目的 探讨康莱特注射液联合盐酸氢吗啡酮治疗肺癌中重度癌痛的临床疗效。方法 纳入2022年1月—2025年2月天津市北辰区中医医院收治的136例肺癌中重度癌痛患者，按随机数字表法平均分为对照组和治疗组。对照组采用电子注药泵持续皮下输注盐酸氢吗啡酮注射液，在此基础上，治疗组静脉滴注康莱特注射液，200 mL/次，1次/d，治疗3 d后评估两组镇痛疗效，比较两组不同时间点静息痛视觉模拟评分法（VAS）评分，以及止痛起效时间、滴定成功率、氢吗啡酮总用量和治疗前后爆发痛次数、简明疼痛评估量表（BPI）评分、心理痛苦温度计（DT）评分、血清学指标[神经生长因子（NGF）、肿瘤坏死因子-α（TNF-α）、白细胞介素-6（IL-6）]水平。结果 治疗组总有效率（92.65%）高于对照组（80.88%，P＜0.05）。治疗1、2、3 d后，治疗组同期静息痛VAS评分低于对照组（P＜0.05）。与对照组相比，治疗组止痛起效时间缩短（P＜0.05），滴定成功率提高（98.53% vs. 88.24%， P＜0.05），氢吗啡酮总用量减少（P＜0.05）。治疗后，两组爆发痛次数和BPI、DT评分均降低（P＜0.05）；且治疗组变化更明显（P＜0.05）。治疗后两组血清NGF、TNF-α和IL-6水平均降低（P＜0.05）；且治疗组变化更明显（P＜0.05）。结论 康莱特注射液联合盐酸氢吗啡酮治疗肺癌中重度癌痛，可有效提高镇痛效果，加速止痛起效时间，减少氢吗啡酮总用量及爆发痛次数，抑制致痛因子刺激和提升对疼痛的耐受力，利于患者身心痛苦减轻。

Objective To investigate the clinical efficacy of Kanglaite Injection combined with hydromorphone hydrochloride in treatment of moderate to severe cancer pain in patients with lung cancer. Methods A total of 136 patients with moderate to severe cancer pain caused by lung cancer admitted to Tianjin Beichen District Hospital of Traditional Chinese Medicine from January 2022 to February 2025 were enrolled and equally divided into control group and treatment group using the random number table method. Patients in the control group were received continuous subcutaneous infusion of Hydromorphone Hydrochloride Injection via an electronic infusion pump. On this basis, patients in the treatment group were additionally administered intravenous drip of Kanglaite Injection at a dose of 200 mL once daily. The analgesic efficacy of the two groups was evaluated after 3 days of treatment. The two groups were compared in terms of resting Visual Analog Scale (VAS) scores at different time points, pain onset time, titration success rate, total consumption of hydromorphone, frequency of breakthrough pain before and after treatment, Brief Pain Inventory (BPI) scores, Distress Thermometer (DT) scores, and serum levels of nerve growth factor (NGF), tumor necrosis factor-α (TNF-α), and interleukin-6 (IL-6). Results The total effective rate of the treatment group was significantly higher than that of the control group (92.65% vs 80.88%, P < 0.05). At 1 d, 2 d and 3 d after treatment, the resting VAS scores of the treatment group were lower than those of the control group at the corresponding time points (P < 0.05). Compared with the control group, the treatment group had a shorter pain onset time (P < 0.05), a higher titration success rate (98.53% vs 88.24%, P < 0.05), and lower total hydromorphone consumption (P < 0.05). After treatment, the frequency of breakthrough pain, BPI scores and DT scores decreased in both groups (P < 0.05), with more remarkable improvements observed in the treatment group (P < 0.05). Serum levels of NGF, TNF-α and IL-6 were reduced in both groups after treatment (P < 0.05), and the reduction was more prominent in the treatment group (P < 0.05). Conclusion For lung cancer patients with moderate to severe cancer pain, Kanglaite Injection combined with hydromorphone hydrochloride can significantly improve analgesic efficacy, accelerate pain relief onset, reduce total hydromorphone dosage and breakthrough pain episodes, inhibit the stimulation of pain-inducing factors and enhance pain tolerance, thereby alleviating physical and psychological suffering of patients.

R979.1

天津市北辰区科技计划项目（SHGY-2022014）