羟考酮替换盐酸吗啡减轻阿片类药物耐药的临床研究  

Clinical research on replacement therapy of morphine with oxycodone to reduce opioid tolerance

作　　者：梁鹏[1] 钟进才[1] 

机构地区：[1]广西医科大学第一附属医院宁养院,南宁530000

出　　处：《中国癌症防治杂志》2011年第1期69-72,共4页CHINESE JOURNAL OF ONCOLOGY PREVENTION AND TREATMENT

基　　金：广西自然科学基金资助项目(桂科自0447064);李嘉诚基金会全国宁养服务计划项目资助

摘　　要：目的研究羟考酮替换盐酸吗啡减轻癌症病人对阿片类药物耐药的影响。方法采用前瞻性自身对照试验,以1.5∶1作为各组病人吗啡向羟考酮转换的基础比率,用数字分级评分(NRS)、卡氏行为状态量表评分(KPS)和生活质量评分(QOL)作为转换前后镇痛效果、活动能力及生活质量的评价指标。结果不同剂量组盐酸吗啡与羟考酮的平均转换比率随着吗啡剂量的增加而增加,转换比值与吗啡的的剂量呈一次线性拟合趋势(F=0.003、P=0.954),大剂量吗啡组比小剂量吗啡组替换后羟考酮的需要量更小。结论应用羟考酮替换大剂量盐酸吗啡止痛是一种减轻阿片类药物耐药的新途径。ObjectiveTo investigate the therapy effect of oxycodone instead of morphine on reduce the opioid tolerance of cancer patients.Methods A prospective self-controlled trial was designed. The basic conversion rate of oxycodone and morphine in each group is 1.5：1. The scores of numeral rating scale （NRS）, Karnofsky performance status （KPS） and quality of life （QOL） were used as the index to evaluate the analgesic effect before and after conversion.Results The average conversion rate of morphine/oxycodone increased with the increasing dosage of morphine. The conversion ratio and the morphine dosage showed a linear fit trend （F=0.003,P=0.954）, namely the patients with high-dose of morphine needed less dosage of oxycodone than the patients with low-dose of morphine.Conclusion Oxycodone replacing morphine may be a new method to reduce opioid tolerance for controlling cancer pain.

关 键 词：吗啡 羟考酮 耐药 替换治疗 

分 类 号：R915[医药卫生—微生物与生化药学]