羟考酮缓释片联合吗啡片在中重度癌痛滴定治疗中的应用  

The dosage titration effect with combiantion of controlled-release oxycodone and oral immediate-release morphine in moderate and severe cancerous pain

作　　者：吴国武[1] 曾娟紫[1] 黄喜文[1] 丘丽君 张英燕 

机构地区：[1]广东省梅州市人民医院化疗二科,梅州514031

出　　处：《中国肿瘤临床与康复》2014年第5期599-602,共4页Chinese Journal of Clinical Oncology and Rehabilitation

基　　金：梅州市科技计划科研基金(2013B15)

摘　　要：目的比较羟考酮缓释片联合吗啡片方案和常规吗啡片方案在中重度癌痛滴定治疗中的作用。方法选取2011年1月至2013年5月期间进行滴定治疗的中重度晚期癌痛患者,根据患者入院顺序单双号,将患者分为对照组(100例,采用常规口服吗啡即释片的方式完成滴定治疗)和观察组(100例,采用羟考酮缓释片联合吗啡片方案完成滴定治疗),评价两组患者滴定治疗前后疼痛数字评价量表(NRS)评分、滴定剂量(镇痛维持剂量)、滴定周期数和不良反应发生率。结果对照组患者NRS评分从(7.8±2.4)分降至(1.8±1.3)分,观察组患者从(7.6±2.7)分降至(1.9±1.1)分,两组患者滴定前后NRS评分差异均无统计学意义(P>0.05)。对照组患者滴定剂量为(60.6±29.7)mg/24h,观察组患者为(65.4±32.5)mg/24h,差异无统计学意义(t=0.524,P>0.05)。对照组患者滴定周期为(4.1±2.7)个,观察组患者为(3.2±1.8)个,差异有统计学意义(t=2.360,P<0.05)。两组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论羟考酮缓释片联合吗啡片滴定方案具有时效优势。Objective To evaluate the dosage tiration effect with combination of controlled-re- lease oxycodone and oral immediate-release morphine. Methods 200 moderate and severe cancerous pain patients were recruited during Jan 2011 and May 2013. Patients were divided into control group （100 patients, given oral immediate-release morphine for dosage titration） and observation group （100 patients, given controlled-release oxycodone as background drug and added with oral immediate-release morphine for dosage titration） by odd or even number of their order of admission. The titration effect and safety were compared between the two groups. Results The numerical rating scale （NRS） of patients in control group were （7. 8 ± 2.4） before dosage titration and （ 1. 8 ±1.3 ） after sosage titration, and in observation group were （ 7. 6± 2. 7） before dosage titration and （ 1.9 ± 1.1 ） after dosage titration. There was none statistical differ- ence between the two groups in NRS before or after dosage titration. The titration doses were （ 60. 6 ± 29.7） mg/24h oral immediate-release morphine for patients in control group and （ 65.4 ± 32. 5 ） mg/24h oral immediate-release morphine for patients in observation group respectively （ t = 0. 524, P 〉 0. 05 ）. The titration cycles were （4. 1±2.7） for patients in control group and （ 3.2 ± 1.8 ） for patients in observation group respectively （ t = 2. 360, P 〈 0. 05 ）. There were no statistical differences in incidence rates of side effects between the two groups （ P 〉 0. 05 ）. Conclusion The dosage titration therapy with combination of controlled- release oxycodone and oral immediate-release morphine was superior in efficiency.

关 键 词：癌痛 滴定治疗 羟考酮缓释片 即释口服吗啡片 

分 类 号：R730.59[医药卫生—肿瘤]