草乌甲素胶丸辅助硫酸吗啡缓释片治疗中晚期癌痛

目的比较草乌甲素胶丸辅助硫酸吗啡缓释片与硫酸吗啡缓释片单药治疗中晚期癌痛的疗效差别。方法从我院疼痛门诊及病房就诊的中晚期癌痛患者中选符合入选标准的病例40例进行分组研究。随机分为草乌甲素胶丸辅助硫酸吗啡缓释片（A组）和硫酸吗啡缓释片单药（B组）。疼痛强度评价采用视觉模拟评分（VAS）,疗效评定标准采用VAS加权值计算。每隔1周记录1次,共4周,观察2组患者在镇痛有效率无差异时,硫酸吗啡缓释片使用剂量及患者不良反应发生率;监测治疗前及治疗2周后血清PGE-2、TNF-α数值。结果 A、B组疼痛缓解有效率均达95%时,A组每周硫酸吗啡缓释片使用剂量少于B组（P〈0.05）;A组不良反应发生率为35%,B组为55%,B组较A组明显升高;实验室指标显示治疗2周后A组血清PGE-2、TNF-α平均水平低于B组,有统计学意义（P〈0.05）。结论草乌甲素胶丸辅助硫酸吗啡缓释片治疗中晚期癌痛能减少硫酸吗啡缓释片使用剂量,并减少不良反应发生率。

Clinical study of Bulleyaconitine A assisted to Morphine Sulfate Sustained-release Tablets in the treatment of mid-late cancer pain

Objective To compare the effective differences of Bulleyaconitine A assisted to Morphine Sulfate Sustained-release Tablets with Morphine Sulfate Sustained-release Tablets mono therapy in the treatment of mid-late cancer pain. Methods Forty patients with mid-late cancer pain were selected from the patients who were admitted in clinic or ward of our hospital. They were divided randomly into 2 groups： Bulleyaconitine A assisted to Morphine Sulfate Sustained-release Tablets （group A） and Morphine Sulfate Sustained-release Tablets （group B）. VAS was applied for pain evaluation. VAS weighted value calculation was used as the evaluation standard of curative effectiveness. Record the outcome per week, a total of 4 weeks. When there was no difference in analgesic effective rate, the total dose of Morphine Sulfate Sustained-release Tablets and its side effects were recorded; the serum levels of PGE-2,TNF-awere monitored before and after 2 weeks of treatment. Results When the analgesic effective rates reached 95% in group A and B, there was a significant decrease in the total dose of Morphine Sulfate Sustained release Tablets（ P 〈 0.05） in group A compared with that of group B; and the rate of side effects in group A was significantly lower than that in group B （A：35 %, B：55 % ）. Laboratory indicators show： Mter 2- week treatment, the PGE-2,TNF-α level of A group were lower than those of group B. The difference was significant in statistics （ P 〈 0.05）. Conclusion Bulleyaconitine A assisted to Morphine Sulfate Sustained-release Tablets in the treatment of mid-late cancer pain can reduce the total dose of Morphine Sulfate Sustained-release Tablets and cut down the rate of side effects.