| 胡家婷,戈 伟,包文庭,王庆兰,郑永法.芬太尼透皮贴剂对吗啡不耐受晚期癌痛患者疼痛介质水平及生存质量的影响[J].,2019,19(12):2307-2310 |
| 芬太尼透皮贴剂对吗啡不耐受晚期癌痛患者疼痛介质水平及生存质量的影响 |
| Influence of Fentanyl Transdermal Patch on the Levels of serum Pain Medium and Quality of Life in Late-stage Cancer Patients with Pain and Morphine Intolerance |
| 投稿时间：2018-10-23 修订日期：2018-11-18 |
| DOI：10.13241/j.cnki.pmb.2019.12.023 |
| 中文关键词: 吗啡 晚期癌痛 芬太尼透皮贴剂 疼痛介质 生存质量 |
| 英文关键词: Morphine Advanced cancer pain Fentanyl transdermal patch Pain media Quality of life |
| 基金项目:国家自然科学基金青年基金项目（81702819） |
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| 中文摘要: |
| 摘要 目的：探讨芬太尼透皮贴剂对吗啡不耐受晚期癌痛患者疼痛介质水平及生存质量的影响。方法：回顾性分析我院2016年12月~2017年12月收治的102例吗啡不耐受晚期癌痛患者为研究对象，按治疗方式不同分为对照组和研究组，每组51例。对照组予以氨酚羟考酮片治疗，研究组予以芬太尼透皮贴剂治疗。比较两组的镇痛疗效，治疗前后血清疼痛介质、视觉模拟评分（VAS）、生活质量水平的变化和不良反应的发生情况。结果：治疗后，研究组镇痛总有效率显著高于对照组（86.27% vs. 68.23%，P<0.05）。治疗后，两组血清P物质（SP）、前列腺素E2（PGE2）及VAS评分均较治疗前显著下降，且研究组以上指标均明显低于对照组，两组血清?茁-内啡肽（?茁-EP）均较治疗前明显上升，且研究组显著高于对照组（P<0.05）。两组治疗后精神状况、心理状况、功能状况、生理状况及社会功能评分均较治疗前显著上升，且研究组以上指标均显著高于对照组（P<0.05）。治疗后，研究组恶心呕吐、便秘、头晕嗜睡发生率低于对照组（P<0.05）。结论：芬太尼透皮贴剂对吗啡不耐受晚期癌痛患者的镇痛效果确切，能够调节疼痛介质表达，提高患者的生存质量，是治疗晚期癌痛有效、安全的阿片类药物。 |
| 英文摘要: |
| ABSTRACT Objective: To explore the influence of fentanyl transdermal patch on the level and quality of pain in patients with morphine intolerance late cancer pain. Methods: Retrospective analysis102 cases of advanced cancer pain who treated from December 2016 to December 2017 as research object, according to the different treatment methods, those patients was divided into control group and the research group, 51 cases in each group. control group was treated with aminophenol oxycodone tablets, and the research group treated with fentanyl transdermal patch. Then analgesic effects, changes of serum pain media, visual analog scale (VAS), quality of life before and after treatment, and adverse reactions in both group were compared. Results: After treatment, analgesia total effective rate in research group was significantly higher than control group (86.27% and 68.23%, P<0.05）. After treatment, the serum substance P （SP）, Prostaglandin E2 （PGE2） and VAS scores in both group were significantly decreased than before treatment, while the above indicators of the research group were significantly lower than the control group. β-endorphin （β-EP） in both groups was increased than before treatment, and the research group was significantly higher than the control group, there was a statistical difference（P<0.05）. after treatment, mental status, psychological status, functional status, physiological status and social function scores in the both groups was all increased than before treatment, while the above indicators of the research group were significantly higher than the control group（P<0.05）. After treatment, occurrence rate of nausea and vomiting, constipation and dizziness in research group was lower than control group（P<0.05）. Conclusion: Analgesic effect of fentanyl transdermal patch on morphine in patients with morphine intolerance late cancer pain is accurate, it can regulate the expression of pain medium and improve the quality of life of patients, which may be an effective and safe opioid drug in the treatment of advanced cancer pain. |
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