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目的观察吗啡联合加巴喷丁治疗中重度神经病理性癌痛的临床效果。方法 118例中晚期恶性肿瘤患者,患者最初单独使用吗啡进行治疗,2周后改用吗啡联合加巴喷丁治疗,观察疼痛缓解情况及不良反应。结果单用吗啡治疗前疼痛数字评分法(NRS)评分为4~10分,平均评分(8.01±1.58)分;单用吗啡治疗后,NRS评分为2~7分,平均评分(5.56±1.43)分;在吗啡联合加巴喷丁用药治疗后,NRS评分为0~3分,平均评分(1.92±0.66)分。吗啡联合加巴喷丁用药治疗后NRS评分明显低于未用吗啡治疗前,差异有统计学意义(P<0.01)。30例(25.4%)患者可以达到完全缓解,而81例(68.6%)患者可达部分缓解,仅7例(5.9%)患者并未明显缓解疼痛。在单用吗啡治疗时,多数患者出现便秘,部分患者出现消化道不良反应,而在联合用药后,不良反应并未出现加重的情况。结论吗啡联合加巴喷丁治疗中重度神经病理性癌痛较单用吗啡治疗具有更好的缓解癌痛的疗效。
Objective To observe the clinical effect of morphine and gabapentin in the treatment of moderate and severe neuropathic pain. Methods A total of 118 patients with advanced malignant tumor were treated with morphine for the first time. After 2 weeks, they were treated with morphine plus gabapentin, and pain relief and adverse reactions were observed. Results The score of NRS before morphine alone was 4 to 10 points (mean 8.01 ± 1.58). After treatment with morphine alone, the NRS score was 2 to 7 with an average score of 5.56 ± 1.43 Points; in the morphine plus gabapentin treatment, NRS score was 0 to 3, the average score (1.92 ± 0.66) points. The NRS scores of morphine plus gabapentin were significantly lower than those before morphine treatment (P <0.01). Thirty (25.4%) patients achieved complete remission, whereas 81 (68.6%) achieved partial remission and only 7 (5.9%) did not significantly relieve pain. In the treatment of morphine alone, the majority of patients with constipation, some patients with gastrointestinal adverse reactions, and in combination, the adverse reactions did not appear aggravated. Conclusion The combination of morphine and gabapentin in the treatment of moderate-severe neuropathic cancer pain has better curative effect on relieving cancer pain than single morphine treatment.