盐酸羟考酮控释片与芬太尼透皮贴剂治疗中-重度癌痛的疗效及不良反应观察  

Observation of Curative Effects and Adverse Effects of Oxycodone Hydrochloride Controlled-release Tablets and Fentanyl Transdermal Patches on the treatment of Moderate or Severe Cancer Pain

作　　者：苏婧 朱跃红[1] 吴尉[1] 罗以[1] 

机构地区：[1]中南大学湘雅医学院附属肿瘤医院肿瘤内科,湖南长沙410013

出　　处：《肿瘤药学》2015年第6期444-448,共5页Anti-Tumor Pharmacy

摘　　要：目的 比较盐酸羟考酮控释片与芬太尼透皮贴剂治疗中-重度癌痛的疗效及不良反应。方法 将80例伴有中-重度癌痛的恶性肿瘤患者随机分为两组。盐酸羟考酮控释片组42例,未使用过吗啡的患者盐酸羟考酮控释片以10 mg、q12h为起始剂量,使用过吗啡者根据既往吗啡使用量进行滴定。芬太尼透皮贴剂组38例,未使用过吗啡的患者给予芬太尼透皮贴剂25μg·h-1,72 h更换一次;使用过吗啡者,芬太尼透皮贴剂的剂量=每日吗啡总剂量×0.5。根据患者情况调整到患者疼痛可缓解的程度,即数字评分法0~3分。观察比较两组患者的疼痛缓解效果、生活质量、不良反应等。结果 盐酸羟考酮控释片组疼痛缓解率为90.48%,芬太尼透皮贴剂组为92.11%,两组间比较差异无统计学意义（P〉0.05）。两组用药后数字评分法（NRS）均明显降低,与用药前比较,差异有统计学意义（P〈0.05）。两组治疗后KPS评分均较治疗前提高,差异有统计学意义（P〈0.05）。盐酸羟考酮控释片组的恶心呕吐及便秘发生率高于芬太尼透皮贴剂组,差异有统计学意义（P〈0.05）。结论 盐酸羟考酮控释片与芬太尼透皮贴剂均适用于中-重度癌痛患者,均可缓解患者的疼痛,提高患者的生活质量。芬太尼透皮贴剂的消化道反应发生率低于盐酸羟考酮控释片。Objective To compare the curative effects and adverse effects of oxycodone hydrochloride controlled-release tablets and fentanyl transdermal patches in the treatment of moderate or severe cancer pain. Methods The selected 80 patients with moderate or severe cancer pain were randomly divided into two groups. The 42 patients in oxycodone hydrochlo- ride controlled-release tablets group take Oxycontin orally. The initial dosage for initially treated patients was 10mg/12h, while the patients who previously had morphine were given oxycodone hydrochloride controlled-release tablets according to the used dosage. The 38 patients in fentanyl transdermal patches group were treated with Durogesic for external use. The initial dosage for initially treated patients was 25 ~tg. h-t, replaced after 72h. For patients treated with morphine previously, the dosage of Durogesic = daily morphine dose x 0.5. Doses should be adjusted until pain relief reach to NRS 0-3. The curative effects, quality of life and adverse effects were compared between the two groups. Results The total alleviating rate of patients was 90.48% in the oxycodone hydrochloride controlled-release tablets group, and 92.11% in the fentanyl transdermal patches group. There was no statistical difference between the two groups （P〉0.05）, NRS were significantly reduced after treatment in both groups, and differences in each group were statistical between before and after the treatment （P〈0.01）, but had no statistical significance between the two groups （P 〉 0.05）. KPS were significantly improved after treatment in both groups. There were statistical differences in each group before and after the treatment （P〈0.01）, but no statistical difference between the two groups （P〉0.05）. The incidence rate of nausea and constipation was higher in oxycodone hydrochloride controlled-release tablets group （P〈0.05）. There were no statistical differences in the incidence rate of dizziness, lethargy and dysuresia between the two groups （P 〉 0.05�

关 键 词：盐酸羟考酮控释片 芬太尼透皮贴剂 癌痛 疗效 不良反应 

分 类 号：R730.6[医药卫生—肿瘤]