切换至 "中华医学电子期刊资源库"

中华乳腺病杂志(电子版) ›› 2014, Vol. 08 ›› Issue (02) : 99 -102. doi: 10.3877/cma. j. issn.1674-0807.2014.02.006

论著

氟哌噻吨-美利曲辛片联合非甾体抗炎药治疗中青年女性乳腺癌保留乳房术后慢性疼痛的疗效观察: 一项前瞻、随机、对照临床研究
王宇1,(), 崔志超1, 马杰1, 张景华1, 谷峥1, 张顺礼1   
  1. 1.063000 唐山市人民医院乳腺外科
  • 收稿日期:2013-11-22 出版日期:2014-04-01
  • 通信作者: 王宇

Flupentixol and Melitracen plus non-steroidal anti-inflammatory drug to treat chronic postoperative pain after breast-conserving surgery in young and middle-aged patients with breast cancer: a prospective randomized controlled clinical study

Yu Wang1,(), Zhi-chao Cui1, Jie Ma1, Jinghua Zhang1, Zheng Gu1, Shun-li Zhang1   

  1. 1.Department of Breast Surgery, People’s Hospital of Tangshan City, Tangshan 063000,China
  • Received:2013-11-22 Published:2014-04-01
  • Corresponding author: Yu Wang
引用本文:

王宇, 崔志超, 马杰, 张景华, 谷峥, 张顺礼. 氟哌噻吨-美利曲辛片联合非甾体抗炎药治疗中青年女性乳腺癌保留乳房术后慢性疼痛的疗效观察: 一项前瞻、随机、对照临床研究[J/OL]. 中华乳腺病杂志(电子版), 2014, 08(02): 99-102.

Yu Wang, Zhi-chao Cui, Jie Ma, Jinghua Zhang, Zheng Gu, Shun-li Zhang. Flupentixol and Melitracen plus non-steroidal anti-inflammatory drug to treat chronic postoperative pain after breast-conserving surgery in young and middle-aged patients with breast cancer: a prospective randomized controlled clinical study[J/OL]. Chinese Journal of Breast Disease(Electronic Edition), 2014, 08(02): 99-102.

目的

探讨氟哌噻吨-美利曲辛片联合非甾体抗炎药对中青年女性乳腺癌保留乳房术后慢性疼痛的疗效。

方法

纳入2011 年3 月至2012 年9 月在本院行乳腺癌保留乳房手术的中青年女性患者120 例,患者术后均有不同程度的慢性疼痛,综合医院焦虑抑郁测定表(HAD)评分为8 ~15 分。 随机数字表法分为治疗组(n=60)及对照组(n=60),对照组采用非甾体抗炎药布洛芬缓释胶囊(芬必得,0.3 g,每日2 次),治疗组采用芬必得联合氟哌噻吨-美利曲辛片(1 片,每日2 次),疗程8 周,分别于入组时、治疗4 周和8 周后进行疼痛模拟评分(VAS)。 采用HAD 进行情绪障碍评分以及采用匹茨堡睡眠质量指数(PSQI)进行睡眠质量评分。 计量资料的比较采用t 检验、重复测量的方差分析,率的比较采用χ2 检验。

结果

治疗4 周和8 周后治疗组疼痛VAS 评分显著降低(F=8.337, P=0.002),有效率高于对照组(38.33% 比20.00%, χ2=4.881,P=0.027;70.00% 比36.67%, χ2=13.393,P=0.000);治疗组焦虑及抑郁指数明显降低(F=16.825, P=0.000;F=10.026, P=0.000),且均低于对照组(F=6.074, P=0.033; F=4.221, P=0.172);治疗组PSQI 下降(F=8.681, P=0.001),两组差异无统计学意义(F=3.587, P=0.284)。

结论

氟哌噻吨-美利曲辛片联合非甾体抗炎药治疗中青年女性乳腺癌保留乳房术后慢性疼痛疗效优于单纯非甾体抗炎药,且伴有情绪及睡眠质量改善。

Objective

To investigate the efficacy of Flupentixol and Melitracen tablets(Deanxit)combined with non-steroidal anti-inflammatory drug in young and middle-aged patients with chronic postoperative pain after breast-conserving surgery of breast cancer.

