标题：乌司他丁联合加巴喷丁及芬太尼对神经病理性疼痛患者的镇痛效果及炎症因子的影响

      作者：屈丽虹 1，雷世雄 2，闫辉 1，张芳芳 1    中国人民解放军空军军医大学第二附属医院麻醉科 1、疼痛科 2，陕西 西安 710038

      卷次： 2022年33卷21期

      【摘要】 目的 探讨乌司他丁联合加巴喷丁及芬太尼治疗神经病理性疼痛(NP)的镇痛效果及对患者炎症因子水平的影响。方法 选择中国人民解放军空军军医大学第二附属医院2019年 1月至 2021年1月收治的 200例NP患者为研究对象，采用随机数表法分为对照组和观察组，每组100例。对照组患者给予加巴喷丁及芬太尼治疗，观察组患者在对照组治疗基础上联合乌司他丁治疗，1周为一个疗程，共治疗4周。比较两组患者治疗前后的疼痛数字评分(NRS)、炎症因子[前列腺素E2 (PEG2)、白细胞介素-6 (IL-6)、白细胞介素-1β (IL-1β)]水平及生活质量量表(QOL)变化，并统计两组患者治疗期间的不良反应发生情况。结果 治疗后，两组患者的NRS评分均降低，且观察组为(2.21±0.26)分，明显低于对照组的(3.38±0.47)分，差异均有统计学意义(P<0.05)；治疗后，两组患者的PGE2、IL-1β、IL-6水平均降低，且观察组患者的上述各项指标分别为(34.14±4.23) μg/mL、(7.91±1.23) pg/mL、(8.21±1.34) pg/mL，明显低于对照组的(78.91±5.99) μg/mL、(11.39±2.21) pg/mL、(13.41±2.67) pg/mL，差异均有统计学意义(P<0.05)；治疗后，两组患者的睡眠、食欲、日常生活、精神状态评分均降低，且观察组患者的上述各项评分分别为(2.31±0.30)分、(2.19±0.21)分、(2.10±0.31)分、(2.51±0.19)分，明显低于对照组的(3.89±0.28)分、(3.98±0.40)分、(3.74±0.51)分、(3.92±0.17)分，差异均有统计学意义(P<0.05)；观察组和对照组患者的不良反应发生率分别为8.00%、11.00%，差异无统计学意义(P>0.05)。结论 乌司他丁联合巴喷丁及芬太尼治疗NP可有效抑制炎症因子释放，缓解疼痛，改善生活质量，安全性较高，可在临床中推广应用。
      【关键词】 神经病理性疼痛；乌司他丁；加巴喷丁；芬太尼；镇痛效果；炎症因子；生活质量；不良反应
      【中图分类号】 R441.1 【文献标识码】 A 【文章编号】 1003—6350（2022）21—2741—04

Effects of ulinastatin combined with gabapentin and fentanyl on analgesic effect and inflammatory factor level inpatients with neuropathic pain.
QU Li-hong 1, LEI Shi-xiong 2, YAN Hui 1, ZHANG Fang-fang 1. Department ofAnesthesiology 1, Department of Pain 2, the Second Affiliated Hospital of Air Force Medical University of PLA, Xi'an 710038,Shaanxi, CHINA
【Abstract】 Objective To investigate the analgesic effect of ulinastatin combined with gabapentin and fentanylin the treatment of neuropathic pain (NP) and its effect on the level of inflammatory factors.Methods A total of 200 pa-tients with NP treated in the Second Affiliated Hospital of Air Force Medical University of PLA from January 2019 toJanuary 2021 were selected and divided into a control group and an observation group according to random number ta-ble, with 100 patients in each group. The patients in the control group were treated with gabapentin and fentanyl, and thepatients in the observation group were treated with ulinastatin on the basis of the treatment in the control group, with oneweek as a course of treatment, for a total of 4 weeks. The Pain Numerical Rating Scale (NRS) for Pain Intensity, inflam-matory factors levels [prostaglandin E2 (PEG2), interleukin-6 (IL-6), and interleukin-1β (IL-1β)], and quality of life(QOL) scale changes were compared between the two groups before and after treatment, and the adverse reactions of thetwo groups during treatment were counted. Results After treatment, the NRS score of the two groups decreased, andthe score of the observation group was (2.21±0.26) points, which was significantly lower than (3.38±0.47) points of thecontrol group; the differences were statistically significant (P<0.05). After treatment, PGE2, IL-1β, and IL-6 levels inthe two groups significantly decreased, and the above indexes in the observation group were (34.14±4.23) μg/mL, (7.91±1.23) pg/mL, and (8.21±1.34) pg/mL, which were significantly lower than (78.91± 5.99) μg/mL, (11.39±2.21) pg/mL,and (13.41±2.67) pg/mL in the control group, with statistically significant differences (P<0.05). After treatment, thescores of sleep, appetite, daily life, and mental state of patients in the two groups decreased, and the above scores of pa-tients in the observation group were (2.31±0.30) points, (2.19±0.21) points, (2.10±0.31) points, and (2.51±0.19) points,which were significantly lower than (3.89±0.28) points, (3.98±0.40) points, (3.7± 0.51) points, and (3.92±0.17) pointsin the control group, with statistically significant differences (P<0.05). The incidence of adverse reactions in the obser-