氨酚曲馬多治療骨科急慢性疼痛療效

1、氨酚曲馬多治療骨科急慢性疼痛療效【摘要】目的探討氨酚曲馬多治療骨科急慢性疼痛的療 效。方法對骨科門診124例疼痛患者(111例急性疼痛，13 例慢性疼痛)其疼痛的程度用視覺模擬評分法(vas)進(jìn)行評 分后，給予氨酚曲馬多治療5 d,然后再次對疼痛進(jìn)行評分并 對療效進(jìn)行評價，并記錄不良反應(yīng)。結(jié)果急性疼痛患者治療 前平均疼痛的vas評分為(5. 38±1.43),治療后平均疼痛的 vas評分為(3. 50±1. 69)，二者有統(tǒng)計學(xué)意義;慢性疼痛患者 治療前平均疼痛的vas評分為(4. 83±1. 30),治療后平均疼 痛的vas評分為(4.00±1.47)

2、,二者有統(tǒng)計學(xué)意義。急性疼 痛患者的不良反應(yīng)主要為頭暈14%、惡心4.5%、嘔吐8. 1%； 慢性疼痛患者沒有不良反應(yīng)的發(fā)生。結(jié)論氨酚曲馬多對于 治療骨科急慢性疼痛安全性較好，總體效果滿意。【關(guān)鍵詞】氨酚曲馬多；急慢性疼痛；療效efficacy of paracetamol and tramadol in the treatment of acute and chronic orthopedic painding yue, zeng zhan-peng, xu jie, et al. department of orthopaedics,sun yat-sen memorial hospita

3、l,guangzhou 510120,chinaabstract objective to observe the efficacy ofparacetamol and tramadol in the treatment of acute and chronic orthopedic pain. methods the extent of pain of 124 patients (111 cases of acute pain and 13 cases of chronic pain)was assessed in visual analogue scale (vas) for the fi

4、rst vis it and assessed again after the treatment of paracetamol and tramado 1. evaluate the efficacy of the treatment finally. results the vas of average pain before and after treatment was 5. 38 + 1. 43 and 3. 50± 1. 69 in patients of acute pain,while the vas of average pain before and after

5、treatment was 4.83 +1. 30 and 4.00±1.47 in patients of chronic pain,and both were statistically significant .the incidence of adverse reactions in patients with acute pain was 23.4%,mainly dizziness 14%,nausea 4. 5%,vomiting 8.1%,while patients with chronic pain were in no adverse event.conclus

6、ion paracetamol and tramadol for the treatment of acute and chronic pain was in good safe ty ,and the overall resu its were satisfactory.key words】paracetamol and tramadol； acute and chronic pain； effectiveness.作者單位：510120廣州，中山大學(xué)附屬孫逸仙紀(jì)念醫(yī)院骨外科近年來，多模式鎮(zhèn)痛在疼痛的控制中得到廣泛的應(yīng)用,不同作用機制的鎮(zhèn)痛藥物已被聯(lián)合應(yīng)用于急慢性疼痛的治 療當(dāng)中，其鎮(zhèn)痛效果

7、、耐受性和安全性都較單一使用某種藥 物要好。氨酚曲馬多（西安楊森制藥有限公司生產(chǎn)，每片含37.5 mg曲馬多和325 mg對乙酰氨基酚）是近年來的一種復(fù)合鎮(zhèn)痛藥物，其保留了對乙酰氨基酚的快速鎮(zhèn)痛效果，又有 曲馬多的持久鎮(zhèn)痛效果1,已經(jīng)應(yīng)用于口腔科、乳腺癌術(shù)后 鎮(zhèn)痛等，但在國內(nèi)骨科領(lǐng)域中應(yīng)用相對較少，尤其對慢性疼 痛的療效方面文獻(xiàn)報導(dǎo)較少。2008年710月，對我院骨科門 診124例疼痛患者（111例急性，13例慢性）給予氨酚曲馬多 片治療，評價治療前后疼痛的緩解以及不良反應(yīng)的發(fā)生，現(xiàn) 報告如下。1資料與方法1. 1研究對象2008年710月，以124例就診于我院骨 科門診的疼痛患者為研究對象,

8、其中急性疼痛111例（疼痛持 續(xù)時間急性疼痛患者疼痛程度vas評分vas評分治療前治療后t值p值最痛 vas6. 29±1. 464. 32±1. 6311. 850. 05平均疼痛 vas4. 83±1. 314. 00±1. 472. 294 mccarberg,b.tramadol extended-release in the management of chronic pain. ther clin risk manag,2007,3(3)：401-105 filitz,j,et al. supra-additive effects of tr

9、amadol and acetaminophen in a human pain model. pain,2008,10(1):p.15-22.6 楊慶銘，氨酚曲馬多片治療中重度骨科門急診急性 疼痛的療效及安全性臨床研究.中華關(guān)節(jié)外科雜志(電子 版),2007(03)7 金勛杰，等氨酚曲馬多治療骨科中重度疼痛的療 效及安全性的研究.中華關(guān)節(jié)外科雜志(電子 版),2009,3(3):68-69.8 翟文勇，張兆川氨酚曲馬多治療骨科腰椎術(shù)后疼 痛的臨床觀察.中國醫(yī)藥指南：學(xué)術(shù)版,2009,7(21): 78-780.9 edwards, j. e. , h. j. mcquay and r. a.

10、 moore,combination analgesic efficacy：individual pati ent data met a-ana.lysis of single-dose oral tramadol plus acetaminophen in acute postoperative pain. j pain symptom manage,2002,23(2):121-130.10 emkey,r,et al. efficacy and safety of tramadol/acetaminophen tablets (ultracet)as add-on therapy for osteoarthritis pain in subjects receiving a cox-2 nonsteroidal antiinflammatory drug：a multicenter,randomized,double-blind,placebo-control led trial. j rheumatol,2004,31 (1):150-156.11 md, ger. ,et al. , tramadol/acetaminophencombination