吗啡缓释片直肠、口服给药方式在癌痛治疗 中的疗效比较

 目的　比较吗啡缓释片直肠、口服两种给药方式在癌痛控制中的疗效和胃肠道反应情况。方法 　120 名中晚期癌痛患者随机分成4 组,每组30 人。每组患者给予吗啡缓释片(30～60 mg) 止痛治疗, 每日2 次,共4 周。OR 组第1～2 周口服给药,第3～4 周直肠给药;RO 组第1～2 周直肠给药,第3～4 周口服给药;OO 组第1～4 周口服给药;RR 组第1～4 周直肠给药,观察两种给药方式在癌痛控制中的 疗效和胃肠道反应情况。结果　吗啡缓释片直肠、口服给药两种方式的镇痛缓解总有效率(RR) 分别: OR 组77 % ,RO 组80 % ,OO 组82 % ,RR 组77 %。直肠给药方式的胃肠道反应情况明显低于口服给药 方式。结论　吗啡缓释片通过直肠给药可以取得与口服给药一样的镇痛效果,且减少了胃肠道不良反 应。

Comparison of Morphine Sustained Release Tablets between Rectal Administration and O2 ral Administration in Treatment of Cancer Pain

Objective 　To compare rectal administ ration with oral administ ration in the t reatment of cancer pain and the side effect s. Methods 　One hundred and twenty patient s with cancer pain were randomly di2 vided into 4 group s with 30 patient s in each group. The patient s were given sustained2release morphine tablet s with total dosage of 30～60 mg/ d ,twice daily. OR group was administered orally in the first two weeks and rectally in the later two weeks ; RO group was administered rectally in the first and second weeks ,orally in the third and th fort weeks ; OO group was administered orally in four weeks ; RR group was administered rectally in four weeks. The analgesic efficacy and the side effect s of nausea ,vomiting and constipation were compared. Results 　Af ter the patient s given sustained2release morphine tablet s ,RR was 77 % (OR group) ,80 %(RO group) ,82 % (OO group) , 77 % (RR group) . The occuring rate of nausea was 24 % (OR group) ,3 %(RO group) ,33 % (OO group) ,18 % (RR group) ; vomiting was 16 % (OR group) ,13 %(RO group) ,20 % (OO group) ,3. 3 % ( RR group ) ,constipation was 20 % (OR group) , 14 %(RO group) ,33 % (OO group) ,20 % (RR group) . Conclusion 　The patient s given sustained2release morphine tablet s with rectal administ ration got the same analgesic effect s and less adverse reactions com2 pared with the patient s given sustained2release morphine tablet s with oral administ ration.