吗啡控释片、双氯芬酸联合塞来苷布治疗转移性骨癌痛的临床疗效  

Curative efficacy of morphine controlled-release tablets and celecoxib combined with diclofenac in the treatment of metastatic bone cancer pain

作　　者：张欣[1] 李涛[1] 何钊[1] ZHANG Xin;LI Tao;HE ZhaoDepartment of Orthopedics(Department of Orthopedics, Qinghai Provincial People’s Hospital, Xining 810007, Qinghai, China)

机构地区：[1]青海省人民医院骨科,西宁810007

出　　处：《癌症进展》2018年第14期1798-1800,1803,共4页Oncology Progress

摘　　要：目的探讨吗啡控释片、双氯芬酸联合塞来昔布治疗转移性骨癌痛的临床疗效。方法选择90例转移性骨癌痛患者作为研究对象,采用随机数字表法分为观察组45例和对照组45例(5例中途退出研究)。对照组患者接受吗啡控释片联合双氯芬酸治疗,观察组患者在对照组的基础上加用塞来昔布进行治疗。比较两组患者的临床疗效、疼痛视觉模拟评分(VAS)、爆发痛发作次数、吗啡使用量及不良反应发生情况。结果治疗后,观察组患者的总有效率为95.56%,高于对照组的77.50%,差异有统计学意义(P﹤0.05)。治疗前,两组患者的VAS评分比较,差异无统计学意义(P﹥0.05);治疗后7、14、28天,两组患者的VAS评分均低于本组治疗前(P﹤0.05),且观察组患者的VAS评分均明显低于对照组(P﹤0.01)。治疗前,两组患者爆发痛发作次数比较,差异无统计学意义(P﹥0.05);治疗后7、14、28天,两组患者爆发痛发作次数均少于本组治疗前(P﹤0.05),且观察组患者爆发痛发作次数均明显少于对照组(P﹤0.01)。治疗后7、14、28天观察组患者的吗啡使用量均明显少于对照组(P﹤0.01)。观察组患者嗜睡、头晕及便秘的发生率均明显低于对照组,差异均有统计学意义(P﹤0.01);两组患者恶心呕吐、呼吸抑制、外周水肿发生率比较,差异均无统计学意义(P﹥0.05)。结论在转移性骨癌痛患者中使用吗啡控释片、双氯芬酸联合塞来昔布效果显著,可有效改善患者疼痛情况,减少并发症,值得推广与应用。Objective To study the clinical efficacy of morphine controlled-release tablets and celecoxib combined with diclofenac in the treatment of metastatic bone cancer pain.Method A total of90patients with metastatic bone cancer pain was included in the study,a randomized number table was used to stratify these patients as study group(n=45)and control group(n=45,5dropped out).The control group was treated with morphine controlled-release tablets combined with diclofenac,and the study group was administered with celecoxib additionally.The clinical efficacy,visual analogue scale(VAS)of pain,number of pain episodes,morphine dosage and adverse reactions were recorded and compared between the two groups.Result After treatment,the overall response rate of study group was95.56%,which was higher than that of the control group at77.50%(P<0.05).There was no significant difference in VAS scores between the two groups before treatment(P>0.05);while the VAS scores in7,14and28days after treatment of the two groups were significantly lower compared with those before treatment(P<0.05),and were lower in study group compared with those in control group(P<0.01).Before treatment,the number of pain episodes did not differ significantly between the two groups(P>0.05);while in7,14and28days after treatment,the number of pain episodes in both groups were significantly decreased compared with that before treatment(P<0.05),and was less in study group than in control group(P<0.01).Morphine use in the study group was significantly less compared with that in control group in7,14and28days after treatment(P<0.01).The incidence of somnolence,dizziness and constipation in study group was significantly lower than that in control group(P<0.01),though there was no significant difference regarding the incidence of nausea and vomiting,respiratory depression and peripheral edema between the two groups(P>0.05).Conclusion The use of morphine controlled-release tablets and celecoxib combined with diclofenac in patients with metastatic bone cancer pain is fairly

关 键 词：吗啡控释片 塞来昔布 双氯芬酸 转移性骨癌痛 

分 类 号：R738.1[医药卫生—肿瘤]