标题：盐酸羟考酮缓释片联合SGB对非小细胞肺癌中重度癌痛患者的镇痛效果

      作者：白晓博 1，魏晓辉 2，贾本治 3    1.陕西省康复医院手术麻醉科，陕西 西安 710065；2.陕西省肿瘤医院内三科，陕西 西安 710061；3.陕西省康复医院脊髓损伤康复科，陕西 西安 710065

      卷次： 2023年34卷9期

      【摘要】 目的 观察盐酸羟考酮缓释片联合星状神经节阻滞(SGB)对非小细胞肺癌(NSCLC)中重度癌痛患者的镇痛效果。方法 选取2019年1月至2022年3月陕西省康复医院收治的84例NSCLC中重度癌痛患者，采用随机数表法将患者分为观察组和对照组各42例。两组患者均进行化疗，对照组采用盐酸羟考酮缓释片，观察组采用盐酸羟考酮缓释片联合SGB阻滞，均治疗两周。比较两组患者的镇痛有效率，治疗前后Ramsay镇静(RSS)评分、血清β-内啡肽(β-EP)、5-羟色胺(5-HT)、前列腺素E2 (PGE2)水平及不良反应发生情况。结果 治疗后，观察组患者镇痛总有效率为92.86%，明显高于对照组的71.43%，差异有统计学意义(P<0.05)；治疗前，两组患者的RSS评分比较差异无统计学意义(P>0.05)，治疗后，两组患者的RSS评分均升高，且观察组为(3.88±0.45)分，明显高于对照组的(2.97±0.37)分，差异均有统计学意义(P<0.05)；治疗前，两组患者的血清 5-HT、β-EP、PGE2水平比较差异均无统计学意义(P>0.05)；治疗后，两组患者的5-HT、PGE2水平均降低，且观察组明显低于对照组，β-EP水平均升高，且观察组明显高于对照组，差异均有统计学意义(P<0.05)；治疗后，观察组患者的不良反应发生率为9.52%，略低于对照组的 14.28%，但差异无统计学意义(P>0.05)。结论 盐酸羟考酮缓释片联合SGB阻滞用于NSCLC中重度癌痛患者，可调节血清β-内啡肽、5-羟色胺水平，有效缓解NSCLC患者的癌痛程度。
      【关键词】 盐酸羟考酮缓释片；非小细胞肺癌；β-内啡肽；5-羟色胺；镇痛效果
      【中图分类号】 R734.2 【文献标识码】 A 【文章编号】 1003—6350（2023）09—1263—05

Analgesic effect of oxycodone hydrochloride prolonged-release tablet combined with stellate ganglion blockon moderate to severe cancer pain in patients with non-small cell lung cancer.
BAI Xiao-bo 1, WEI Xiao-hui 2,JIA Ben-zhi 3. 1. Department of Surgical Anesthesiology, Shaanxi Rehabilitation Hospital, Xi'an 710065, Shaanxi,CHINA; 2. Third Department of Internal Medicine, Shaanxi Provincial Cancer Hospital, Xi'an 710061, Shaanxi, CHINA; 3.Department of Spinal Cord Injury Rehabilitation, Shaanxi Rehabilitation Hospital, Xi'an 710065, Shaanxi, CHINA
【Abstract】 Objective To observe the analgesic effect of oxycodone hydrochloride prolonged-release tablet(OXYCONTIN) combined with stellate ganglion block (SGB) in patients with moderate to severe cancer pain inducedby non-small cell lung cancer (NSCLC). Methods A total of 84 patients with NSCLC-induced moderate to severe can-cer pain admitted to Shaanxi Rehabilitation Hospital between January 2019 and March 2022 were enrolled. According torandom number table method, the patients were divided into an observation group and a control group, with 42 patientsin each group. After chemotherapy, control group was treated with OXYCONTIN, while observation group was addition-ally treated with SGB, all for 2 weeks. The response rate of analgesia, score of Ramsay sedation scale (RSS), levels of se-rum β-endorphin (β-EP), 5-hydroxytryptamine (5-HT), and prostaglandin E2 (PGE2) before and after treatment, andthe occurrence of adverse reactions in the two groups were compared between the two groups. Results After treatment,total response rate of analgesia in the observation group was significantly higher than that in the control group (92.86%vs 71.43% , P<0.05). Before treatment, there was no significant difference in RSS score between the two groups (P>0.05). After treatment, RSS scores in the observation group and the control group were all increased, and RSS score wassignificantly higher in the observation group than the control group: (3.88±0.45) points vs (2.97±0.37) points, P<0.05.Before treatment, there was no significant difference in levels of serum 5-HT, β-EP, and PGE2 between the two groups(P>0.05). After treatment, levels of 5-HT and PGE2 in both groups were decreased, which were significantly lower inthe observation group than the control group, while β-EP in both groups was increased, which was significantly higherin observation group than the control group (P<0.05). After treatment, incidence of adverse reactions in the observationgroup was slightly lower than that in the control group (9.52% vs 14.28%), but the difference between observation groupand control group was not statistically significant (P>0.05). Conclusion OXYCONTIN combined with SGB can regu-late levels of serum β-EP and 5-HT, and effectively relieve cancer pain in NSCLC patients.
      【Key words】 Oxycodone hydrochloride prolonged-release tablet; Non-small cell lung cancer; β-endorphin; 5-hy-droxytryptamine; Analgesic effect