关键词: 阿米替林, 阿片类药物, 癌痛, 抑郁, 生活质量

Abstract:

AIM: To investigate the effect and safety of amitriptyline combined with opioid for moderate to severe cancer pain patients with depression. METHODS: Forty-two patients with moderate to severe cancer pain and depression were randomly divided into two groups. The control group was given strong opioids (n=21), the treatment group was given opioids combined with amitriptyline (n=21). The digital classification method (NRS), depression self rating scale (SDS) and Hamilton depression scale (HAMD 17), quality of life questionnaire (SF-36) were used to assess the clinical effect of pain, depression and quality of life. In addition, the opioids dose and adverse drug reactions were recorded. RESULTS: Pain was significantly alleviated in each group (P<0.01) after two or four weeks, and the NRS of the treatment group was better than that of the control group after two or four weeks (P<0.05); depression was relieved in each group (P<0.01), and the depression score of the treatment group was better than that of the control group (P<0.05); after the treatment, the quality of life had improved to a certain extent in both groups, and the emotional function, energy, mental health, social functioning and body pain in the treatment group were better than those of the control group (P<0.05); the average daily dosage of opioids for treatment group was significantly lower than that of the control group after four weeks (P<0.01); the total incidence of adverse of the treatment group was slight higher than that of the control gtoup (P>0.05), but the dizziness, sleepiness and urinary retention were obviously more than those of the control group (P<0.05). CONCLUSION: Amitriptyline combined with opioids can effectively control severe cancer pain, relieve depressive symptoms, and improve the quality of life for cancer pain patients, which is referential for clinical application.

Key words: amitriptyline, opioids, cancer pain, depression, quality of life