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癌症患者的吗啡个体化滴定
引用本文:董雅芬,杨秋娅,李成敏,周怀俊,张海霞,胡滨.癌症患者的吗啡个体化滴定[J].世界临床药物,2014(6):371-374.
作者姓名:董雅芬  杨秋娅  李成敏  周怀俊  张海霞  胡滨
作者单位:上海市第一人民医院分院药剂科,上海200081
基金项目:虹口区区级支持课题(1203-07)
摘    要:目的观察吗啡个体化滴定对晚期癌症患者疼痛的镇痛效果。方法纳入本研究的中、重度癌痛患者124例,接受吗啡即释片的起始剂量为10~20 mg,治疗中根据疼痛缓解程度调整剂量。以疼痛强度(NRS)评分评价镇痛疗效。结果经治疗患者NRS评分由滴定前(4.5±1.2)下降至(1.2±1.6),治疗前后差异具有统计学意义(P〈0.05);完全缓解76例,明显缓解32例,中度缓解8例,未缓解8例,疼痛缓解率为93.5%。治疗中观察到的不良反应有:便秘、恶心、头昏、呕吐、嗜睡和排尿困难等,经及时治疗均能克服,未见因不良反应中止治疗者。结论以最大限度减轻患者痛苦为目标的疼痛治疗有益于提高患者的生活质量。癌痛患者接受吗啡即释片个体化滴定治疗,疗效显著,不良反应大多数能耐受,值得探讨。

关 键 词:吗啡  晚期癌痛  个体化滴定

Morphine individual titration on cancer patients
DONG Ya-fen,YANG Qiu-ya,LI Cheng-min,ZHOU Huai-jun,ZHANG Hai-xia,HU Bin.Morphine individual titration on cancer patients[J].WORLD CLINICAL DRUGS,2014(6):371-374.
Authors:DONG Ya-fen  YANG Qiu-ya  LI Cheng-min  ZHOU Huai-jun  ZHANG Hai-xia  HU Bin
Institution:(Department of Pharmacy, Branch Court of Shanghai First People's Hospital, Shanghai 200081, China)
Abstract:Objective To observe the analgesic effect of morphine individual titration on cancer patients at late stage. Methods 124 patients with moderate and severe pain were treated with morphine tables whose beginning dose was 10~20 mg/d and then adjusted individually according to analgesic effect. Results Analgesic effect: the mean pain score(NRS) was reduced from(4.5±1.2) to(1.2±1.6)(P0.05); complete remission was found in 76 cases, obvious remission in 32 cases, mild relief in 8 cases and 8 cases showed no effect. The total effective rate was 93.5%. The side effects were constipation, nausea, dizziness, vomiting, drowsiness and dysuria, and all these symptoms were under controlled. Conclusion The dosage of morphine should be prescribed individually to improve life quality.
Keywords:morphine  cancer pain at late stage  individual titration
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