目标:度洛西汀,美国临床肿瘤学会(ASCO)唯一推荐用于癌症幸存者化疗引起的周围神经病变(CIPN)的治疗方法,对40%的幸存者无效。这项研究检查了度洛西汀-哌唑嗪组合在奥沙利铂诱导的周围神经病变(OPIN)大鼠模型中预防异常性疼痛和痛觉过敏的能力。
方法:雌性(n=24)和雄性(n=41)大鼠开始服用度洛西汀(15mg),哌唑嗪(2毫克),或度洛西汀-哌唑嗪联合化疗前一周,奥沙利铂,并继续使用度洛西汀-哌唑嗪组合32天。在研究过程中,使用选定的vonFrey细丝进行机械异常性疼痛和机械痛觉过敏的行为测试。
结果:接受度洛西汀-哌唑嗪组合的大鼠的总体爪退缩百分比在雌性(两种情况下p<.001)和雄性(p=.029对于异常性疼痛;p<.001对于痛觉过敏)中明显低于接受水的大鼠。在接受度洛西汀治疗的大鼠和接受度洛西汀-哌唑嗪组合的大鼠之间,治疗后的异常性疼痛或痛觉过敏均未发现显着差异。
结论:这些发现提供了初步证据,证明度洛西汀-哌唑嗪组合可以预防雄性和雌性大鼠治疗后异常性疼痛和痛觉过敏的发展;然而,结果表明,在预防慢性OIPN方面,度洛西汀-哌唑嗪联合用药并不比单用度洛西汀有效.
结论:护理专业建立在科学研究支持的临床实践基础上。目前的研究解决了疼痛性OIPN的预防和管理的临床实践问题,这是肿瘤学护理的优先领域。
OBJECTIVE: Duloxetine, the only American Society of Clinical Oncology (ASCO) treatment recommended for chemotherapy-induced peripheral neuropathy (CIPN) in cancer survivors, is not effective for 40% of survivors. This study examined the ability of a duloxetine-prazosin combination to prevent the development of allodynia and
hyperalgesia in a rat model of oxaliplatin-induced peripheral neuropathy (OPIN).
METHODS: Female (n = 24) and male (n = 41) rats were started on duloxetine (15 mg), prazosin (2 mg), or a duloxetine-prazosin combination one week prior to administration of the chemotherapy drug, oxaliplatin, and continued the duloxetine-prazosin combination for 32 days. Behavioral testing for mechanical allodynia and mechanical
hyperalgesia was done with selected von Frey filaments over the course of the study.
RESULTS: Overall percent paw withdrawal for rats that received the duloxetine-prazosin combination was significantly lower in female (p < .001 for both conditions) and male (p = .029 for allodynia; p < .001 for
hyperalgesia) than those that received water. No significant posttreatment differences were found for allodynia or
hyperalgesia between rats treated with duloxetine and rats that received the duloxetine-prazosin combination in either sex.
CONCLUSIONS: These finding provide preliminary evidence that a duloxetine-prazosin combination can prevent the posttreatment development of allodynia and
hyperalgesia in both male and female rats; however, the results suggest that the duloxetine-prazosin combination is no more efficacious than duloxetine alone in preventing chronic OIPN.
CONCLUSIONS: The profession of nursing is built on clinical practice supported by scientific research. The current study addressed the clinical practice problem of prevention and management of painful OIPN, which is a priority area in oncology nursing.