盐酸羟考酮缓释片与硫酸吗啡缓释片治疗重度癌痛的疗效分析

 目的　比较盐酸羟考酮缓释片（商品名：奥施康定，简称羟考酮）和硫酸吗啡缓释片（商品名：美施康定，简称吗啡）治疗晚期恶性肿瘤重度疼痛的疗效及患者不良反应。方法　将204例重度癌性疼痛患者用数字表法随机分为两组，每组102例，分别接受羟考酮和吗啡镇痛治疗，每48 h进行 1次疼痛评估，根据疼痛缓解情况调整药物剂量。用药后疼痛评分≤3分者为有效。对两组患者镇痛起效时间、镇痛效果及不良反应进行分析比较。结果　镇痛效果羟考酮组有效率79.4 %（81／102），吗啡组有效率75.5 %（77／102），两组差异无统计学意义（χ2＝0.225，P＞0.05）；对疼痛控制的起效时间羟考酮组比吗啡组更快，两组比较差异有统计学意义（χ2＝22.916，P＜0.05）。羟考酮组总不良反应发生率为62.7 %（64／102），吗啡组为98.0 %（99／102），两组间差异有统计学意义（χ2＝20.151，P＜0.05）。结论　羟考酮和吗啡对重度癌痛控制效果相当，但羟考酮镇痛起效快，患者不良反应发生率低，程度轻，具有一定优势。

The curative effect analysis of Oxycontin and MS Contin in the treatment of sever cancerous pain

Objective　To evaluate effect and adverse effect of oxycontin and MS contin in the treatment of sever cancerous pain. Methods　204 patients with sever cancerous pain were randomly derided into 2 groups, oxycontin and MS contin group. Each pain was evaluated in every 48 hours and dose was adjusted according to the pain relief. And 2 groups were evaluated the analgesic onset time, effect and adverse effect, respectively. Results　Efficiency was according to less than or equal to 3 of pain score after administer in analgesic effect. Effect rates of oxycontin group and MS contin group were 79.4 % (81/102) and 75.5 % (77/102) respectively, and the difference was not statistically significant (χ2 = 0.225, P > 0.05). However, there were significant differences in the analgesic onset time between two groups (χ2 = 22.916, P < 0.05). Adverse effect rates in oxycontin group and MS contin group were 62.7 % (64/102) and 98.0 % (99/102) respectively, and the difference was statistically significant (χ2 = 20.151, P < 0.05). Conclusion　Oxycontin and MS contin in the treatment of serious cancerous pain have the same controlling effect. But oxycontin worked better with quick analgesic onset, low incidence and few of adverse reaction.