羟考酮缓释片和芬太尼透皮贴对放射性口腔黏膜炎所致疼痛的疗效观察

目的 观察盐酸羟考酮缓释片和芬太尼透皮贴对放射性口腔黏膜炎所致疼痛的止痛效果、患者生活质量改善程度和不良反应.方法 将66例鼻咽癌放疗患者随机分为两组,羟考酮组34例,患者初始剂量为10 mg口服,q12h,芬太尼组32例,给予25μg/h（4.2 mg,q72h）,根据疼痛情况调整剂量,每3个小时记录一次疼痛程度,每24小时评估生活质量及不良反应.结果 两组放射性黏膜炎所致疼痛均有所减轻,在放疗的第5～7周,羟考酮组的止痛效果略优于芬太尼组,第7周（3.59±0.28）vs（4.42±0.33）,差异有统计学意义（P＜0.05）.两组便秘、恶心呕吐、头晕发生率差异无统计学意义（P＞0.05）;两组均无呼吸抑制及成瘾性的发生.结论 羟考酮缓释片和芬太尼透皮贴均适用于放射性黏膜炎所致疼痛,疗效确切.放射性黏膜炎所致疼痛随着放疗剂量的增加而逐渐加重,如何既利用羟考酮缓释片加快镇痛的剂量调整,又发挥芬太尼透皮贴剂长效稳定、使用方便、不良反应少的特点,是我们下一步的研究方向.

Observation of therapeutic efficacy and toxicity of Durogesic and OxyContin in radiotheraputic mucositis-induced pain

Objective To observe the clinical efficacy of Durogesic and OxyContin in relieving moderate or severe acute radiotheraputic mucositis-induced pain,improving the life quality and adverse drug reactions in patients with nasopharyngeal carcinoma.Method A total of 66 patients with nasopharyngeal carcinoma who severe radiotheraputic mucosi-tisinduced pain was complained during radiotherapy were randomly divided into two groups：34 patients （OxyContin group） were treated with OxyContin plus routine therapy,and 32 patients（Durogesic group） were treated with Durogesic.The pain-relieving efficacy were recorded every 3 hours.The score of life quality and the side effects were recorded every 24 hours.Results There was significant difference between the two groups in radiotheraputic mucositis-induced pain.Conclusion OxyContin is convenient in the control of radiotheraputic mucositis-induced pain because of its rapid action and easy adjustment.