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目的观察加巴喷丁对顽固性癌痛患者的镇痛效果。方法 46例癌症患者分别采用吗啡(M组,22例)和吗啡联合加巴喷丁(MG组,24例)镇痛。M组患者根据疼痛VAS评分递加吗啡镇痛;MG组口服加巴喷丁900mg/d的同时再根据镇痛情况服用吗啡。给药1、2、4周时进行VAS疼痛评分及镇痛效果评定,记录吗啡使用剂量及服药4周后的镇痛相关不良反应。结果镇痛期间,两组VAS疼痛评分均低于治疗前(P<0.01),镇痛优良率达79.17%~90.91%。随着治疗时间的延长,M组吗啡用量明显增加(P<0.05或P<0.01),MG组吗啡用量与初始量仅稍有增加(P>0.05)。治疗的第2、4周,MG组吗啡使用量小于M组(P<0.05)。两组治疗相关主要不良反应为便秘、尿潴留、恶心呕吐、皮肤瘙痒和嗜睡等;两组近期不良反应发生率相仿(59.09%vs.62.50%)(P>0.05)。结论复合应用加巴喷丁和吗啡能有效缓解顽固性癌痛,并可以明显减少吗啡需要量。
Objective To observe the analgesic effect of gabapentin on refractory cancer patients. Methods Forty-six cancer patients were treated with morphine (M group, n = 22) and morphine plus gabapentin (n = 24). Patients in group M were given morphine analgesia according to the pain VAS score. In the MG group, gabapentin 900 mg / d was taken while taking morphine according to the analgesic situation. VAS pain scores and analgesic effects were assessed at 1, 2, and 4 weeks after administration, and analgesic-related adverse events were recorded after morphine was administered for 4 weeks. Results During the period of analgesia, VAS pain scores of both groups were lower than before treatment (P <0.01), and the pain relief rate was 79.17% -90.91%. With the prolongation of treatment time, the morphine consumption in M group increased significantly (P <0.05 or P <0.01), and the morphine consumption and initial dose in MG group increased only slightly (P> 0.05). At the second and fourth week of treatment, the morphine consumption in MG group was less than that in M group (P <0.05). The main adverse reactions of the two groups were constipation, urinary retention, nausea and vomiting, pruritus and drowsiness. The incidences of recent adverse reactions in the two groups were similar (59.09% vs.62.50%) (P> 0.05). Conclusion Combined application of gabapentin and morphine can effectively relieve refractory cancer pain, and can significantly reduce the need for morphine.