硫酸吗啡控释片与盐酸吗啡缓释片治疗121例中、重度癌痛患者的疗效比较

背景与目的:硫酸吗啡控释片、盐酸吗啡缓释片均是治疗中、重度癌痛的首选药物之一,两者在作用、代谢、不良反应等方面有一定差异.本研究的目的是比较硫酸吗啡控释片、盐酸吗啡缓释片治疗中、重度癌痛患者的疗效和不良反应.方法:对121例有中、重度癌痛的患者进行随机分组,其中61例采用硫酸吗啡控释片、60例采用盐酸吗啡缓释片治疗,观察两药疗效和不良反应.结果:硫酸吗啡控释片组中中度疼痛12例,重度疼痛的例,治疗后有效率91.80%;盐酸吗啡缓释片组中中度疼痛13例,重度疼痛47例,治疗后有效率91.67%,两组比较在镇痛效果上差异无统计学意义.消化道反应(恶心、呕吐、便秘),盐酸吗啡缓释片较硫酸吗啡控释片发生率高(66.66%vs.4.43%),差异有统计学意义(P＜0.05).结论:硫酸吗啡控释片、盐酸吗啡缓释片用于治疗中、重度癌痛,疗效相近,安全性好,不良反应可耐受.对年龄大,既往有消化道疾病的患者,推荐使用硫酸吗啡控释片.

Efficacy comparison between morphine sulfate controlled-released tablet and morphine hydrochloride sustained-released tablet in treating cancer pain

BACKGROUND & OBJECTIVE: Morphine sulfate controlled-released tablet and morphine hydrochloride sustained-released tablet are preferred medicines for treating moderate-severe cancer pain. There are some differences between the two medicines in their efficacy, metabolism and adverse events. This study was to compare the efficacy and toxicities between morphine sulfate controlled-released tablet and morphine hydrochloride sustained-released tablet in treating moderate-severe cancer pain. METHODS: A total of 121 patients with moderate-severe cancer pain were randomized into two groups: 61 were treated with morphine sulfate controlled-released tablet and 60 were treated with morphine hydrochloride sustained-released tablet. Analgesic efficacy and toxicities of the two medicines were observed. RESULTS: Of the 61 patients treated with morphine sulfate controlled-released tablet, 12 had moderate pain, 49 had severe pain; the total response rate was 91.80%. Of the 60 patients treated with morphine hydrochloride sustained-released tablet, 13 had moderate pain, 47 had severe pain; the total response rate was 91.67%. There was no significant difference in the efficacy between the two medicines. Digestive system adverse events, including nausea, vomiting and constipation, were more common in morphine hydrochloride sustained-released tablet group than in morphine sulfate controlled-released tablet group (66.66% vs. 34.43%, P<0.05). CONCLUSIONS: Both morphine sulfate controlled-released tablet and morphine hydrochloride sustained-released tablet are safety in treating moderate-severe cancer pain and the toxicities are tolerable. We recommend to take morphine sulfate controlled-released tablet for older patients and the patients with digestive disorders.