超大剂量盐酸羟考酮缓释片与硫酸吗啡缓释片治疗重度癌痛的疗效及安全性比较

摘要

目的:观察超大剂量盐酸羟考酮缓释片(奥施康定)与硫酸吗啡缓释片(美施康定)治疗重度疼痛的临床疗效及安全性.方法:将重度疼痛的晚期肿瘤患者随机分为盐酸羟考酮缓释片组(奥施康定组)和硫酸吗啡缓释片(美施康定组)组,剔除观察期内(14天)两组患者中奥施康定和美施康定使用未达到超大剂量的患者.共有76例患者纳入本研究,其中奥施康定组33例,美施康定组43例.比较两组患者的止痛疗效、生活质量、不良反应.结果:奥施康定组达到首次疼痛控制稳定时间短于美施康定组,且在观察期间内,奥施康定组爆发痛发生次数以及解救药物使用剂量均少于美施康定组,差异具有统计学意义(P<0.05).奥施康定组疼痛缓解率87.88%,美施康定组疼痛缓解率83.72%,两组相比差异无统计学意义(P>0.05).奥施康定组和美施康定组治疗后生活质量较治疗前好转,差异有统计学意义(P<0.05);两组患者用药后生活质量变化比较,差异无统计学意义(P>0.05).治疗过程中,奥施康定组便秘发生情况低于美施康定组,差异具有统计学意义(P<0.05).结论:奥施康定和美施康定可有效缓解晚期癌症患者的疼痛,改善患者生活质量,具有较好的临床疗效,但盐酸羟考酮缓释片止痛快速、持久、稳定,不良反应发生率低.%Objective:To observe the clinical efficacy and safety of super high dose of oxycodone hydrochloride prolonged-release tablets (OXYcontin)and morphine sulfate sustained-release tablets (MScontin)in the treat-ment of severe pain in advanced cancer patients.Methods:The advanced cancer patients with severe pain were ran-domly divided into oxycodone hydrochloride prolonged-release tablets group (OXYcontin group)and morphine sul-fate sustained-release tablets group (MScontin group),got rid of the patients whose OXYcontin or MScontin use not reach the super high dose during the observation period (14 days).A total data of 76 patients were included in this study,there were 33 cases in the OXYcontin group and 43 cases in the MScontin group.The analgesic efficacy,quality of life and adverse effect were compared between the two groups.Results:OXYcontin group reached the first stable pain control in a shorter time,and during the observation period,the times of breakout pain and the rescue analgesic doses were less than the MScontin group,the difference was statistically significant (P< 0.05).The rate of pain relief of OXYcontin group was 87.88%,of MScontin group was 83.72%,there was no significant difference between the two groups (P > 0.05).After treatment,the quality of life of patients in OXYcontin group and MScontin group was better than that before treatment,showing significant difference (P< 0.05),there was no significant difference in quality of life between the two groups after treatment (P > 0.05).During the treatment,the incidence of constipation in OXYcontin group was lower than that of the MScontin group (P< 0.05).Conclusion:OXYcontin and MScontin can effectively alleviate the pain of patients with advanced cancer,improve the quality of life of patients,has good clin-ical curative effect.But OXYcontin relieve pain fast,lasting and stable,and with a low incidence of side effect.