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。
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（comhined use of Morphine and Amitfiptyline） 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 statistical｜y significant difference（F--O.04）, the SOS 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 significantlyhigher 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.
出处
《中外医学研究》
2015年第11期1-3,共3页
CHINESE AND FOREIGN MEDICAL RESEARCH
关键词
晚期癌痛
吗啡
阿米替林
异丙嗪
止痛
Advanced cancer pain
Morphine
Amitriptyline
Phenergan
Analgesia
