Objective To evaluate the analgesic efficacy of pregabalin combined with opioids in the treatment of malignant neuropathic pain ( MNP ) . Methods Fifty-two patients with MNP of moderate to severe pain were enrolled and initially took 72 hours morphine-patient control intravenous analgesia(PCIA), randomly assigned into 3 group group A (n=17), receiving morphine-PCIA;group B (n=18), receiving morphine-PCIA plus 75mg pregabalin (per 12h); group C (n=17), receiving morphine-PCIA plus 150mg pregabalin ( per 12h) . The oxycodone was calculated and substituted for morphine 72h after morphine-PCIA for continuous 4 weeks. The 24h dosage of morphine was analyzed in 3 groups. The number of break-through pain, resting visual analogue scale ( VAS) and VAS at activity during PCIA period and oral administration of oxycodone were recorded in 3 groups as well as the adverse reaction. Results Compared to group A, the dosage of every 24 hour morphine in 72h of group B and in 48, 72h of group C were low ( P<0�05) . The number of break-through pain and VAS at activity of group C were lower than group A ( P<0�05) . During the period of morphine-PCIA, no serious adverse reaction were observed in 3 groups, and the common adverse reactions included nausea, vomi-ting, dizziness, drowsiness and constipation with not statistically significant difference among 3 groups ( P>0�05) . The dosages of oxy-codone were (94�06±25�38)mg and (88�21±24�46)mg in group B and C, lower than (117�67±36�39)mg in group A with signifi-cant difference ( P<0�05) . The number of break-through pain of group B and C at day 7, 14, 28 were lower than group A ( P<0�05) , and the VAS at activity of group B at day 14 and group C at day 7, 14 were lower than group A ( P<0�05) . Conclusion MNP may be well controlled by pregabalin plus opioid, and the dosage of pregabalin may be needed more.%目的：观察普瑞巴林联合阿片类药物治疗癌性神经病理性疼痛（ MNP ）的疗效。方法2011年8月至2014年1月间52例中度以上MNP患者采用简单随机抽样法分为：A组（17例），仅接受吗啡；B组（18例），接受吗啡加75mg普瑞巴林（每日2次）；C组（17例），接受吗啡加150mg普瑞巴林（每日2次）。患者采用静脉自控镇痛（PCIA）方式给予吗啡注射72h，滴定其所需剂量。72h后将吗啡换成口服羟考酮控释片，继续治疗4周。分析A、B、C 3组每24h吗啡用量，PCIA期间及口服羟考酮控释片后的疼痛情况（爆发痛次数、静息以及活动VAS评分）并记录不良反应。结果与A组比较，B组72h内、C组48h内及72h内的每24h吗啡用量较低，差异均有统计学意义（ P＜0�05）；C组72h内爆发痛次数及活动VAS评分均低于A组，差异有统计学意义（ P＜0�05）；吗啡PCIA滴定期间，3组均未出现严重不良反应，常见不良反应为恶心、呕吐、头晕、嗜睡及便秘，组间差异均无统计学意义（P＞0�05）；A组第28天羟考酮缓释片用量（mg）为117�67±36�39，而B、C组分别为94�06±25�38和88�21±24�46，均低于A组，差异有统计学意义（P＜0�05）；B、C组第7、14、28天爆发痛次数均低于A组，差异有统计学意义（ P＜0�05）；B组第14天活动VAS评分低于A组，C组第7、14天活动VAS评分均低于A组，以上差异均有统计学意义（ P＜0�05）。结论普瑞巴林联合阿片类药物治疗MNP 的效果较好，优于单用阿片类药物，且普瑞巴林可能需使用较大的剂量。
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