Methods

Totally 120 patients undergoing breast-conserving surgery in our hospital from March 2011 to September 2012 were enrolled and randomly divided into treatment group (n=60) and control group (n=60). All patients had chronic pain to different degree, with the scores of 8-15 by the hospital anxiety and depression(HAD) scale. Control group was treated with nonsteroidal anti-inflammatory drug Ibuprofen sustained release capsules (Fenbid, 0.3 g, bid), while treatment group took Fenbid plus Flupentixol and Melitracen tablets (1 tablet, bid). The treatment lasted for 8 weeks. At 0, 4, 8 weeks after treatment, the postoperative pain, emotional disorder and sleep quality were assessed using visual analogue scale(VAS),HAD scale,and Pittsburgh sleep quality index (PSQI). The t test and repeated analysis of variance were used to compare measurement data, chi-square test was used to compare the rates.

Results

At 4 weeks and 8 weeks after treatment, in treatment group, VAS showed a significant improvement (F=8.337, P=0.002), the effective rate was higher than that in control group (38.33% vs 20.00%, χ2=4.881,P=0.027; 70.00% vs 36.67%, χ2 =13.393,P<0.001); the indexes of anxiety and depression were significantly reduced (F=16.825, P<0.001; F=10.026, P<0.001), and both were lower than those in control group (F=6.074, P=0.033; F=4.221, P=0.172); PSQI was decreased (F=8.681,P=0.001), but the difference was not statistically significant between two groups (F=3.587, P=0.284).

Conclusion

Flupentixol and Melitracen tablets combined with non-steroidal anti-inflammatory drug show a better efficacy than non-steroidal anti-inflammatory drug used alone in the treatment of chronic pain after breastconserving surgery in young and middle-aged patients with breast cancer, accompanied by the improvement of emotion and sleep quality.

