盐酸羟考酮缓释片不同给药途径治疗中重度癌痛的临床观察
《现代肿瘤医学》[ISSN:1672-4992/CN:61-1415/R]
- 期数:
- 2018年12期
- 页码:
- 1917-1921
- 栏目:
- 论著（综合治疗）
- 出版日期:
- 2018-05-08
文章信息/Info
- Title:
- Clinical observation of Oxycodone Hydrochloride Prolonged-release Tablets on moderate to severe cancer pain following different routes of administration
- 作者:
- 刘海波1; 胡大勇1; 周 娟2; 杜清瑞1; 丁 乐1; 黄文琴1; 彭 涛1; 刘 波1; 王 蕾1; 熊 虎1; 刘 勇3; 于 洋3
- 1.勉县医院肿瘤血液科，陕西 汉中 724200； 2.徐州市中心医院检验科；3.肿瘤内科，江苏 徐州 221009
- Author(s):
- Liu Haibo1; Hu Dayong1; Zhou Juan2; Du Qingrui1; Ding Le1; Huang Wenqin1; Peng Tao1; Liu Bo1; Wang Lei1; Xiong Hu1; Liu Yong3; Yu Yang3
- 1.Department of Internal Medical Oncology and Hematology,Mianxian Hospital,Shaanxi Hanzhong 724200,China;2.Department of Clinical Laboratory;3.Department of Medical Oncology,Xuzhou Hospital,Affiliated to Medical College of Southeast University & Xuzhou Central Hospital,Jiangsu Xuzhou 221009,China.
- Keywords:
- cancer pain; Oxycodone Hydrochloride Prolonged-release Tablets; rectal administration; oral administration; clinical efficacy
- 分类号:
- R730.6
- DOI:
- 10.3969/j.issn.1672-4992.2018.12.029
- 文献标识码:
- A
- 摘要:
- 目的：比较盐酸羟考酮缓释片直肠给药与口服给药两种途径治疗癌痛的临床疗效和不良反应。方法：选择2015年1月至2016年6月在勉县医院肿瘤血液科治疗的68例癌症伴有中、重度疼痛患者，随机分为观察组34例和对照组34例，两组患者均给予盐酸羟考酮缓释片进行治疗，观察组采用直肠给药，对照组采用口服给药。观察比较两组患者用药后缓解疼痛的疗效、患者生活质量的改善以及不良反应的发生情况。结果：观察组和对照组用药后的止痛有效率分别为85.3%和88.2%，两组1 h、12 h、1周、2周的NRS评分及疼痛缓解有效率比较差异均无统计学意义(P＞0.05)；观察组和对照组KPS的改善率分别为91.2%和88.2%，差异亦无统计学意义(P＞0.05)；但观察组便秘发生率(17.6%)和恶心呕吐发生率(11.8%)明显低于对照组（41.2%和26.5%），差异均有统计学意义(P＜0.05)。结论：对中重度癌痛患者使用盐酸羟考酮缓释片经直肠途径给药与口服给药相比，具有相同的镇痛效果，但便秘和恶心呕吐的不良反应发生率明显减少。
- Abstract:
- Objective:To observe the clinical efficacy and side effect of Oxycodone Hydrochloride Prolonged-release Tablets in the treatment of cancer pain by rectal administration and oral administration.Methods:68 patients with moderate to severe cancer pain who were treated in the ward of Internal Medical Oncology and Hematology,Mianxian Hospital from January 2015 to June 2016 were randomly divided into observation group(34 cases) and control group(34 cases).Both groups were given Oxycodone Hydrochloride Prolonged-release Tablets for treatment,the observation group using rectal administration,the control group using oral administration.Compare the efficacy of pain relief,quality of life and the incidence of adverse reactions in the two groups.Results:The effective rate of pain relief was 85.3% in the observation group and 88.2% in the control group.There were no statistically significant differences in the NRS score of two groups after medication at 1 h，12 h，1 week,2 weeks and total pain effective rate.The improvement rate of KPS in the observation group and the control group was 91.2% and 88.2%,there was no significant difference.However,in the observation group，the incidence of constipation was 17.6%,incidence of nausea and vomiting was 11.8%，they were significantly lower than 41.2% and 26.5% in the control group,the differences were statistically significant(P＜0.05).Conclusion:The use of Oxycodone Hydrochloride Prolonged-release Tablets in the treatment of moderate to severe cancer pain by rectal route has the same analgesic effect as oral administration,but the adverse reactions of constipation and nausea and vomiting are significantly reduce.
参考文献/References
[1]Roberto A,Greco MT,Legramandi L,et al.A comparison between the administration of oral prolonged-release oxycodone-naloxone and transdermal fentanyl in patients with moderate-to-severe cancer pain:A propensity score analysis［J］.J Pain Res,2017,10:2123-2133.
