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阿片类镇痛药联合非甾体抗炎药对周围神经病变的治疗作用及其对炎症因子的影响

Therapeutic effect of opioid analgesics combined with non-steroidal anti-inflammatory drugs on peripheral neuropathy and its influence on inflammatory factors.

作者信息

Huang Zhiqi, Lin Kai

机构信息

Department of Intensive Care Unit, Hanchuan People's Hospital Hanchuan 431600, Hubei Province, China.

Department of Interventional Vascular Surgery, Hanchuan People's Hospital Hanchuan 431600, Hubei Province, China.

出版信息

Am J Transl Res. 2021 Oct 15;13(10):11752-11757. eCollection 2021.

PMID:34786103
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8581913/
Abstract

OBJECTIVE

To study the therapeutic effect of opioid analgesics combined with non-steroidal anti-inflammatory drugs on peripheral neuropathy and inflammatory factors.

METHODS

Clinical data of 60 patients with peripheral neuropathy were collected and studied retrospectively. The patients were divided into Group A (30 cases, treated with tramadol combined with ibuprofen) and Group B (30 cases, treated with tramadol alone). The visual analogue scale (VAS) and numerical rating scale (NRS) pain scores were recorded before and 3, 7, 14 and 21 days after taking the medicine. The adverse reactions of nausea, vomiting, gastrointestinal disorder, dizziness, rash and lethargy were recorded within 21 days after taking the medicine. Blood samples were obtained from patients before and 3, 7, 14 and 21 days after taking medicine to detect the inflammatory factors IL-6, IL-1β and TNF-α.

RESULTS

VAS and NRS scores of patients in Group A were significantly lower than those of patients in Group B after 7, 14 and 21 days of treatment (all P<0.05), but there was no significant difference in VAS and NRS scores between the two groups after 3 days of treatment (all P>0.05). The incidence of gastrointestinal disturbance in Group A was significantly higher than that in Group B (P<0.001). There was no significant difference in IL-6, IL-1β and TNF-α between the two groups 3 days after treatment (all P>0.05), but after 7, 14 and 21 days of treatment, the levels of IL-6, IL-1β and TNF-α in Group A were significantly lower than those in Group B (all P<0.05).

CONCLUSION

Opioid analgesics combined with non-steroidal anti-inflammatory drugs is better than opioid analgesics alone in the treatment of peripheral neuropathy, and brings no more adverse reactions except gastrointestinal disorders, so the combined treatment can be further promoted for clinical use.

摘要

目的

研究阿片类镇痛药联合非甾体抗炎药对外周神经病变及炎症因子的治疗效果。

方法

回顾性收集并研究60例外周神经病变患者的临床资料。将患者分为A组(30例,接受曲马多联合布洛芬治疗)和B组(30例,仅接受曲马多治疗)。记录服药前及服药后3天、7天、14天和21天的视觉模拟评分法(VAS)和数字评定量表(NRS)疼痛评分。记录服药后21天内恶心、呕吐、胃肠道紊乱、头晕、皮疹和嗜睡等不良反应。在患者服药前及服药后3天、7天、14天和21天采集血样,检测炎症因子白细胞介素-6(IL-6)、白细胞介素-1β(IL-1β)和肿瘤坏死因子-α(TNF-α)。

结果

治疗7天、14天和21天后,A组患者的VAS和NRS评分显著低于B组患者(均P<0.05),但治疗3天后两组患者的VAS和NRS评分无显著差异(均P>0.05)。A组胃肠道紊乱发生率显著高于B组(P<0.001)。治疗3天后两组患者IL-6、IL-1β和TNF-α水平无显著差异(均P>0.05),但治疗7天、14天和21天后,A组IL-6、IL-1β和TNF-α水平显著低于B组(均P<0.05)。

结论

阿片类镇痛药联合非甾体抗炎药治疗外周神经病变优于单纯使用阿片类镇痛药,且除胃肠道紊乱外未带来更多不良反应,故联合治疗可进一步推广用于临床。