盐酸羟考酮缓释片与芬太尼透皮贴剂治疗中重度癌症疼痛的不良反应比较分析  

A comparative analysis on adverse reactions of oxycodone hydrochloride prolonged‑release tablets and fentanyl transdermal system for moderate to severe cancer pain

作　　者：罗娟 袁琦 刁长冬 陈旭[1] 范丽[1] 史琛 Luo Juan;Yuan Qi;Diao Changdong;Chen Xu;Fan Li;Shi Chen(Department of Pharmacy,Union Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430022,China)

机构地区：[1]华中科技大学同济医学院附属协和医院药学部,武汉430022

出　　处：《药物不良反应杂志》2021年第7期361-364,共4页Adverse Drug Reactions Journal

基　　金：国家重点研发计划(2017YFC0909900)。

摘　　要：目的比较盐酸羟考酮缓释片与芬太尼透皮贴剂治疗中重度癌症疼痛(癌痛)的不良反应发生情况。方法收集2018年1月至2019年12月在华中科技大学同济医学院附属协和医院住院期间使用盐酸羟考酮缓释片(羟考酮组)或芬太尼透皮贴剂(芬太尼组)且用药时间≥1周的中重度癌痛患者的病历资料,对镇痛治疗后的不良反应发生情况进行回顾性分析。结果纳入分析的患者为698例,羟考酮组535例,芬太尼组163例。羟考酮组不良反应发生率明显高于芬太尼组[72.5%(388/535)比51.5%(84/163),χ^(2)=25.139,P<0.001)。羟考酮组常见不良反应(发生率≥5%)为便秘、恶心呕吐、口干、嗜睡和头晕,芬太尼组为便秘、恶心呕吐和头晕。羟考酮组便秘发生率明显高于芬太尼组[60.9%(326/535)比40.5%(66/163),χ^(2)=21.209,P<0.001],其他不良反应发生率与芬太尼组比较差异均无统计学意义(均P>0.05)。不良反应的分级均≤2级,经对症治疗后好转,无≥3级的严重不良反应发生。结论盐酸羟考酮缓释片和芬太尼透皮贴剂治疗中重度癌痛均较安全,不良反应较轻,经对症治疗可缓解。盐酸羟考酮缓释片比芬太尼透皮贴剂更易导致便秘。Objective To compare the adverse reactions of oxycodone hydrochloride prolonged‐release tablets and fentanyl transdermal system in the treatment of moderate and severe cancer pain.Methods The medical records of patients with moderate to severe cancer pain who used oxycodone hydro‐chloride prolonged‐release tablets(oxycodone group)or fentanyl transdermal systems(fentanyl group)for more than 1 week during hospitalization in Union Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology from January 2018 to December 2019 were collected.The occurrence of adverse reactions after analgesic treatments were retrospectively analyzed.Results A total of 698 patients were enrolled in the analysis,including 535 in the oxycodone group and 163 in the fentanyl group.The incidence of adverse reactions in the oxycodone group was significantly higher than that in the fentanyl group[72.5%(388/535)vs.51.5%(84/163),χ^(2)=25.139,P<0.001].The common adverse reactions(with incidence≥5%)in the oxycodone group were constipation,nausea/vomiting,xerostomia,drowsiness,and dizziness,while those in the fentanyl group were constipation,nausea/vomiting,and dizziness.The incidence of constipation in the oxycodone group was significantly higher than that in the fentanyl group[60.9%(326/535)vs.40.5%(66/163),χ^(2)=21.209,P<0.001].The differences in the incidence of other adverse reactions in the 2 groups were not statistically significant(all P>0.05).All adverse reactions were grade 1 or 2,which were improved after symptomatic treatments.No adverse reactions of grade 3 or more severe occurred.Conclusions Both oxycodone hydrochloride prolonged‐release tablets and fentanyl transdermal system are safe during the treatment for moderate to severe cancer pain,with mild adverse reactions,which can be relieved by symptomatic treatments.Oxycodone hydrochloride prolonged‐release tablets are more likely to cause constipation than fentanyl transdermal system.

关 键 词：镇痛药 阿片类 癌症疼痛 羟考酮 芬太尼 

分 类 号：R730.5[医药卫生—肿瘤]