羟考酮控释片与吗啡缓释片治疗中重度癌痛的疗效比较

目的:观察并比较中、重度癌痛患者服用盐酸羟考酮控释片与硫酸吗啡缓释片后疼痛缓解情况及生存质量的改善。方法:将60例中、重度癌痛患者1∶1分为2组,A组给予盐酸羟考酮控释片治疗,B组给予硫酸吗啡缓/控释片治疗,均规律服药14d后评定疼痛缓解度并评估患者的生存质量、记录不良反应。结果:2组患者疼痛程度均较治疗前显著减轻(P<0.05),总有效率分别为96.7%和93.3%,2组比较差异无统计学意义(P>0.05),但A组镇痛起效较B组快(P<0.01)。2组患者治疗后生存质量明显改善,但差异无统计学意义(P>0.05)。2组不良反应主要为便秘、头晕、恶心、呕吐、嗜睡等,且A组便秘明显较轻(P<0.01),其他不良反应比较差异无统计学意义(P>0.05)。结论:盐酸羟考酮控释片与硫酸吗啡缓/控释片治疗中、重度癌痛镇痛效果相近,服用安全,且羟考酮控释片起效快,便秘较轻,可作为中、重度癌痛治疗的首选药物之一。

Efficacy Comparison of Oxycodone Controlled-release Tablets and Morphine Sustained-release Tablets in the Treatment of Moderate to Severe Cancer Pain

OBJECTIVE： To observe pain relief and quality of life changes in patients with moderate to severe cancer pain who take Oxycodone hydrochloride controlled-release tablets and Morphine sulfate tablets, and to investigate the difference of therapeutic efficacy and side effect of Oxycodone hydrochloride controlled release tablets and Morphine sulfate sustained release tablets for moderate to severe cancer pain to provide guidance for clinical drug use. METHODS： Patients with moderate to severe cancer pain in our hospital were divided into group A （30 cases） and group B （30 cases）, regular medication for 2 weeks to evaluate pain relief, quality of life of patients, record adverse drug reactions （ADR）. RESULTS： In 2 groups pain intensity reduced significantly（P〈0.05）, the total effective rate was 96.7% and 93.3%, there was no significant difference （P〈0.05）; onset of analgesia in A group was faster than in B group, there was significant difference （P〈0.01）. Quality of life in 2 groups were improved significantly after treatment, there was no significant difference between 2 groups （P〈0.05）. ADR mainly were constipation, dizziness, nausea, vomiting, lethargy, etc. Constipation in A group was significantly slighter than B group （P〈0.01）, the others had no significant difference（P〈0.05）. CONCLUSION： Oxycodone controlled-release tablets and Morphine sustained release tablets in the treatment of moderate to cancer pain have similar analgesic effect and both are safe. Oxycodone controlled release tablets have a rapid onset and slight main ADR （constipation）, while can be used as one of first choice for the moderate to severe cancer pain treatment.