奥施康定联合唑来膦酸治疗骨转移性癌痛的临床研究

目的:观察奥施康定（盐酸羟考酮缓释片）联合唑来膦酸治疗骨转移性癌痛的临床疗效及安全性。方法:共纳入我院收治的286例骨转移性癌痛患者。根据患者疼痛评分给予奥司康定起始剂量，有爆发痛予即释吗啡止痛治疗，第二日根据前日总剂量调整奥施康定用量。1周后行注射用唑来膦酸4 mg输注，每4周重复用药。评价用药后患者止痛疗效、生活质量及毒副反应情况。结果:所有患者疼痛均有所缓解；奥施康定联合唑来膦酸治疗后，191例患者奥施康定用量减少，87例患者维持原剂量，仅有8例患者奥施康定用量增加。治疗前所有患者KPS评分为67.5±12.7,奥施康定治疗后KPS评分为73.8±18.3,奥施康定联合唑来膦酸治疗后KPS评分为78.4±17.1。治疗毒副反应主要为发热、一过性骨痛加剧、消化道症状及嗜睡等，经对症治疗后耐受性好。结论:奥施康定联合唑来膦酸治疗骨转移性癌痛具有较好的临床疗效和安全性，值得临床推广使用。

Clinical study of oxycodone combined with zoledronic acid in the treatment for bone metastases tumor pain patients

Objective:To investigate the efficacy and safety of oxycodone combined with zoledronic acid in the treatment for bone metastases tumor pain patients.Methods:A total of 286 bone metastases tumor pain patients were selected.The dosage of oxycodone was administered according to the pain score.Immediate-release morphine was given when they suffered breakthrough pain.We adjusted the dosage of oxycodone by the total dosage of the previous day,injected zoledronic acid after one week,with repeat ever 4 weeks.Analgesic effect,quality of live and adverse action were analyzed.Results:After treatment,the score of pain was significantly decreased in all of patients.The dosage of oxycodone was decreased in 191 patients after administering oxycodone combined with zoledronic acid.87 patients maintained former dosage,and only 8 patients increased dosage.The KPS score was 67.5±12.7 before treatment.KPS score was 73.8±18.3 after administering oxycodone.KPS score was 78.4±17.1 after administering oxycodone combined with zoledronic acid.Adverse actions had fever,transient exacerbation of bone pain,digestive symptoms and somnolence etc.The patients could be tolerance after symptomatic treatment.Conclusion:Oxycodone combined with zoledronic acid is effective and safe,and can be widely used in bone metastases tumor pain patients.