| Yuhong Dai,Man Zou,Tingting Huang,Hong Qiu. Efficacy and adverse effects of olanzapine in the treatment of moderate to severe refractory neuropathic pain. Oncol Transl Med, 2020, 6: 47-51. |
| 奥氮平治疗中重度难治性神经病理性疼痛的临床观察 |
| Efficacy and adverse effects of olanzapine in the treatment of moderate to severe refractory neuropathic pain |
| Received:January 15, 2020 Revised:April 21, 2020 |
| DOI：10.1007/s10330-020-0401-1 |
| 中文关键词: 奥氮平；难治性癌痛；神经病理性疼痛；疗效；不良反应 |
| 英文关键词: Olanzapine; refractory cancer pain; neuropathic pain; efficacy; adverse effect |
| 基金项目:华中科技大学双一流自主创新学科医师资助项目( 3011540024，5001540074，5001540095) ; 武汉市中青年医学骨干人才培养工程( 2016whzqnyxggrcl) |
| Author Name | Affiliation | E-mail | | Yuhong Dai | Cancer Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science & Technology | eier_dai@163.com | | Man Zou* | Cancer Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science & Technology | skyfountain@163.com | | Tingting Huang | Cancer Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science & Technology | | | Hong Qiu | Cancer Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science & Technology | |
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| 中文摘要: |
| 目的 探讨奥氮平在中重度难治性神经病理性疼痛患者中使用的疗效及安全性。 方法 选择我科收治的40例中重度难治性神经病理性疼痛的消化道肿瘤患者，口服2周奥氮平，5-10mg/d（基于药物反应和耐受性调整），每晚一次。联合常规止痛治疗。记录患者用药前后的NRS评分及PSQI评分。记录不良反应。根据患者疼痛情况随时调整常规止痛药物剂量。 结果 40例患者加用奥氮平3天后NRS评分下降2.575±1.318（P＜0.000），30%的患者疼痛明显缓解；用药2周后NRS评分下降3.400±1.614（P＜0.000），50%的患者疼痛明显缓解。用药2周后患者PSQI下降4.725±2.828（P＜0.000），患者睡眠状况明显改善。使用奥氮平的副反应主要为嗜睡、体重增加、头晕、乏力、口干、便秘等，均为轻度可耐受。 结论 在难治性神经病理性疼痛的癌症患者中，常规止痛治疗的基础上加用小剂量奥氮平，止痛效果明显，不良反应轻微，耐受性好，可选择使用。 |
| 英文摘要: |
| Objective: The aim of the study was to investigate the efficacy and adverse effects of olanzapine in the
treatment of moderate to severe refractory neuropathic pain.
Methods: Forty patients with digestive system cancer were enrolled, who had moderate to severe
refractory neuropathic pain; the patients were treated with olanzapine for 2 weeks at a daily dosage of 5 mg
to 10 mg per night according to patients’ response and tolerability, combined with conventional analgesic
therapy. Pain intensity was evaluated by using a Numeral Rating Scale (NRS) at baseline, 3 days, and 2
weeks after therapy. The Pittsburg Sleep Quality Index (PSQI) was evaluated at baseline and 2 weeks after
therapy. Data on adverse events were recorded. The dosage of conventional analgesics was adjusted over
time based on the severity of pain.
Results: The mean pain score decreased by 2.575 ± 1.318 (P < 0.000) at 3 days and by 3.400 ± 1.614 (P
< 0.000) at 2 weeks; 30% of the patients experienced significant pain relief at 3 days and 50% at 2 weeks.
The PSQI decreased by 4.725 ± 2.828 (P < 0.000) at 2 weeks. The adverse events induced by olanzapine
included sleepiness, weight gain, dizziness, fatigue, dry mouth, and constipation; all the side effects were
mild.
Conclusion: When combined with conventional analgesic therapy, olanzapine was effective in relieving
pain and sleep disturbance, and was well-tolerated among patients with refractory neuropathic pain. |
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