保健医学研究与实践2025，Vol.22Issue(4)：50-56,7.DOI:10.11986/j.issn.1673-873X.2025.04.08
硫酸吗啡控释片联合SGB对晚期肺癌中重度癌痛患者临终前症状、疼痛介质和爆发痛频次的影响
Effects of controlledrelease morphine sulfate tablets combined with SGB on premortem symptoms,pain mediators,and breakthrough pain frequency in patients with moderate to severe cancer pain from advanced lung cancer
摘要
Abstract
Objective To investigate the effects of controlledrelease morphine sulfate tablets combined with stellate ganglion block(SGB)on premortem symptoms,serum pain mediators,and breakthrough pain frequency in patients with moderate to severe cancer pain from advanced lung cancer,aiming to provide evidence for alleviating pain and improving quality of life.Methods Clinical data were retrospectively collected for 110 patients with moderate to severe cancer pain from advanced lung cancer treated at Hebei Yanda Hospital from January 2021 to January 2024.Patients were assigned to a control group(n=48),receiving controlledrelease morphine sulfate tablets alone,or a combination group(n=62),receiving SGB plus controlle-drelease morphine.Functional status,Edmonton Symptom Assessment System(ESAS)scores,pain mediator levels[serum levels of substance P(SP)and prostaglandin E2(PGE2)],breakthrough pain frequency,morphine dosage,and adverse reac-tions were compared.Results Before treatment,ESAS dimension scores and Palliative Performance Scale(PPS)scores did not differ significantly between groups(P>0.05).After treatment,the combination group showed significantly lower ESAS scores across all dimensions except for the paresthesia dimension,and significantly higher PPS scores compared to both their own baseline and the control group(P<0.05).Baseline serum SP and PGE2 levels did not differ significantly between groups(P>0.05).With ongoing treatment,both groups experienced progressive declines in SP and PGE2,and posttreatment levels in the combination group were significantly lower than those in the control group at corresponding time points(P<0.05).The combination group also had significantly fewer breakthrough pain episodes and required lower total morphine doses than the control group(P<0.05).Adverse reaction rates during treatment were 52.08%(25/48)in the control group and 48.39%(30/62)in the combination group,with no significant difference(χ2=0.148,P=0.701).Conclusion In advanced lung cancer patients with moderate to severe cancer pain,compared with the administration of controlledrelease morphine sulfate tablets alone,adding SGB to the controlledrelease morphine sulfate tablets provides superior improvement in premortem symp-toms,greater reductions in pain mediator levels,and fewer breakthrough pain episodes,without increasing the risk of adverse reactions.关键词
肺癌/癌痛/硫酸吗啡控释片/星状神经节阻滞/疼痛介质Key words
Lung cancer/Cancer pain/Controlledrelease morphine sulfate tablets/Stellate ganglion block/Pain mediators分类
医药卫生引用本文复制引用
谢建新,王诗男,李红钰,杨宁,常辰,高超,安阳,马朝磊,张丽萍..硫酸吗啡控释片联合SGB对晚期肺癌中重度癌痛患者临终前症状、疼痛介质和爆发痛频次的影响[J].保健医学研究与实践,2025,22(4):50-56,7.基金项目
河北省卫生健康委员会医学科学研究课题计划项目(20190148) （20190148）
河北省廊坊市科学技术研究与发展计划项目(2022013006). （2022013006）
