盐酸羟考酮缓释片与硫酸吗啡缓释片治疗晚期恶性肿瘤重度疼痛的比较观察

目的观察盐酸羟考酮缓释片（奥施康定）与硫酸吗啡缓释片（美施康定）治疗晚期恶性肿瘤重度疼痛的临床效果及毒副反应。方法58例晚期恶性肿瘤重度疼痛患者随机分为2组，奥施康定组30例，美施康定组28例。奥施康定起始剂量10mg·（12h）-1，美施康定起始剂量20mg·（12h）-1，根据疼痛缓解程度调整剂量，评价镇痛效果及毒副反应。结果2组患者疼痛程度均显著减轻，镇痛总有效率分别为96．7％、96．4％，比较差异无统计学意义（P〉0．05）。奥施康定组起效更快，其起效时间均为1h之内，而美施康定组起效时间为2～3h。奥施康定组的毒副反应发生率为40．0％，低于美施康定组的53．6％，差异有统计学意义（P〈0．05）。2组均无严重毒副反应发生。结论奥施康定与美施康定治疗晚期恶性肿瘤重度疼痛的临床效果相近，但奥施康定起效更快，毒副反应更轻，服用安全，是治疗晚期恶性肿瘤重度疼痛的首选药物之一。

Oxycodone Hydrochloride Sustained-release Sustained Tablets and Morphine Sulfate Sustained-release Tablets for Advanced Malignancy Severe Pain

Objective To investigate the efficacy and toxicities of oxycodone hydrochloride sustained-release tab- lets （oxycontin） and morphine sulfate sustained-release tablets （MS-contin） for advanced malignancy severe pain. Methods Fifty-eight patients with advanced malignancy severe pain were randomly divided into two groups： 30 pa- tients of the oxycontin group and 28 patients of the MS-contin group. The starting dose of oxycontin was 10 mg·（ 12 h） -1 ,the starting dose of MS-contin was 20 mg · （12 h） -1 ,the dose was changed according to the degree of pain easement,and the analgesic efficacy and toxicities were evaluated. Results The pains of the patients in the two groups were significantly reduced,the total response rates of analgesia were 96.7% and 96.4% （ P 〉 0.05 ）. The time of producing analgesic efficacy of the oxycontin group （ 1 h） was less than that of the MS-contin group （2-3 h）, the toxicity incidences of the two groups were 40.0% and 53.6% （P 〈 0.05 ）. There were no serious toxicities in the two groups. Conclusion The efficacy of oxycontin is similar to that of MS Contin in the treatment of ad- vanced malignancy severe pain, but oxycontin produces marked efficacy faster, and is safer, taking security; oxycon- tin is a preferred drug for advanced malignancy severe pain.