多瑞吉和奥施康定治疗癌痛的效果观察

目的对比观察多瑞吉（芬太尼透皮贴剂）和奥施康定（盐酸羟考酮控释片）在治疗中、重度癌症疼痛中的止痛效果和不良反应。方法将110例中、重度癌痛患者随机分为两组。多瑞吉组56例,初治患者最初剂量为25μg/h,外用,入组前使用过吗啡的患者多瑞吉剂量（μg/h）=每日吗啡剂量×0.5。奥施康定组54例,未使用过吗啡者给予10 mg,口服,q12h,入组前使用过吗啡的患者奥施康定剂量=每日吗啡剂量×0.5。根据疼痛缓解情况调整剂量,调整到患者满意的疼痛程度,即数字评分法（NRS）0～3。密切观察药物剂量、止痛效果、副作用、药物依赖性等,填写疼痛观察表。结果多瑞吉组疼痛缓解率为89.3%,奥施康定为88.9%,两组比较差异无统计学意义（P〉0.05）。两组患者生活质量均明显提高,组内前后比较差异有高度统计学意义（P〈0.01）,组间比较差异无统计学意义（P〉0.05）。多瑞吉组不良反应发生率：恶心、呕吐占10.7%,便秘占19.6%,头晕占8.9%;奥施康定组分别为18.5%、22.2%、12.9%。数值上奥施康定组高于多瑞吉,但差异无统计学意义（P〉0.05）。无呼吸抑制、成瘾发生。结论多瑞吉和奥施康定均适用于中、重度癌性疼痛治疗,疗效确切,能提高疼痛患者生活质量。多瑞吉使用方便,副作用轻,略优于奥施康定。

Observation of therapeutic efficacy and toxicity of Durogesic and OxyContin in moderate or severe cancer pain

Objective To observe the efficacy and adverse reactions of Durogesic and OxyContin in the treatment of patients with moderate or severe cancer pain.Methods 110 patients with moderate or severe cancer pain were randomly divided into 56 cases of Durogesic regimen group and 54 cases of OxyContin group.Durogesic group patients were treated with Durogesic for external use.The initial dosage of initially treated patients was 25 μg/h.The patients treated with strong opioids previously were carried out the dose conversion of Durogesic according to the conditions of administration.Durogesic doses（μg/h） = daily morphine dose × 0.5.OxyContin group patients take OxyContin per os.The initial dosage of initially treated patients was 10 mg q12h.The patients treated with strong opioids previously were carried out the dose conversion of OxyContin according to the conditions of administration.OxyContin doses = daily Morphine dose × 0.5.Doses should be adjusted until pain relief to NRS 0-3.The drug dose,efficacy,side effects,drug dependence treatment were closely observed.The standard pain observation table was filled out.Results The total alleviating rate of patients in the Durogesic group was 89.3%（50/56） and in the OxyContin group was 88.9%（48/54）.Durogesic and OxyContin also improved the quality of life of the patients with cancer pain.No significant differences were found between two groups（P 0.05）.The quality of life of the patients in the two groups was improved,there were significant differences of the two groups before and after treatment（P 0.01）,while there were no significant differences between the two groups（P 0.05）.The chief adverse reactions were nausea,constipation,dizziness and lethargy.Each reaction of Durogesic group were 10.7%,19.6%,8.9%;OxyContin group were 18.5%,22.2%,12.9%.The difference between the two groups was not statistically significant（P 0.05）.No respiratory inhibition and addiction occurred.Conclusion Durogesic and OxyContin are proved to be good,slight side effect.And Durogesic is convenient in the control of cancer pain.