芬太尼透皮贴剂联合尼美舒利治疗鼻咽癌放化疗中口腔黏膜损伤疼痛的临床疗效分析  

Observation of the Therapeutic Effects of Duragesic Combined with Nimesulide on the Damage and Pain of Oral Mucosa during the Concurrent Chemoradiotherapy of Nasopharyngeal Carcinoma

作　　者：卢奕宇[1] 邓瑾[2] 杨文[1] 唐武兵[1] 伍楚蓉[1] 

机构地区：[1]南方医科大学附属南海医院,广东佛山528200 [2]广州医学院附属肿瘤医院,广东广州510095

出　　处：《肿瘤药学》2012年第2期116-119,共4页Anti-Tumor Pharmacy

摘　　要：目的观察芬太尼透皮贴剂联合尼美舒利治疗鼻咽癌放化疗中口腔黏膜损伤疼痛的临床疗效。方法 60例因同期化放疗发生口腔黏膜损伤及中-重度疼痛的鼻咽癌患者,随机分为单一用药组和联合用药组,每组30例患者,单一用药组仅给予芬太尼透皮贴剂治疗,联合用药组给予芬太尼透皮贴剂联合尼美舒利治疗,比较两组患者治疗12、24小时后疼痛缓解的有效率,生活质量的变化以及不良反应的发生情况。结果两组患者芬太尼透皮贴剂最大维持剂量为50μg.h-1,尼美舒利的最大剂量为400mg.d-1。单一用药组芬太尼透皮贴剂的平均维持剂量为35.8μg.h-1,而联合用药组为26.6μg.h-1,显著低于单一用药组(P<0.01)。单一用药组治疗12小时、24小时后疼痛缓解的总有效率分别为53%,80%;而联合用药组疼痛缓解的总有效率为80%,90%,均显著高于单一用药组(P<0.05)。两组患者生活质量的变化无明显差异。此外,两组患者均见嗜睡、头晕、恶心呕吐和便秘的不良反应,但联合用药组仅头晕的发生率较单一用药组显著降低(P<0.05)。结论芬太尼透皮贴剂联合尼美舒利治疗鼻咽癌放化疗中口腔黏膜损伤引起的疼痛疗效较单用芬太尼透皮贴剂更好,且不良反应的发生率较低,值得临床进一步研究和推广。Objective To investigate the therapeutic effect of Duragesic combined with Nimesulide on the damage and pain of oral mucosa during the concurrent chemoradiotherapy of nasopharyngeal carcinoma.Methods 60 nasopharyngeal carcinoma patients with damage and pain of oral mucosa induced by concurrent chemoradiotherapy were selected and randomly divided into single agent group and combined-treatment group,30 patients in each group.Patients in single agent group were given Duragesic,while patients in combined-treatment group were given Duragesic and Nimesulide.The effective odynolysis rate at 12-hours and 24-hours after treatment,change of quality of life and incidence of adverse effects were compared between the two groups.Results The maximum maintenance dosage of Duragesic in both groups were 50μg·h-1,and the maximum dosage of Nimesulide was 400 mg·d-1.The average maintenance dosage of Duragesic in combined-treatment group was 26.6μg·h-1,which was significantly lower than that in single agent group（35.8μg·h^-1）（P〈0.01）.The effective rates of odynolysis 12-hours and 24-hours after treatment in single agent group were respectively 53% and 80%,both were lower than those in combined-treatment group（80% and 90%,P〈0.05）.There was no significant difference in changes of quality of life between the two groups.Dizziness,drowsiness,nausea and vomitting as well as constipate were all observed in both groups,but only the incidence of drowsiness in combined-treatment group was significantly lower than single agent group（P〈0.05）.Conclusion The combined treatment of Duragesic and Nimesulide showed better therapeutic effect than single treatment of Duragesic on the damage and pain of oral mucosa during the concurrent chemoradiotherapy of nasopharyngeal carcinoma.It also had lower incidence of adverse effects.So it was worth of further research and generalization in clinic.

关 键 词：鼻咽癌 芬太尼透皮贴剂 尼美舒利 口腔黏膜损伤 疼痛 

分 类 号：R739.6[医药卫生—肿瘤]