盐酸羟考酮控释片和盐酸吗啡片滴定治疗中重度癌痛的对比研究  

Comparative study of the efficacy of oxycontin and morphine tablets in the treatment of moderate and 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3期355-358,共4页Chinese Journal of Clinical Oncology and Rehabilitation

摘　　要：目的观察盐酸羟考酮控释片（奥施康定）和盐酸吗啡片滴定治疗中重度癌痛的疗效及不良反应。方法选取2012年3月至2014年2月间接受治疗的100例无阿片类药物使用史的中重度癌痛患者,按照随机数字表法分为A组和B组,每组50例,A组患者使用奥施康定10 mg、20 mg作为初始剂量分别治疗中、重度癌痛,q12h,连续滴定3d;B组患者使用盐酸吗啡片5 mg、10 mg作为初始剂量分别治疗中、重度癌痛,q4h,连续滴定3d。结果给药1、24、48、72 h后,A组患者疼痛缓解率分别为78.0%、88.0%、92.0%和94.0%,B组分别为46.0%、60.0%、88.0%和96.0%;两组患者1、24 h后疼痛缓解率的差异有统计学意义（P〈0.01）;两组患者48 h与72 h后疼痛缓解率的差异无统计学意义（P〉0.05）。两组患者的主要不良反应为便秘、恶心、呕吐、胃不适、头晕和排尿困难等。奥施康定日服药片量明显少于盐酸吗啡片,差异有统计学意义（P〈0.01）。奥施康定每天平均用药次数明显小于盐酸吗啡片,差异有统计学意义（P〈0.01）。B组患者生活质量（Qo L）方面（睡眠、精神状态、情绪和与人交往等4项）的评分明显高于A组患者,差异有统计学意义（P〈0.05）。药物优势评定方面,患者对奥施康定的欢迎程度明显高于吗啡片,差异有统计学意义（P〈0.01）。结论奥施康定和吗啡片滴定治疗中重度癌痛2-3d均能达到较好的疼痛缓解率,但奥施康定较吗啡片有滴定优势,不良反应少,耐受性良好,且奥施康定比吗啡片滴定治疗癌痛更简单、实用、迅速,能显著改善患者Qo L,更多患者愿意使用奥施康定滴定。Objective To compare the efficacy of oxycodone controlled-release tablets（ oxycontin）and morphine tablets in the treatment of moderate and severe chronic cancer pain. And the adverse effects,daily amount of medication pills,medication frequency and advantage assessment were compared. Methods Between March 2012 and Feburary 2014,100 patients with mederate and severe chronic cancer pain（ without history of the use of opioids） were randomly divided into two groups. Group A（ 50 cases） used oxycodone controlled-release tablets 10 mg,20 mg,respectively,as the initial dose of moderate and severe chronic cancer pain,q12 h for 3 d; Group B group（ 50 cases） used morphine tablets 5 mg,10 mg,respectively,as the initial dose of moderate and severe chronic cancer pain,q4 h for 3 d. Results After medication 1 h,24 h,48 h,72 h,the overall rate of pain relief of two groups were respectively： group A 78. 0%,88. 0%,92. 0%,94. 0%; group B 46. 0%,60. 0%,88. 0%,96. 0%; 1 h and 24 h later,the overall rates of pain relief between group A,B were significantly diference（ P〈0. 01）; 1 h and 24 h later,the two groups had no significant difference in pain relief rate（ P〈0. 05）. Adverse effects in the both two groups were constipation,nausea,vomiting,stomach discomfort,dizziness and difficulty urinating; Tingri medication Oxycontin tablets was significantly less morphine tablets,with significant difference（ P〈0. 01）; About the daily average number of drugs,oxycontin was obviously less than morphine tablets,with significant difference（ P〈0. 01）. About quality of life（ QOL）,sleep,mental state,mood and interpersonal scores of group B were significantly higher thanthose of group A（ P〈0. 05）. Drug evaluation advantage of oxycontin was significantly higher than that of morphine（ P〈0. 01）. Conclusions After 2 ~ 3 d,Oxycontin tablets and morphine titration can relieve moderate and severe chronic cancer pain. Compared to morphine,oxycontin have many advantages,and adverse reactions are well tole

关 键 词：中重度癌痛 盐酸羟考酮控释片 盐酸吗啡片 剂量滴定 

分 类 号：R730.5[医药卫生—肿瘤]