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【罌粟摘要】普瑞巴林聯合嗎啡治療胰腺癌疼痛的回顧性研究

治療慢性病手段生活方式王建華殷大奎

普瑞巴林聯合嗎啡治療胰腺癌疼痛的回顧性研究
貴州醫科大學麻醉與心臟電生理課題組
翻譯：劉云琴 編輯：陳銳 審校：曹瑩
HOLIDAY
研究目的
普瑞巴林通常用于緩解神經病理性疼痛。然而，關于治療慢性癌痛的療效的數據是缺乏的。本研究的目的是確定普瑞巴林聯合嗎啡治療胰腺癌疼痛的鎮痛效果。
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結果
共有240名與胰腺癌相關的疼痛患者被納入研究。結果顯示，聯合治療組（普瑞巴林+嗎啡）和單一治療組（嗎啡）的患者達到了相似的鎮痛效果，研究結束時的NRS評分（2.4±0.9 vs.2.6±0.9；聯合治療vs.單一治療）證明了這一點。與單一治療組相比，聯合治療組使用的嗎啡平均日劑量顯著降低（39.5±16.0 mg vs.61.5±19.3 mg，凈差異23.5，95%可信區間：18.4–28.6，p<0.001）。與疼痛相關的功能干擾評分變化在聯合治療組和單一治療組之間存在顯著差異（分別為12.0±0.4和9.8±4.9；凈差異為2.3；95% 可信區間:1.1–3.3；P<0.001）。聯合治療組患者出現爆發性癌痛的持續時間比單一治療組短（X2 P<0.001，克拉默氏指數V:0.36）。與單一治療組相比，聯合治療組的嗜睡、頭暈和認知功能障礙的發生率顯著較高，未觀察到嚴重的治療相關副作用。

【罌粟摘要】普瑞巴林聯合嗎啡治療胰腺癌疼痛的回顧性研究
文章插圖

HOLIDAY結論
這項研究的結果支持普瑞巴林和嗎啡用于緩解胰腺癌患者的疼痛。
HOLIDAY 原始文獻來源
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.
【【罌粟摘要】普瑞巴林聯合嗎啡治療胰腺癌疼痛的回顧性研究】 Conclusion: The findings of this study supported the use of pregabalin with morphine to relieve pain in patients of pancreatic cancer.