3种常用双膦酸类药物治疗转移癌性骨痛的疗效分析  

Clinical study of bisphosphonates in relieving bone pain in malignant tumor patients with bone metastasis

作　　者：陈达伟[1] 江晓肖[1] 邢旺兴[2] 陈少明[1] 沈四新[1] 

机构地区：[1]解放军第117医院呼吸消化科,浙江杭州310013 [2]杭州师范大学医药卫生管理学院药学教研室,浙江杭州310036

出　　处：《健康研究》2009年第3期187-190,共4页Health Research

摘　　要：目的评价3种常用双膦酸类药物治疗转移癌性骨痛的疗效和安全性。方法51例患者入选参与随机、平行对照临床研究,A组(20例)用氯屈膦酸钠1 500 mg,溶于500 ml生理盐水中,缓慢静滴4 h;B组(20例)用帕米膦酸钠90 mg,溶于500 ml生理盐水中,缓慢静滴4 h;C组(11例)用唑来膦酸4 mg加生理盐水50 ml静脉滴注15min,单次为1疗程,5周后重复给药,连续2疗程后观察用药患者的疗效及不良反应。结果51例入组患者,均可评价疗效和不良反应。A组骨痛治疗2疗程的总有效率为55%(11/20),B组总有效率为65.0%(13/20),C组总有效率为81.8%有效(9/11);经统计学处理,C组与A组两者疗效有显著性差异(P<0.05)。A、B、C三组的1疗程缓解率分别为33.3%、40%和66.7%,经统计学处理,A组与C组之间、B组与C组之间的差异具统计学意义(P<0.05)。C组不良反应较少,患者耐受性好。结论唑来膦酸对癌性骨转移性疼痛有较好的临床疗效和安全性。它比传统使用同类治疗药物具有使用更方便,疗效更明显的优势。Objective To evaluate the efficacy and safety of three kinds of bisphosphonates in relieving bone pain and the tolerability in malignant tumor patients with bone metastasis. Methods A randomized, positive drug parallel controlled trial was performed and totally 51 inpatients with terminal osteoid metastasis were recruited and divided into three groups. 1500 mg disodium clodronate diluted into 500 ml normal sodium was given intravenously once to 20 patients of group A （ the positive-control group）. Ninety mg pamidronate dissolved into 500 ml normal saline was given intravenously once to 20 patients of group B and 4 mg zoledronic acid dissolved into 50 ml normal saline was administered intravenously once to 11 patients of group C. The same treatment was repeated 5 weeks later and the therapeutic evaluation was performed by the relief of bone pain,motor function and toxic reaction. Results Eleven of 20 patients in group A（55% ） , 13 of 20 in group B （65%） and 9 of 11 in group C （81.8%） were found to have their pain relieved after the second course of treatment. Compared with group A or group B, group C had a significant changes in the total remission rate of pain （P 〈 0.05）. The remission rate of the first course of treatment in group C was 66.7% , while the side effects were less. Conclusion The efficacy and safety of zoledronic acid in abating bone pain and its tolerability in malignant tumor patients with bone metastasis was superior to those of disodium clodronate or pamidronate （ P 〈 0.05 ）. Zoledronic acid had the advantage of convenient use, good bone pain relief, well tolerated and few adverse effects in malignant tumor patients with bone metastases.

关 键 词：唑来膦酸 帕米膦酸 氯屈膦酸 骨转移 

分 类 号：R738.1[医药卫生—肿瘤]