塞来昔布联合奥施康定治疗中重度癌痛的临床观察  

Clinical Observation of Cyclooxygenase -2 Inhibitor Celecoxib Combined with Oxycontin in Treatment of Moderate and Severe Cancer Pain

作　　者：雷俊华[1] 洪涛[1] 曾江正[1] 

机构地区：[1]海南医学院附属医院血液肿瘤内科,海口570102

出　　处：《临床误诊误治》2013年第7期83-85,共3页Clinical Misdiagnosis & Mistherapy

基　　金：海南省重点项目(ZDXM 20100046)

摘　　要：目的观察塞来昔布联合奥施康定治疗中重度癌痛的疗效及安全性。方法选择2011年5月—2013年1月住院的恶性肿瘤且有中重度疼痛、意识清晰的55例作为研究对象。阿片未耐受者,奥施康定起始量10 mg每12 h 1次;阿片耐受者,中度疼痛奥施康定起始量10 mg每12 h 1次,重度疼痛奥施康定起始量20 mg每12 h 1次。同时应用塞来昔布200 mg每12 h 1次。结果用药4周后进行疼痛缓解率及生活质量评价。55例中,未缓解1例(1.82%),轻度缓解4例(7.27%),中度缓解13例(23.64%),明显缓解26例(47.27%),完全缓解11例(20.00%),疼痛缓解率90.91%。KPS功能评分明显提高,与治疗前比较差异有统计学意义(P<0.05)。常见不良反应有便秘、恶心、呕吐,偶见头晕、嗜睡和排尿困难,无严重药物不良反应。结论塞来昔布联合奥施康定治疗中重度癌痛效果确切,疼痛缓解率高,有助于改善患者生活质量,且安全性较好。Objective To observe curative effect and safety of Celecoxib combined with Oxycontin in treatment of moderate and severe cancer pain.Methods A total of 55 hospitalized patients with cancer of moderate and severe cancer pain,clear consciousness during May 2011 and January 2013 were recruited in this study.Patients without tolerance of opium were treated with Oxycontin at an initial dose of 10mg and 1 time of every 12 h;patients with tolerance of opium were treated with Oxycontin at an initial dose of 10mg and once every 12 h for moderate cancer pain,and Oxycontin at an initial dose of 20mg and once every 12 h for severe cancer pain.A total of 200mg of celecoxib was given every 12 h at the same time.Results The pain remission rate and quality of life were evaluated after medication for 4 weeks.In the 55 patients,there were 1 patient（1.82） without remission,4（7.27%） with slight remission,13（23.64%） with moderate remission,26（47.27%） with obvious remission and 11（20.00%） with complete remission.The pain remission rate was 90.91%.The KPS function score improved significantly,and the difference was statistically significant between that before treatment and that after treatment（P 0.05）.The common adverse reactions were constipation,nauseated,vomiting,dizziness,somnolence and dysuria,and there was no serious adverse drug reaction.Conclusion Celecoxib combined with Oxycontin in treatment of moderate and severe cancer pain may have obvious efficiency,with a better rate of pain remission and improvement of quality of life.

关 键 词：塞来昔布 奥施康定 癌痛 疗效 不良反应 生活质量 

分 类 号：R730.5[医药卫生—肿瘤]