盐酸羟考酮控释片与美沙酮治疗重度癌痛的临床疗效比较  

Comparison of clinical effects of oxycontin and methadone in the treatment of severe cancer pain

作　　者：钟爱虹[1] 谢强[1] 陈群[1] 臧焕平[1] 朱金秀[1] 卢筠[1] 廖胜祥[1] 孙卫红[1] 石琴[1] 吴鹭龄 杨庆明[2] 

机构地区：[1]福建医科大学临床教学医院福州肺科医院肿瘤科,福州350008 [2]福建医科大学临床教学医院福州肺科医院药剂科,福州350008

出　　处：《中国肿瘤临床与康复》2015年第1期112-115,共4页Chinese Journal of Clinical Oncology and Rehabilitation

摘　　要：目的探讨不同剂量盐酸羟考酮控释片(奥施康定)转换成美沙酮治疗重度癌痛的疗效、不良反应及药物价格。方法 25例口服奥施康定治疗重度癌痛患者按不同比例转换成美沙酮口服治疗,分别记录药物使用剂量、疼痛缓解率及不良反应、生活质量、药物费用、药物优势等。结果25例口服奥施康定患者的疼痛缓解率为88.0%,转换为口服美沙酮后,患者的疼痛缓解率为96.0%。美沙酮的周用量药物价格中位数为180.4元,明显低于奥施康定中位数501.4元,差异有统计学意义(t=3.1,P<0.01)。奥施康定治疗时,患者的恶心、呕吐和便秘更多见,与美沙酮治疗相比,差异均有统计学意义(P<0.01);美沙酮治疗时头,患者的晕和嗜睡更多见,与奥施康定治疗相比,差异有统计学意义(χ2值分别为7.0、12.8,P<0.01);药物优势评定显示更多患者喜欢使用美沙酮治疗,差异有统计学意义(P<0.01)。结论美沙酮和奥施康定均可有效控制重度癌痛,安全性好。在奥施康定药物治疗效果不佳或剂量大时可考虑转换美沙酮治疗,而且美沙酮剂量小、经济,不良反应也较少,更多患者愿用美沙酮进行治疗。Objective To observe the analgesic effect,adverse effects and drug price of Oxy-Codone HCL controlled-release labels（oxycontin） and methadone in the treatment of severe cancer pain.Methods Twenty-five cases of oral oxycontin therapy in patients with severe cancer pain in different proportions were converted to accept oral methadone treatment.And the dose,pain relief and adverse reactions,quality of life,cost of medicines,drug advantage were recorded.Results For patients accepting oral oxycontin,the overall rate of pain relief was 88.0%,and when they were converted to accept oral methadone treatment,the overall rate of pain relief was 96.0%;weekly dosage of methadone drug median prices 180.4 RMB was significantly lower than that of oxycodone drug median prices 501.4 RMB,with stastastical significance（t =3.1,P〈0.01）;About adverse effects,nausea,vomiting and constipation were more common in the process of oxycontin treatment（χ^2values were 22.8,18.0 and 15.8,P〈0.01）,and dizziness and drowsiness were more common in the process of methadone treatment（χ^2values were 7.0,12.8,P〈0.01）;Considering drug advantage assess,more patients liked using methadone（t = 3.7,P〈0.01）.Conclusion In the treatment of severe cancer pain,methadone and oxycontin were effective,safe,and when the clinical effects of methadone treatment was poor or need larger dose,conversion to oxycontin drug treatment could be considered.But for a smaller dose,economy,fewer adverse reactions,more patients like using methadone treatment.

关 键 词：美沙酮 盐酸羟考酮控释片 癌痛 

分 类 号：R730.5[医药卫生—肿瘤]