神经病理性疼痛的镇痛效果。方法：回顾性分析60例在院接受羟考酮单药或联合加巴喷丁镇痛治疗14 d以上、合并中度以上癌性神经病理性疼痛的老年患者的临床疗效及安全性。比较2组各30例患者在给药后3、7、14 d时盐酸羟考酮缓释片的用量、镇痛效果和生活质量，观察2组患者的不良反应。结果：联合用药组盐酸羟考酮缓释片在3、7、14 d的日均用量均低于单药组（P<0.05）；2组治疗后疼痛均有不同程度缓解，联合用药组优于单药组（P<0.05）；2组患者治疗后各时间点的各项生活质量评分较治疗前均有明显改善，其中日常活动、情绪、睡眠及生活乐趣4个方面的评分，联合用药组与单药组组间差异明显（P<0.05），行走能力、日常工作、与他人的关系3个方面组间差异不明显（P>0.05）；联合用药组便秘及恶心、呕吐的发生率低于单药组（P<0.05），头晕、嗜睡的不良反应高于单药组（P>0.05）。结论：盐酸羟考酮缓释片联合加巴喷丁能有效控制老年患者癌性神经病理性疼痛，可减少羟考酮的用量，降低其不良反应，提高患者的生活质量，值得在临床推广应用。

Abstract:

Objective：To investigate the analgesic effect of oxycodone hydrochloride sustained-release tablets combined with gabapentin in the treatment of cancerous neuropathic pain in elderly cancer patients. Methods：A retrospective analysis was performed for the clinical outcome and safety of 60 elderly patients with moderate or above cancerous neuropathic pain who were treated with oxycodone hydrochloride sustained-release tablets alone or combined with gabapentin for more than 14 days in our hospital. There were 30 patients in the combination group and 30 in the monotherapy group，and the two groups were compared in terms of the dose of oxycodone hydrochloride sustained-release tablets，analgesic effect，and quality of life on days 3，7，and 14 of treatment. Adverse reactions were observed for both groups. Results：On days 3，7，and 14 of treatment，the combination group had a significantly lower average daily dose of oxycodone hydrochloride than the monotherapy group（P<0.05）. Both groups had a certain degree of pain relief after treatment，and the combination group had significantly greater pain relief than the monotherapy group（P<0.05）. Both groups had significant improvements in the scores of each item of quality of life at each time point after treatment，and there were significant dif－ferences in the scores of daily activities，mood，sleep，and the pleasures of life between the two groups（P<0.05），while there were no significant differences in walking ability，daily work，and relationship with others between the two groups（P>0.05）. Compared with the monotherapy group，the combination group had significantly lower incidence rates of constipation，nausea，and vomiting（P<0.05） and higher incidence rates of dizziness and somnolence（P>0.05）. Conclusion：In elderly cancer patients with cancerous neuropathic pain，oxycodone hydrochloride sustained-release tablets combined with gabapentin can effectively control the pain，reduce the dose of oxycontin hydrochloride and adverse reactions，and improve their quality of life. Therefore，it holds promise for clinical application.