目的 探讨普瑞巴林联合吗啡、恩丹西酮、羟考酮控释片对癌性神经病理性疼痛患者睡眠和抑郁的影响.方法 用随机数字法将178例癌性神经病理性疼痛患者分为2组,每组89例.对照组给予吗啡150.0 mg和恩丹西酮16.0 mg,溶于0.9%氯化钠注射溶液150 mL中,滴注,完成后给予羟考酮控释片,口服,20 mg,2次/天.观察组加用普瑞巴林,口服,150 mg,2次/天.比较两组镇痛效果、睡眠情况(MOS量表)、抑郁情况[密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD)].结果 观察组疼痛缓解率为8.89%,显著高于对照组的69.66%(P<0.05).治疗后,观察组MOS-SS量表综合睡眠障碍指数、睡眠量、睡眠干扰、睡眠充足度显著改善(P<0.05),且优于对照组(P<0.05).治疗后,两组HAMA、HAMD显著降低(P<0.05),且观察组HAMA、HAMD显著低于对照组(P<0.05).结论 普瑞巴林联合吗啡、恩丹西酮、羟考酮控释片可有效缓解癌性神经病理性疼痛患者的疼痛,改善睡眠质量和抑郁状态.%Objective To investigate the effects of pregabalin combined morphine,ondansetron,and oxycodone controlled release tablets on sleep and depression of patients with cancerous neuropathic pain.Methods 178 patients with cancerous neuropathic pain were divided into two groups by randomized digital method and each group had 89 ca-ses.The control group was routinely given morphine,ondansetron and oxycodone controlled release tablets,and the obser-vation group was added with pregabalin besides the drugs used in the control group.The analgesic effects,sleep(MOS scale)and depression(HAMA and HAMD)of two groups were compared.Results The pain relief rate of observation group was 89.89%,which was significantly higher than that of control group(69.66%,P<0.05).After the treatment, the 9-items,SLPQ,SLPA and SLPD in MOS-SS table of observation group were significantly improved compared with the control group(P<0.05).After the treatment,HAMA and HAMD of two groups were significantly decreased(P<0.05),and HAMA and HAMD of observation group were significantly lower than those of control group(P<0.05). Conclusion Pregabalin combined morphine may effectively relieve the pain of patients with cancerous neuropathic pain and improve sleep quality and depression.
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