目的：研究盐酸羟考酮缓释片联合阿米替林对重度癌症疼痛（以下简称癌痛）伴抑郁患者的疗效。方法：34例重度癌痛伴抑郁患者随机分为2组，研究组应用盐酸羟考酮缓释片联合阿米替林治疗，盐酸羟考酮缓释片止痛治疗作为对照组，进行为期4周的临床观察。采用面部表情疼痛评分量表（FPS-R）和汉密尔顿抑郁量表（HAMD17）评估止痛效果和抑郁缓解，同时观察盐酸羟考酮缓释片用药量、药物不良反应等情况。结果：2组患者治疗后疼痛症状明显缓解（P＜0.01）；研究组治疗后症状改善明显，与治疗前比，HAMD17评分显著降低（P＜0.01）；与对照组治疗后比，HAMD17评分亦显著降低（P＜0.01）；研究组治疗第4周盐酸羟考酮缓释片日平均用药量明显低于对照组（P＜0.01）；2组药物不良反应情况无明显差异。结论：盐酸羟考酮缓释片联合阿米替林能有效控制重度癌痛，改善抑郁症状，改善晚期癌症患者的生活质量。%Objective: To investigate the clinical efifcacy of oxycodone hydrochloride prolonged-release tablets with or without amitriptyline for severe cancer pain patients with depression.Methods: Thirty-four pa-tients with severe cancer pain and depression were randomly divided into two groups. Oxycodone hydrochloride sustained-release tablets combined with amitriptyline were applied for 17 patients in treating group. Oxycodone hydrochloride sustained-release tablets without amitriptyline for cancer pain treatment as control group. All patients were observed for a period of four weeks. The facial pain rating scale (FPS-R) and Hamilton rating scale for depression (HAMD17) were used to assess the clinical efifcacy. The dose and adverse drug reactions of Oxycodone were recorded.Results: Pain relieved in each groups of the patients after treatment (P<0.01). It was more effective that depression improved in treating group, HAMD17 scores were signiifcantly lower than that of pretreatment and the control group (P<0.01). The average daily dosage of oxycodone hydrochloride prolonged-release tablets for treating group was signiifcantly lower than that for the control group during the fourth week (P<0.01) and the adverse reactions between two groups have no signiifcant difference.Conclusion: Oxycodone hydrochloride prolonged-release tablets combined amitriptyline can effectively control severe cancer pain, im-prove depressive symptoms and quality of life for advanced cancer patients.
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