[2]Greco MT,Roberto A,Corli O,et al.Quality of cancer painmanagement:An update of a systematic review of undertreatment of patients with cancer［J］.J Clin Oncol,2014,32:4149-4154.
[3]Rudd RA,Aleshire N,Zibbell JE,et al.Increases in drug and Opioid overdose deaths—United States,2000-2014［J］.Morb Mortal Wkly Rep,2016,64:1378-1382.
[4]Van den Beuken-van Everdingen MH,De Rijke JM,Kessels AG,et al.Prevalence of pain in patients with cancer:A systematic review of the past 40 years［J］.Ann Oncol,2007,18:1437-1449.
[5]Voon P,Karamouzian M,Kerr T.Chronic pain and opioid misuse:A review of reviews［J］.Subst Abuse Treat Prev Policy,2017,12(1):36.
[6]Harding R,Selman L,Agupio G,et al.The prevalence and burden of symptoms amongst cancer patients attending palliative care in two African countries［J］.European Journal of Cancer,2011,47(1):51-56.
[7]Yu Y,Zhou J,Li Q,et al.The preliminary application of assessment system for cancer pain management［J］.European Review for Medical and Pharmacological Sciences,2015,19:1164-1169.
[8]Riley J,Branford R,Droney J,et al.Morphine or oxycodone for cancer-related pain? A randomized,open-label,controlled trial［J］.J Pain Symptom Manage,2015,49:161-172.
[9]Yu S,Shen W,Yu L,et al.Safety and efficacy of once-daily hydromorphone extended-release versus twice-daily oxycodone hydrochloride controlled-release in Chinese patients with cancer pain:A phase 3,randomized,double-blind,multicenter study［J］.J Pain,2014,15:835-844.
[10]Li CG,Huang XE,Li Y,et al.Clinical observations on safety and efficacy of Oxy Contin administered by rectal route in treating cancer related pain［J］.Asian Pac J Cancer Prev,2011,12(10):2477-2478.
[11]Yu SY,Wang JJ,Huang YG,et al.Managing pain in patients with cancer:The Chinese good pain management experience［J］.J Glob Oncol,2016,3(5):583-595.
[12]Wilson KG,Graham ID,Viola RA,et al.Structured interview assessment of symptoms and concerns in palliative care［J］.Can J Psychiatry,2004,49:350-358.
[13]Corli O,Floriani I,Roberto A,et al.CERP Study OF Pain Group(List of collaborators) CERP Study of Pain Group are strong opioids equally effective and safe in the treatment of chronic cancer pain? A multicenter randomized phase Ⅳ real life trial on the variability of response to opioids［J］.Ann Oncol,2016,27(6):1107-1115.
[14]Caraceni A,Hanks G,Kaasa S,et al.Use of opioid analgesics in the treatment of cancer pain:Evidence-based recommendations from the EAPC［J］.Lancet Oncol,2012,13:e58-e68.
[15]Oosten AW,Oldenmenger WH,Mathijssen RH,et al.A systematic review of prospective studies reporting adverse events of commonly used opioids for cancer-related pain:A call for the use of standardized outcome measures［J］.J Pain,2015,16:935-946.
[16]MucciLoRusso P,Berman BS,Silberstein PT,et al.Controlled release oxycodone compared with controlled release morphine in the treatment of cancer pain:A randomized,double blind,parallel group study［J］.Eur J Pain,1998,2:239-249.
[17]Koopmans G,Simpson K,De Andres J,et al.Fixed ratio(2∶1) prolonged-release oxycodone-naloxone combination improves bowel function in patients with moderate-to-severe pain and opioid-induced constipation refractory to at least two classes of laxatives［J］.Curr Med Res Opin,2014,30(11):2389-2396.
[18]Hwang BY,Kwon JY,Kim E,et al.Oxycodone vs fentanyl patient-controlled analgesia after laparoscopic cholecystectomy［J］.International Journal of Medical Sciences,2014,11(7):658-662.
[19]Kokki M，Vlitalo P，Rasanen I，et al.Absorption of different oral dosage forms of oxycodone in the elderly：A cross-over clinical trial in patients undergoing cystoscopy［J］.Eur J Clin Pharmacol，2012，68(10)：1357-1363.
[20]Kim HJ,Kim YS,Park SH.Opioid rotation versus combination for cancer patients with chronic uncontrolled pain:A randomized study［J］.BMC Palliat Care,2015,16,14:41.
[21]Radbruch L,Trottenberg P,Elsner F,et al.Systematic review of the role of alternative application routes for opioid treatment for moderate to severe cancer pain:An EPCRC opioid guidelines project［J］.Palliat Med,2011,25:578-596.
[22]Kestenbaum MG,Vilches AO,Messersmith S,et al.Alternative routes to oral opioid administration in palliative care:A review and clinical summary［J］.Pain Med,2014,15(7):1129-1153.
备注/Memo
- 备注/Memo:
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