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丁丙诺啡片用于镇痛随机双盲双模拟对照多中心的临床试验
摘    要:采用双盲双模拟对照多中心实验,临床评价了丁丙诺啡(Bup)舌下含片(每片0.2mg)的镇痛效果,对照药为硫酸吗啡普通片。结果表明:(1)Bup用于缓解手术后急性中度疼痛0.2mg-0.4mg丁丙诺啡的临床镇痛效果与10mg吗啡相当;(2)丁丙诺啡片用于缓解中度疼痛,其一次剂量0.2mg与0.4mg的临床镇痛效果几乎无差别,提示每次应用1片即可;(3)Bup片用于缓解晚期癌症慢性中度疼痛,每次剂量0.2-0.8mg,一日三次,可使80%的疼痛患者得到中度以上缓解,临床镇痛总有效率91.67%,显效率86.11%。本试验,日剂量加大到1.2-2.4mg时,完全缓解率达到60%,中度以上缓解率达到95%,给药间隔时间可延长到6-8h,显示本药具有中长镇痛时效。可以认为,通过剂量调整能使中度癌痛患者达到无疼痛;(4)Bup的不良反应主要为头晕、恶心、呕吐,服药当天较重,分别可达30%、30%和20%左右。1wk内明显下降。少数人可有头痛、皮肤瘙痒、皮疹、排尿困难等。开放试验思睡发生率2wk内一直在20%-30%左右,明显高于对照试验丁丙诺啡组;(5)未发现丁丙诺啡对呼吸、血压、心率造成明显影响。经2wk用药观察,血?

关 键 词:盐酸丁丙诺啡舌下含片;镇痛;临床试验

CLINICAL EVALUATION OF ANALGESIC EFFECTS OF BUPRENORPHINE SUBLINGUAL TABLET BY DOUBLE BLIND, DOUBLE DUMY, MULTIPLE CENTER METHOD
Abstract:A singal day and 7 day clinical evaluation of analgesic effect of buprenorphine sublingual tablet was carried out in several hospitals according to a randomized and double-blind,double-dumy design.The clinical results showed that: (1) The analgesic effect of buprenorphine sublingual tablet (dose 0.2-0.4 mg, tid) was equal to that of morphine sulfate tablet (dose 10 mg);(2) Taking one sublingual tablet of buprenorphine could well relieve the middle pain intensity of patients;(3) There was no significant differences between 0.2 mg and 0.4 mg singal oral dose of buprenorphine sublingual tablet in pain control;(4) The adverse effects of buprenorphine tablet were dizzy, vomitting and nausing,but the rate of occurence of these three reactions decreased after taking Bup for a week;(5)Buprenorphine sublingual tablet showed no influence on respiration,heart rate and blood pressure, no damage of liver,kidney and blood system was found. No tolerance and dependence were formed.
Keywords:buprenorphine sublingual tablet  analgesia  clinical trial
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