阿片类镇痛药用于慢性非癌性疼痛的药物临床综合评价  

Comprehensive Evaluation on Opioid Analgesics for Chronic Non-Cancer Pain

作　　者：那一凡 姜文亮[1] 杨雪[1] 夏路风[1] 常涛 谭玲[1] NA Yifan;JIANG Wenliang;YANG Xue;XIA Lufeng;CHANG Tao;TAN Ling(Dept.of Pharmacy,Beijing Hospital,Beijing Key Laboratory of Drug Clinical Risk and Personalized Medication Evaluation,National Center of Gerontology,Institute of Geriatric Medicine of Chinese Academy of Medical Science,Beijing 100730,China)

机构地区：[1]北京医院药学部,药物临床风险与个体化应用评价北京市重点实验室,国家老年医学中心,中国医学科学院老年医学研究所,北京100730

出　　处：《中国医院用药评价与分析》2025年第3期346-351,共6页Evaluation and Analysis of Drug-use in Hospitals of China

摘　　要：目的:基于《中国医疗机构药品评价与遴选快速指南(第二版)》,对我国批准用于治疗慢性非癌性疼痛的阿片类镇痛药进行综合评价,为医疗机构药品遴选、临床用药决策提供参考。方法:通过相关权威机构的信息化平台收集评价证据,从有效性、安全性、药学特性、经济性及其他属性5个方面对纳入的药品进行打分。结果:通过量化评分,纳入评价的阿片类镇痛药的平均得分为50.83分。但各药品之间差距较大,其中芬太尼透皮贴剂的制剂安全性高,适用人群广,综合评分最高,为62.27分;注射用盐酸曲马多得分最低,为36.28分。结论:阿片类镇痛药是治疗慢性非癌性疼痛的二线用药。对于经过非药物治疗和非阿片类镇痛药治疗无效的患者,可以采用阿片类镇痛药进行治疗。其中芬太尼透皮贴剂可以相对安全、有效地缓解患者疼痛,但仍应注意定期评估患者的风险和疗效,避免严重不良反应的发生。OBJECTIVE:Based on A Quick Guideline for Drug Evaluation and Selection in Chinese Medical Institutions(the Second Edition),to conduct a comprehensive evaluation on opioid analgesics approved for the treatment of chronic non-cancer pain in China,so as to provide reference for the drug selection and medication decision-making in medical institutions.METHODS:Evaluative evidence was collected through the informatization platform of relevant authoritative institutions,and the enrolled drugs were scored in 5 aspects,including effectiveness,safety,pharmacological properties,economical efficiency and other attributes.RESULTS:Through quantitative scoring,the average score of opioid analgesics enrolled in the evaluation was 50.83 points.However,there was a large gap between different drugs,among which fentanyl transdermal patch had a high formulation safety and a wide range of applicability,with the highest comprehensive score of 62.27 points;tramadol hydrochloride for injection had the lowest score of 36.28 points.CONCLUSIONS:Opioid analgesics are the second-line drugs for the treatment of chronic noncancer pain.Opioid analgesics can be used for the treatment of patients who are ineffective after non-pharmacologic treatment and non-opioid analgesic treatment.Fentanyl transdermal patche can safely and effectively relieve pain in patients,but attention should still be paid to regularly evaluate the risk and efficacy of patients to avoid the occurrence of severe adverse drug reactions.

关 键 词：阿片类镇痛药 慢性非癌性疼痛 综合评价 

分 类 号：R971[医药卫生—药品]