氨酚曲马多治疗骨科急慢性疼痛疗效

1、氨酚曲马多治疗骨科急慢性疼痛疗效【摘要】目的探讨氨酚曲马多治疗骨科急慢性疼痛的疗 效。方法对骨科门诊124例疼痛患者(111例急性疼痛，13 例慢性疼痛)其疼痛的程度用视觉模拟评分法(vas)进行评 分后，给予氨酚曲马多治疗5 d,然后再次对疼痛进行评分并 对疗效进行评价，并记录不良反应。结果急性疼痛患者治疗 前平均疼痛的vas评分为(5. 38±1.43),治疗后平均疼痛的 vas评分为(3. 50±1. 69)，二者有统计学意义;慢性疼痛患者 治疗前平均疼痛的vas评分为(4. 83±1. 30),治疗后平均疼 痛的vas评分为(4.00±1.47)

2、,二者有统计学意义。急性疼 痛患者的不良反应主要为头晕14%、恶心4.5%、呕吐8. 1%； 慢性疼痛患者没有不良反应的发生。结论氨酚曲马多对于 治疗骨科急慢性疼痛安全性较好，总体效果满意。【关键词】氨酚曲马多；急慢性疼痛；疗效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.作者单位：510120广州，中山大学附属孙逸仙纪念医院骨外科近年来，多模式镇痛在疼痛的控制中得到广泛的应用,不同作用机制的镇痛药物已被联合应用于急慢性疼痛的治 疗当中，其镇痛效果

7、、耐受性和安全性都较单一使用某种药 物要好。氨酚曲马多（西安杨森制药有限公司生产，每片含37.5 mg曲马多和325 mg对乙酰氨基酚）是近年来的一种复合镇痛药物，其保留了对乙酰氨基酚的快速镇痛效果，又有 曲马多的持久镇痛效果1,已经应用于口腔科、乳腺癌术后 镇痛等，但在国内骨科领域中应用相对较少，尤其对慢性疼 痛的疗效方面文献报导较少。2008年710月，对我院骨科门 诊124例疼痛患者（111例急性，13例慢性）给予氨酚曲马多 片治疗，评价治疗前后疼痛的缓解以及不良反应的发生，现 报告如下。1资料与方法1. 1研究对象2008年710月，以124例就诊于我院骨 科门诊的疼痛患者为研究对象,

8、其中急性疼痛111例（疼痛持 续时间急性疼痛患者疼痛程度vas评分vas评分治疗前治疗后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 杨庆铭，氨酚曲马多片治疗中重度骨科门急诊急性 疼痛的疗效及安全性临床研究.中华关节外科杂志(电子 版),2007(03)7 金勋杰，等氨酚曲马多治疗骨科中重度疼痛的疗 效及安全性的研究.中华关节外科杂志(电子 版),2009,3(3):68-69.8 翟文勇，张兆川氨酚曲马多治疗骨科腰椎术后疼 痛的临床观察.中国医药指南：学术版,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