盐酸羟考酮控释片治疗中、重度癌痛的临床观察

目的观察盐酸羟考酮控释片（奥施康定）治疗晚期中、重度癌痛的临床效果、不良反应及患者生活质量的改善情况。方法102例中、重度癌痛患者给予奥施康定镇痛治疗,初始剂量5～10mg/q12h,正在用吗啡类镇痛药者,按照吗啡1/2剂量换算,使用过多瑞吉贴剂按25ug/h换算奥施康定15mg/q12h计算。根据疼痛情况调整剂量,直至患者疼痛评分≤2分,每位患者至少治疗15d以上,同时进行疼痛强度、生活质量评分及不良反应观察。结果奥施康定的最终滴定剂量为20～240mg/d,中位剂量50mg/d。总疼痛缓解率为91%,其中完全缓解42例（42%）,明显缓解36例（36%）,中度缓解13例（13%）。患者生活质量明显提高,不良反应主要为便秘,治疗后可缓解。结论盐酸羟考酮控释片治疗中、重度癌性疼痛疗效显著,不良反应可耐受,能显著改善癌症患者的生活质量。

Clinical Observation of Oxycodone Hydrochloride Controlled-release Tablets in the Treatment of Moderate to Severe Cancer Pain

Objective To investigate the efficacy,adverse effect,and improvement on quality of life of oxycodone hydrochloride controlled-release tablets （Oxycontin） for the treatment of moderate to severe cancer pain.Methods 102 patients suffering from moderate to severe cancer pain received oral Oxycontin at an initial dosage of 5mg to 10mg every 12 hours;patients treating with morphine converted to Oxycontin in a half dosage of morphine;and those using transdermal fentanyl（Durogesic）patients would converted to Oxycontin by adjusted dosage as transdermal fentany 25.0 mcg/hour every 72 hours equal to Oxycontin 15mg every 12 hours. Dose of Oxycontin was adjusted according to pain score until patient scoring〈or = 2.All patient received oral Oxycontin treatment not less than fifteen days,and would be re-evaluated their pain scores,quality of life and adverse effects simultaneously. Results The ultimately daily titrated dosage of Oxycontin ranged from 20 mg to 240 mg,and the median daily dose was 50 mg. The overall response rate of pain relief was 91%,with 42% patient getting complete response,36% patient meeting obviously response,and 13% patient resulting in partial response.The analgesia by Oxycontin improved patient＇s quality of life significantly. The mainly side effect of Oxycontin was constipation,which could be solved after treatment.Conclusion It could bring significant analgesia and improve the patient＇s quality of life to treat moderate to severe cancer pain with oxycodone hydrochloride controlled-release tablets,and the side effects were tolerable.