目的 探究氨酚曲馬多片聯(lián)合普瑞巴林膠囊治療癌性神經(jīng)病理性疼痛的臨床療效。方法 選取2015年4月—2017年4月鄭州大學(xué)附屬鄭州中心醫(yī)院收治的癌性神經(jīng)病理性疼痛患者150例為研究對象，所有患者隨機(jī)分為普瑞巴林組、氨酚曲馬多組和聯(lián)合治療組，每組各50例。普瑞巴林組口服普瑞巴林膠囊，75 mg/次，2次/d；氨酚曲馬多組口服氨酚曲馬多片，100 mg/次，1次/d；聯(lián)合治療組口服普瑞巴林膠囊和氨酚曲馬多片，用法同上。所有患者均連續(xù)治療4周。觀察兩組的臨床療效，比較兩組的疼痛數(shù)字（NRS）評分、生活質(zhì)量（QOL）評分和睡眠質(zhì)量（MOS）評分。結(jié)果 治療后，普瑞巴林組、氨酚曲馬多組、聯(lián)合治療組疼痛總緩解率分別為62.00%、64.00%、82.00%，聯(lián)合治療組與普瑞巴林組、氨酚曲馬多組比較差異具有統(tǒng)計學(xué)意義（P < 0.05）。治療后，3組NRS評分均顯著降低，同組治療前后比較差異具有統(tǒng)計學(xué)意義（P < 0.05）；且聯(lián)合治療組NRS評分明顯低于普瑞巴林組、氨酚曲馬多組，兩組比較差異具有統(tǒng)計學(xué)意義（P < 0.05）。治療后，3組QOL評分均顯著降低，同組治療前后比較差異具有統(tǒng)計學(xué)意義（P < 0.05）；且聯(lián)合治療組QOL評分明顯低于普瑞巴林組、氨酚曲馬多組，兩組比較差異具有統(tǒng)計學(xué)意義（P < 0.05）。治療后，普瑞巴林組、聯(lián)合治療組睡眠干擾（SLPD）、睡眠量（SLPQ）評分顯著降低，睡眠充足度（SLPA）評分顯著升高，同組治療前后比較差異具有統(tǒng)計學(xué)意義（P < 0.05）；且聯(lián)合治療組這些觀察指標(biāo)的改善程度明顯優(yōu)于普瑞巴林組、氨酚曲馬多組，3組比較差異具有統(tǒng)計學(xué)意義（P < 0.05）。結(jié)論 氨酚曲馬多片聯(lián)合普瑞巴林膠囊治療癌性神經(jīng)病理性疼痛具有較好的臨床療效，可緩解患者癌性疼痛，改善患者生活質(zhì)量和睡眠質(zhì)量，安全性較好，具有一定的臨床推廣應(yīng)用價值。

Objective To explore the clinical effect of Paracetamol and Tramadol Hydrochloride Tablets combined with Pregabalin Capsules in treatment of cancerous neuropathic pain. Methods Patients (150 cases) with cancerous neuropathic pain in Zhengzhou Central Hospital Affiliated to Zhengzhou University from April 2015 to April 2017 were randomly divided into pregabalin, paracetamol and tramadol, and combined treatment groups, and each group had 50 cases. Patients in the pregabalin group were po administered with Pregabalin Capsules, 75 mg/time, twice daily. Patients in the paracetamol and tramadol group were po administered with Paracetamol and Tramadol Hydrochloride Tablets, 100 mg/time, once daily. Patients in the combined treatment group were given Pregabalin Capsules and Paracetamol and Tramadol Hydrochloride Tablets, usage as above. Patients in three groups were treated for 4 weeks. After treatment, the clinical efficacies were evaluated, and NRS scores, QOL scores, and MOS scores in three groups were compared. Results After treatment, the pain relief rates in the pregabalin, paracetamol and tramadol, and combined treatment groups were 62.00%, 64.00%, and 82.00%, respectively, and there was difference between combined treatment group with pregabalin group, paracetamol and tramadol group (P < 0.05). After treatment, the NRS scores in three groups were significantly decreased, and the difference was statistically significant in the same group (P < 0.05). And the NRS score in the combined treatment group were significantly lower than that in the pregabalin group and the paracetamol and tramadol group, with significant difference between two groups (P < 0.05). After treatment, the QOL scores in three groups were significantly decreased, and the difference was statistically significant in the same group (P < 0.05). And the QOL score in the combined treatment group were significantly lower than that in the pregabalin group and the paracetamol and tramadol group, with significant difference between two groups (P < 0.05). After treatment, the SLPD scores and SLPQ scores in the pregabalin group and the combined treatment group were significantly decreased, but the SLPA scores in the pregabalin group and the combined treatment group were significantly increased, and the difference was statistically significant in the same group (P < 0.05). And the observational indexes in the combined treatment group were significantly better than those in the pregabalin group and the paracetamol and tramadol group, with significant difference between two groups (P < 0.05). Conclusion Paracetamol and Tramadol Hydrochloride Tablets combined with Pregabalin Capsules has clinical curative effect in treatment of cancerous neuropathic pain, can relieve the cancer pain, improve the quality of life and the quality of sleep, which has a certain clinical application value.