两种滴定方法治疗癌痛的疗效及经济学评价

目的:针对阿片类药物治疗癌性疼痛,探讨临床常用的两种滴定方法的疗效、不良反应及费用情况。方法:两组癌性疼痛患者(n=30)分别口服吗啡滴定(观察组)和口服盐酸羟考酮缓释片(对照组)进行滴定。记录疼痛缓解程度、不良反应和1周内的镇痛药物费用。结果:两种方法均能很好地缓解疼痛,总缓解率分别达到96.7%和96.6%。观察组的不良反应发生率高于对照组(P<0.05)。治疗1周内观察组的成本-效果比低于对照组。结论:两组滴定镇痛疗效相当。使用吗啡滴定费用低但是不良反应发生率高,患者依从性稍差;使用盐酸羟考酮滴定则反之。两种方法各有优缺点,可根据患者实际情况选择使用。

Effects and Pharmacoeconomic Analysis of Two Titration Methods for the Treatment of Cancer Pain

OBJECTIVE：To evaluate effects,adverse reaction and costs of two titration methods for the treatment of cancer-induced pain by opioid drugs.METHODS：60 patients with cancer pain were divided into two groups （n =30） by using two different dosage titration,such as oral Morphine tablets（in observation group） and Oxycodone hydrochloride controlled-release tablets （in control group）.The degree of pain relief,adverse reactions and costs within 1 week of analgesics were recorded and studied.RESULTS：The two methods relieved pain well.Pain remission rate was 96.7％ in observation group while 96.6％ in control group.Adverse reaction rate of observation group was higher than control group（P ＜ 0.05）.The cost-effectiveness of the drugs within 1 week in observation group was lower than control group.CONCLUSIONS：There were no statistic differences of analgesic effect between two groups.Contrast to the oxycodone hydrochloride controlled-release dosage titration,oral morphine titration cost is lower but with higher adverse reaction rate and less compliance.The suitable treatment method should be chosen according to the actual situation of patients.