目的 探讨羟考酮对晚期结肠癌癌性神经病理性疼痛的临床疗效和机制的研究.方法 选取2015年3月~2016年3月于浙江省绍兴第二医院肿瘤科以结肠癌为诊断收治的80例患者,随机分为2组,每组各40例.对照组予以临床常规治疗,实验组在对照组的治疗基础上加用羟考酮治疗.观察2组患者治疗前后疼痛评分、生活质量评分、血清β-内啡肽(β-EP)、含降钙素基因相关肽(calcitonin gene related peptide,CGRP)及前列腺素E-2(prostaglandin E2,PGE2)水平,临床疗效和不良反应发生率变化情况.结果与治疗前比较,2组患者治疗后疼痛评分、生活质量评分、血清β-EP、CGRP及PGE2水平均降低;治疗后,实验组疼痛评分(2.38±0.34)、生活质量评分(28.39±3.97)、血清β-EP(228.71±34.92)、CGRP(22.46±3.15)、PGE2水平(2.45±0.35)及不良反应发生率17.50%,均低于对照组的疼痛评分(3.51±0.51)、生活质量评分(33.53±4.76)、血清β-EP(246.67±34.83)、CGRP(30.36±4.25)、PGE2水平(3.36±0.47)及不良反应发生率40.00%,差异有统计学意义(P<0.05);实验组治疗总有效率为87.50%,高于对照组的治疗总有效率60.00%,差异有统计学意义(P<0.05).结论 羟考酮能有效降低晚期结肠癌神经病理性疼痛患者疼痛评分,提高生活质量,且具有较高的临床疗效和安全性.
Clinical efficacy and mechanism of oxycodone in cancerous neuropathic pain in advanced colon cancer
Objective To investigate the effect and mechanism of oxycodone on the treatment of cancerous neuropathic pain in advanced colon cancer.Methods 80 cases of advanced colon cancer in department of anorectal of Shaoxing Second Hospital of Zhejiang Province from March 2015 to March 2016 were selected and randomly divided into two groups with 40 cases in each group.The control group were treated with routine clinical treatment, and the experiment group were treated with oxycodone treatment on the basis of the control group.The levels of pain score, quality of life score, serum β-EP, calcitonin gene related peptide (CGRP) and prostaglandin E2(PGE2), clinical efficacy and adverse reaction incidence rate changes were compared between two groups before and after treatment.Results Compared with before treatment, levels of the pain score, serum β-EP, CGRP and PGE2 decreased in two groups after treatment, after treatment, the experiment group pain score (2.38 ±0.34), quality of life score (28.39 ± 3.97), serumβ-EP (228.71 ±34.92), CGRP (22.46 ±3.15), PGE2 level (2.45 ±0.35) and the incidence of adverse reactions was 17.50%, were lower than that of the control group the pain score (3.51 ±0.51), the quality of life score (33.53 ±4.76), serum β-EP (246.67 ±34.83), CGRP (30.36 ±4.25), PGE2(3.36 ±0.47) and the incidence of adverse reactions was 40.00%, the difference was statistically significant (P<0.05), the total effective rate of the experiment group was 87.50%, higher than that of the control group, the total effective rate was 60.00%, the difference was statistically significant (P<0.05).Conclusion Oxycodone can effectively reduce pain in patients with advanced colon cancer neuropathic pain score, improve the quality of life, and has high clinical efficacy and safety.
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