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目的评估替利定治疗腰椎间盘突出症合并神经根性疼痛的疗效和安全性。方法连续将94例接受髓核摘除术的腰椎间盘突出症合并神经根性疼痛患者,以1∶1随机分为替利定(T)组和氨酚羟考酮(O)组。T组患者于术前2 h及术后4、10、16 h予盐酸替利定口服溶液100 mg,po;O组患者于同一时间予氨酚羟考酮片(每片包含羟考酮5 mg+对乙酰氨基酚325 mg)1片,po。于术前和术后24 h以内评估患者疼痛视觉模拟评分(VAS),患者整体状态(PGA)评分,使用哌替啶的人数、用量以及不良反应。结果 T组患者在术后12和24 h VAS评分(2.7±1.8 vs 3.6±1.5;2.4±1.4 vs 3.1±1.5)和PGA评分(3.3±1.9 vs 4.1±1.8;2.7±1.5 vs 3.5±1.7)均显著低于O组患者(P<0.05)。同时,T组患者因出现难以忍受的疼痛而使用哌替啶进行解救的患者比例显著低于O组患者(8.5%vs 23.4%,P=0.049)。此外,2组患者出现不良反应如恶心、便秘、呕吐、嗜睡和头晕的比例之间差异均无统计学意义(P>0.05)。结论替利定治疗腰椎间盘突出症合并神经根性疼痛疗效优于氨酚羟考酮,而安全性与氨酚羟考酮相当。
Abstract：AIM To investigate the efficacy and safety of tilidine in treating lumbar disc herniation in combination with nerve root pain. METHODS A total of 94 patients with lumbar disc herniation in combination with nerve root pain who received lumbar discectomy were consecutively recruited and randomly assigned to the tilidine group(group T) and the oxycodone & acetaminophen group(group O) with a ratio of 1∶1. Patients in group T received tilidine hydrochloride oral liquid(100 mg) while patients in group O received oxycodone & acetaminophen tablets(one tablet contained 5 mg oxycodone +325 mg acetaminophen) before and post operation, respectively. Pain visual analogue scale(VAS) score, patient global assessment(PGA) score, percentage and dose of pethidine as well as adverse drug reactions were evaluated. RESULTS Patients in group T exhibited decreased pain VAS score compared to patients in group O 12 h(2.7±1.8 vs 3.6±1.5,P=0.012) and 24 h(2.4±1.4 vs 3.1±1.5,P=0.016) post operation. Meanwhile, PGA score in group T was also lower than that in group O 12 h(3.3±1.9 vs 4.1±1.8,P=0.042) and 24 h(2.7±1.5 vs 3.5±1.7,P=0.011) post operation, respectively. In the meantime, group T presented decreased percentage of patients(8.5% vs 23.4%,P=0.049) using pethidine for intolerable pain compared to group O. In addition, no difference of adverse drug reactions between group T and group O was observed(P>0.05). CONCLUSION Tilidine is a more effective and equally safe drug compared to oxy-codone & acetaminophen in treating lumbar disc herniation in combination with nerve root pain.
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基本信息:
DOI：10.19577/j.1007-4406.2020.02.001
中图分类号:R969.4
引用信息:
[1]秦世强,倪文卓.替利定治疗腰椎间盘突出症合并神经根性疼痛的疗效与安全性[J].中国临床药学杂志,2020,29(02):81-84.DOI:10.19577/j.1007-4406.2020.02.001.
2020-03-25
2020-03-25