帕米膦酸二钠治疗肺癌骨转移疼痛的临床研究  

A clinical study of different administration of pamidronate in the patients with painful bone metastases due to lung cancer

作　　者：陈映霞[1] 秦叔逵[2] 施毅[1] 钱军[2] 王琳[2] 何泽明[2] 

机构地区：[1]南京大学医学院临床学院(南京军区南京总医院)呼吸科,江苏南京210002 [2]解放军第八一医院肿瘤内科,江苏南京210002

出　　处：《医学研究生学报》2005年第6期523-526,共4页Journal of Medical Postgraduates

摘　　要：目的:观察比较帕米膦酸二钠(PamidronateDisodium)不同用法治疗国人肺癌骨转移疼痛的有效性及安全性。方法:本研究采用随机对照的方法。96例患者分为A组53例(34例分2天用药,19例分5天用药)、B组43例。A组为帕米膦酸二钠150mg,分2天及5天给药;B组为帕米膦酸二钠90mg,分2天给药。观察患者疼痛计分、止痛药用量、体力状况、活动能力和不良反应等,每周调查生活质量(QOL)并给予评分。结果:两组治疗后疼痛计分均明显下降(P<0.001),而下降幅度无明显差异。A组的止痛有效率明显高于B组(84.9%vs67.4%,P=0.043);止痛作用维持时间较B组长(中位值分别为28天和21天,P<0.001),止痛药降级/减量的患者较B组多(34.8%vs13.5%,P=0.024)。活动能力及KPS评分改善者两组对比无明显差异。治疗后两组QOL评分均有明显改善,改善幅度以A组更明显,在治疗后第3、4周两组比较差异显著。主要不良反应为药物热,其发生率和程度两组之间未见明显差异。结论:帕米膦酸二钠可缓解肺癌骨转移所致疼痛,可改善患者生活质量;疗效A组优于B组,而不良反应并未增加。Objective: To compare the efficacy and safety of different administration of pamidronate for relieving bone pain and to improve the living quality in Chinese patients with painful bone metastases due to lung cancer. Methods:96 patients with painful bone metastases due to lung cancer were randomly enrolled to group A (150 mg) or group B (90 mg). There were 53 patients receiving 150 mg of pamidronate(34 pts for 2 days and 19 patients for 5 days administration). 43 (patients) receiving 90 mg of pamidronate. Results:There were 84.9% of patients relieving bone pain in group A and (67.4%) in group B (P=0.043). The score measuring bone pain decreased from 6.47±1.45 to (3.28±)1.71 in group A and from 6.21±1.49 to 3.49±2.88 in group B after injection of pamidronate , and the mean duration for pain relief were 28.00 days and 21.00 days respectively(P<0.001). There were more patients in group A whose antalgica effects decreased or downgraded than in group B (34.8% vs 13.5%,(P=)(0.027)). There were no differences of the percentages of patients with improvement of activity ability and KPS between the two groups. QOL were improved after the treatment in two groups, and the degree of improvement was higher in the patients in group A .The main side effect of pamidronate was fever , and there was no difference between group A and B. Conclusion: Pamidronate can relieve pain due to bone metastasis from lung cancer and improve the living quality. 150 mg of pamidronate is better than 90 mg of pamidronate in efficacy. The side-effects in two groups were the same.

关 键 词：帕米膦酸二钠 肺癌 骨转移疼痛 治疗 

分 类 号：R734.2[医药卫生—肿瘤]