表1 治疗组和对照组临床病理特征比较
表2 氟哌噻吨-美利曲辛片治疗乳腺癌保留乳房术后慢性疼痛疗效观察
图1 两组乳腺癌保留乳房术后患者慢性疼痛VAS 评分 VAS: 疼痛模拟评分;各时间点比较,F=8.337, P=0.002;组间比较,F=4.802, P=0.036;时间与分组有交互作用,F=5.337,P=0.023
表3 氟哌噻吨-美利曲辛片治疗乳腺癌保留乳房术后慢性疼痛VAS 观察
表4 氟哌噻吨-美利曲辛片对乳腺癌保留乳房术后慢性疼痛患者心理状态及睡眠的影响
[1]
Karam A. Update on breast cancer surgery approaches[J].Curr Opin Obstet Gynecol,2013,25(1): 74-80.
[2]
Wyatt GK, Friedman LL. Physical and psychosocial outcomes of midlife and older women following surgery and adjuvant therapy for breast cancer[J]. Oncol Nurs Forum,1998,25(4): 761-768.
[3]
Schnur JB, Hallquist MN, Bovbjerg DH, et al. Predictors of expectancies for post-surgical pain and fatigue in breast cancer surgical patients[J]. Pers Individ Dif,2007,42(3): 419-429.
[4]
Zigmond AS, Snaith RP. The hospital anxiety and depression scale[J]. Acta Psychiatr Scand,1983,67(6): 361-370.
[5]
Aicher B, Peil H, Peil B, et al. Pain measurement: Visual Analogue Scale (VAS) and Verbal Rating Scale (VRS) in clinical trials with OTC analgesics in headache [ J ].Cephalalgia,2012,32(3): 185-197.
[6]
Buysse DJ, Reynolds CF 3rd, Monk TH, et al. The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research[J]. Psychiatry Res,1989,28(2): 193-213.
[7]
Frassica DA, Bajaj GK, Tsangaris TN. Treatment of complications after breast-conservation therapy[J]. Oncology(Williston Park),2003,17(8): 1118-1128.
[8]
Masuzawa M, Taguchi H, Sugimoto T, et al. Case of successful management with mirtazapine for prolonged pain after esophagectomy[J]. Masui,2012,61(9): 1003-1005.
[1] 李洋, 蔡金玉, 党晓智, 常婉英, 巨艳, 高毅, 宋宏萍. 基于深度学习的乳腺超声应变弹性图像生成模型的应用研究[J/OL]. 中华医学超声杂志(电子版), 2024, 21(06): 563-570.
[2] 河北省抗癌协会乳腺癌专业委员会护理协作组. 乳腺癌中心静脉通路护理管理专家共识[J/OL]. 中华乳腺病杂志(电子版), 2024, 18(06): 321-329.
[3] 刘晨鹭, 刘洁, 张帆, 严彩英, 陈倩, 陈双庆. 增强MRI 影像组学特征生境分析在预测乳腺癌HER-2 表达状态中的应用[J/OL]. 中华乳腺病杂志(电子版), 2024, 18(06): 339-345.
[4] 张晓宇, 殷雨来, 张银旭. 阿帕替尼联合新辅助化疗对三阴性乳腺癌的疗效及预后分析[J/OL]. 中华乳腺病杂志(电子版), 2024, 18(06): 346-352.
[5] 邱琳, 刘锦辉, 组木热提·吐尔洪, 马悦心, 冷晓玲. 超声影像组学对致密型乳腺背景中非肿块型乳腺癌的诊断价值[J/OL]. 中华乳腺病杂志(电子版), 2024, 18(06): 353-360.
[6] 程燕妮, 樊菁, 肖瑶, 舒瑞, 明昊, 党晓智, 宋宏萍. 乳腺组织定位标记夹的应用与进展[J/OL]. 中华乳腺病杂志(电子版), 2024, 18(06): 361-365.
[7] 涂盛楠, 胡芬, 张娟, 蔡海峰, 杨俊泉. 天然植物提取物在乳腺癌治疗中的应用[J/OL]. 中华乳腺病杂志(电子版), 2024, 18(06): 366-370.
[8] 朱文婷, 顾鹏, 孙星. 非酒精性脂肪性肝病对乳腺癌发生发展及治疗的影响[J/OL]. 中华乳腺病杂志(电子版), 2024, 18(06): 371-375.
[9] 周荷妹, 金杰, 叶建东, 夏之一, 王进进, 丁宁. 罕见成人肋骨郎格汉斯细胞组织细胞增生症被误诊为乳腺癌术后骨转移一例[J/OL]. 中华乳腺病杂志(电子版), 2024, 18(06): 380-383.
[10] 葛睿, 陈飞, 李杰, 李娟娟, 陈涵. 多基因检测在早期乳腺癌辅助治疗中的应用价值[J/OL]. 中华乳腺病杂志(电子版), 2024, 18(05): 257-263.
[11] 高杰红, 黎平平, 齐婧, 代引海. ETFA和CD34在乳腺癌中的表达及与临床病理参数和预后的关系研究[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 64-67.
[12] 韩萌萌, 冯雪园, 马宁. 乳腺癌改良根治术后桡神经损伤1例[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 117-118.
[13] 张志兆, 王睿, 郜苹苹, 王成方, 王成, 齐晓伟. DNMT3B与乳腺癌预后的关系及其生物学机制[J/OL]. 中华普外科手术学杂志(电子版), 2024, 18(06): 624-629.
[14] 王玲艳, 高春晖, 冯雪园, 崔鑫淼, 刘欢, 赵文明, 张金库. 循环肿瘤细胞在乳腺癌新辅助及术后辅助治疗中的应用[J/OL]. 中华普外科手术学杂志(电子版), 2024, 18(06): 630-633.
[15] 赵林娟, 吕婕, 王文胜, 马德茂, 侯涛. 超声引导下染色剂标记切缘的梭柱型和圆柱型保乳区段切除术的效果研究[J/OL]. 中华普外科手术学杂志(电子版), 2024, 18(06): 634-637.
阅读次数
全文


摘要