[1]曾媛,孙建海.度洛西汀和帕罗西汀联合羟考酮缓释片治疗晚期癌痛伴抑郁的疗效比较[J].第三军医大学学报,2020,42(19):4890-1897.
 ZENG Yuan,SUN Jianhai.Curative effect of oxycodone sustained-release tablets combined with duloxetine versus paroxetine in treatment of depression and pain from advanced cancer[J].J Third Mil Med Univ,2020,42(19):4890-1897.
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度洛西汀和帕罗西汀联合羟考酮缓释片治疗晚期癌痛伴抑郁的疗效比较(/HTML )
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《第三军医大学学报》[ISSN:1000-5404/CN:51-1095/R]

卷:
42卷
期数:
2020年第19期
页码:
4890-1897
栏目:
神经科学
出版日期:
2020-10-15

文章信息/Info

Title:
Curative effect of oxycodone sustained-release tablets combined with duloxetine versus paroxetine in treatment of depression  and pain from advanced cancer
作者:
曾媛孙建海
江汉大学医学院肿瘤学研究生培养基地;江汉大学附属湖北省第三人民医院肿瘤科
Author(s):
ZENG Yuan SUN Jianhai
Postgraduate Training Base of Oncology, School of Medicine, Jianghan University, Wuhan, Hubei Province, 430056; 2Department of Oncology, Hubei Third People’s Hospital of Jianghan University, Wuhan, Hubei Province, 430033, China
 
关键词:
癌痛抑郁度洛西汀帕罗西汀羟考酮抗抑郁药
Keywords:
cancer pain depression duloxetine hydrochloride paroxetine oxycodone anti-depressive agents
分类号:
R181.32; R730.6; R979.1
文献标志码:
A
摘要:

目的探讨羟考酮缓释片联用不同类型的抗抑郁药对晚期癌痛伴抑郁患者的疗效及安全性。方法选取2018年7月至2019年9月湖北省第三人民医院收治的108例晚期癌痛伴抑郁患者,单盲、随机数字表法分为3组,每组36例,A组:单用羟考酮缓释片,B组:羟考酮缓释片+帕罗西汀,C组:羟考酮缓释片+度洛西汀。比较各组患者在治疗后的疼痛、抑郁、焦虑情况,以及羟考酮用量、睡眠质量、生活质量和不良反应。结果 治疗后1周,C组的数字评分法(NRS)评分显著低于B组和A组(P<0.05);治疗后2周的NRS评分、SAS评分,和治疗后1周的抑郁自评量表(SDS)评分,C组显著低于B组、B组显著低于A组(均P<0.05);治疗后1、2个月的NRS评分、SAS评分和SDS评分,以及治疗后2周的SDS评分,C组和B组的差异无统计学意义(P>0.05),且均显著低于A组(P<0.05)。治疗后2个月,A组和B组的羟考酮人均日口服剂量显著高于治疗前(P<0.05),C组与治疗前的差异无统计学意义(P>0.05);3组的匹兹堡睡眠质量指数量表(PSQI)评分均显著低于治疗前(P<0.05);在羟考酮人均日口服剂量和PSQI 评分上,C组和B组的差异无统计学意义(P>0.05),且均显著低于A组(P<0.05)。治疗后2个月,3组的各项生活质量评分均较治疗前显著上升(P<0.05),除角色功能评分外的其余评分,C组和B组的差异无统计学意义(P>0.05),且均显著高于A组(P<0.05)。治疗后2个月,3组不良反应的差异均无统计学意义(P>0.05),经对症治疗或剂量调整后均逐渐减轻或消失。结论对于晚期癌痛伴抑郁患者,采用羟考酮缓释片伍用度洛西汀起效比伍用帕罗西汀快,能有效改善疼痛、抑郁、焦虑、睡眠及生活质量,减少羟考酮用量,且不增加不良反应。

Abstract:

ObjectiveTo investigate the efficacy and safety of oxycodone sustained-release tablets combined with different types of antidepressants (duloxetine and paroxetine) in the patients suffering from depression and pain due to advanced cancer. MethodsA total of 108 depressive patients with advanced cancer pain in admitted in Hubei Third People’s Hospital from July 2018 to September 2019 were recruited in this study. They were divided into 3 groups single-blindly and randomly, with 36 subjects in each group. The patients from Group A were given oxycodone sustained-release tablets only, those out of Group B the tablets+paroxetine, and those of Group C the tablets+duloxetine. Pain relief, depression, anxiety, dose of oxycodone, sleep quality, quality of life and adverse reactions were compared among the 3 groups after treatment. ResultsAfter treatment of 1 week, the numeric rating scale (NRS) score of Group C was significantly lower than those of Group B and A (P<0.05). The NRS score and self-rating anxiety scale (SAS) score at 2 weeks after treatment, and the self-rating depression scale (SDS) score at 1 week after treatment were significantly decreased in a trend from Group A to Group B to Group C (all P<0.05). But there were no obvious differences in the NRS, SAS and SDS scores at 1 and 2 months after treatment, and the SDS score at 2 weeks after treatment between Group C and B (P>0. 05), and all of these scores were notably lower than those of Group A (P<0. 05). After treatment of 2 months, the average daily oral dose of oxycodone per capita in Group A and B were significantly higher than that before treatment (P<0.05), but no such difference was seen in Group C (P>0.05). The score of Pittsburgh sleep quality index (PSQI) were remarkably decreased in the 3 groups after treatment (P<0.05). But no significant differences were seen in the average daily oral dose of oxycodone per capita and the PSQI score between Group B and C, but the dose and score were both significantly lower than those of Group A (P<0.05). In 2 months after treatment, the scores of different items of quality of life score were significantly increased in the 3 groups (P<0.05), but except for the role function score, there were no differences in other scores between Group C and B (P>0.05), and the scores were significantly higher than those of Group A (P<0.05). After treatment of 2 months, the adverse reactions had no significant differences among the 3 groups (P>0.05), and were gradually reduced or disappeared after symptomatic treatment or dose adjustment. ConclusionIn the treatment of depressive patients with pain from advanced cancer, oxycodone sustained-release tablets combined with duloxetine is superior to paroxetine in quick onset, effective improvement of pain, depression, anxiety and quality of sleep and life, and reduced dose of oxycodone, and does not increase adverse reactions.

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更新日期/Last Update: 2020-10-02