【罂粟摘要】普瑞巴林联合吗啡治疗胰腺癌疼痛的回顾性研究慢性病|治疗|手段|殷大奎|王建

普瑞巴林联合吗啡治疗胰腺癌疼痛的回顾性研究
贵州医科大学麻醉与心脏电生理课题组
翻译：刘云琴编辑：陈锐审校：曹莹
HOLIDAY
研究目的
普瑞巴林通常用于缓解神经病理性疼痛。然而，关于治疗慢性癌痛的疗效的数据是缺乏的。本研究的目的是确定普瑞巴林联合吗啡治疗胰腺癌疼痛的镇痛效果。
HOLIDAY
结果
共有240名与胰腺癌相关的疼痛患者被纳入研究。结果显示，联合治疗组（普瑞巴林+吗啡）和单一治疗组（吗啡）的患者达到了相似的镇痛效果，研究结束时的NRS评分（2.4±0.9 vs.2.6±0.9；联合治疗vs.单一治疗）证明了这一点。与单一治疗组相比，联合治疗组使用的吗啡平均日剂量显著降低（39.5±16.0 mg vs.61.5±19.3 mg，净差异23.5，95%可信区间：18.4–28.6，p<0.001）。与疼痛相关的功能干扰评分变化在联合治疗组和单一治疗组之间存在显著差异（分别为12.0±0.4和9.8±4.9；净差异为2.3；95% 可信区间:1.1–3.3；P<0.001）。联合治疗组患者出现爆发性癌痛的持续时间比单一治疗组短（X2 P<0.001，克拉默氏指数V:0.36）。与单一治疗组相比，联合治疗组的嗜睡、头晕和认知功能障碍的发生率显著较高，未观察到严重的治疗相关副作用。

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HOLIDAY结论
这项研究的结果支持普瑞巴林和吗啡用于缓解胰腺癌患者的疼痛。
HOLIDAY 原始文献来源
Dai Junzhu,Teng Lei,Zhao Liuyuan et al. The combined analgesic effect of pregabalin and morphine in the treatment of pancreatic cancer pain, a retrospective study.[J] .Cancer Med, 2021, 10: 1738-1744.
The combined analgesic effect of pregabalin and morphine in the treatment of pancreatic cancer pain, a retrospective study
Abstract
Background：Pregabalin is commonly used to relieve neuropathic pain. However, data are lacking on its efficacy for the treatment of chronic cancer pain. The purpose of this study was to determine the analgesic efficacy of pregabalin combined with morphine in the management of pancreatic cancer pain.
Methods:This study reviewed patients who were prescribed morphine and 150 mg/d pregabalin between 1 January 2017 and 10 November 2018 in our institute. The primary outcomes of this study were the average pain score and dose of morphine. Secondary outcomes included characters of breakthrough cancer pain, functional interference related to pain, anxiety/depression status, and incidence of treatment-related adverse events during the study.
Results: A total of 240 patients with pain related to pancreatic cancer were included in the study. The results showed that patients of both combination therapy group (pregabalin+morphine) and monotherapy group (morphine) achieved similar analgesic efficacy, demonstrated by NRS (2.4 ± 0.9 vs. 2.6 ± 0.9; combination vs. monotherapy) at the end of the study. Mean daily dose of morphine used in the combination group was significant lower compared to monotherapy group (39.5 ± 16.0 mg vs. 61.5 ± 19.3 mg, net difference 23.5, 95% CI: 18.4-28.6, p < ?0.001). The change of functional interference score related to pain was significantly different between combination and monotherapy group (12.0 ± 0.4 vs. 9.8 ± 4.9; net difference, 2.3; 95% CI: 1.1-3.3; p < 0.001). Patients in combination therapy group had experienced shorter duration of breakthrough cancer pain than those in monotherapy group (X p < 0.001, Cramer's V:0.36). The incidence of somnolence, dizziness, and cognitive dysfunction were significantly higher in the combination group compared to monotherapy group. No serious treatment-related side effects were observed.
【【罂粟摘要】普瑞巴林联合吗啡治疗胰腺癌疼痛的回顾性研究】 Conclusion: The findings of this study supported the use of pregabalin with morphine to relieve pain in patients of pancreatic cancer.