单用吗啡与联合用药治疗晚期癌痛的疗效观察(1)
【摘要】 目的：探讨吗啡和阿米替林、异丙嗪在三阶梯止痛中的作用。方法：选取笔者所在科室2012年6月-2013年6月收治的106例晚期癌症疼痛患者，根据用药情况将所有患者分为单用吗啡组(A组)35例、吗啡联合阿米替林组(B组)35例和吗啡联合用异丙嗪(C组)36例。三组患者治疗前与治疗后6周采用VAS评分对疼痛程度进行评价，采用SDS抑郁自评量表评分对抑郁状况进行评价，并比较三组患者的止痛疗效。结果：三组患者治疗后的VAS评分均明显低于治疗前，差异均有统计学意义(P<0.01)。A组治疗后的SDS评分较治疗前稍下降，但比较差异无统计学意义(P=0.04)，B组和C组治疗后的SDS评分均明显低于治疗前，差异均有统计学意义(P<0.01)。A组单用吗啡的止痛总有效率为51.4%，B组和C组的止痛总有效率分别为74.3%和83.3%，均明显高于A组，差异均有统计学意义(P<0.01)。结论：止痛药联合应用可减少吗啡的用量，能够提高患者生存质量，改善抑郁症状，较安全，值得临床推广。
【关键词】 晚期癌痛； 吗啡； 阿米替林； 异丙嗪； 止痛
中图分类号 R73 文献标识码 A 文章编号 1674-6805(2015)11-0001-03
【Abstract】 Objective：To investigate the role of Morphine，Amitriptyline and Phenergan in tri-ladder analgesia.Method：According to drug administration，106 patients with advanced cancer pain in the department of our hospital from June 2012 to June 2013 were selected as research objects，they were divided into 3 groups：the group A(single use of Morphine)，the group B(combined use of Morphine and Amitriptyline) and the group C(combined use of Morphine and Phenergan).The VAS score was used to evaluate the pain degree before treatment and after 6 weeks of treatment，VAS assessment was adopted to evaluate pain level among the three groups，the SDS self-rating Depression Scale was adopted to compare depression among different groups，the curative effect among the three groups were compared.Result：The VAS pain scores of the three groups patients after treatment were significantly lower than those of before treatment，the differences were statistically significant(P<0.01).The SDS score of the group A was decreased slightly compared with before treatment，there was no statistically significant difference(P=0.04)，the SDS scores of the group B and the group C after treatment were lower than those of before treatment，the differences were statistically significant(P<0.01).The single Morphine analgesic total efficiency of the group A was 51.4%，the analgesic total effective of the group B and the group C were 74.3% and 83.3% respectively，which were significantly higher than the group A，the differences were statistically significant(P<0.01).Conclusion：Combined use of analgesic drugs can reduce the dosage of Morphine，improve the quality of life and alleviate the depression of advanced cancer patients，more safety，is worth clinical promotion.
【Key words】 Advanced cancer pain； Morphine； Amitriptyline； Phenergan； Analgesia
疼痛是癌症患者继体温、脉搏、呼吸、血压之后第五大生命体征，常伴有不同程度疼痛，严重影响晚期癌症患者的生存质量，给患者带来极大痛苦[1-2]。为了安全治疗晚期癌症患者，有效缓解疼痛，笔者所在科室选用单用吗啡控释片或在吗啡控释片的基础上加用阿米替林或异丙嗪片对106例患者进行临床观察，现具体报告如下。, http://www.100md.com(柯莹姣 张建华)
【关键词】 晚期癌痛； 吗啡； 阿米替林； 异丙嗪； 止痛
中图分类号 R73 文献标识码 A 文章编号 1674-6805(2015)11-0001-03
【Abstract】 Objective：To investigate the role of Morphine，Amitriptyline and Phenergan in tri-ladder analgesia.Method：According to drug administration，106 patients with advanced cancer pain in the department of our hospital from June 2012 to June 2013 were selected as research objects，they were divided into 3 groups：the group A(single use of Morphine)，the group B(combined use of Morphine and Amitriptyline) and the group C(combined use of Morphine and Phenergan).The VAS score was used to evaluate the pain degree before treatment and after 6 weeks of treatment，VAS assessment was adopted to evaluate pain level among the three groups，the SDS self-rating Depression Scale was adopted to compare depression among different groups，the curative effect among the three groups were compared.Result：The VAS pain scores of the three groups patients after treatment were significantly lower than those of before treatment，the differences were statistically significant(P<0.01).The SDS score of the group A was decreased slightly compared with before treatment，there was no statistically significant difference(P=0.04)，the SDS scores of the group B and the group C after treatment were lower than those of before treatment，the differences were statistically significant(P<0.01).The single Morphine analgesic total efficiency of the group A was 51.4%，the analgesic total effective of the group B and the group C were 74.3% and 83.3% respectively，which were significantly higher than the group A，the differences were statistically significant(P<0.01).Conclusion：Combined use of analgesic drugs can reduce the dosage of Morphine，improve the quality of life and alleviate the depression of advanced cancer patients，more safety，is worth clinical promotion.
【Key words】 Advanced cancer pain； Morphine； Amitriptyline； Phenergan； Analgesia
疼痛是癌症患者继体温、脉搏、呼吸、血压之后第五大生命体征，常伴有不同程度疼痛，严重影响晚期癌症患者的生存质量，给患者带来极大痛苦[1-2]。为了安全治疗晚期癌症患者，有效缓解疼痛，笔者所在科室选用单用吗啡控释片或在吗啡控释片的基础上加用阿米替林或异丙嗪片对106例患者进行临床观察，现具体报告如下。, http://www.100md.com(柯莹姣 张建华)