Objective To explore the efficacy and adverse reactions of oxycodone hydrochloride prolonged-release tablets and immediate-release morphine tablets of two different titration schemes in the treatment of moderate and severe cancer pain.Methods One hundred and twenty-three patients with moderate and severe cancer pain were randomly divided into long-acting group (oxycodone hydrochloride prolonged-release tablets,10-20 mg of inital dose,q 12 h) and short-acting group (oral morphine tablets,10 mg of inital dose,q4 h).The pain relief rate and total remission rate in 24,48 and 72 h were evaluated by numerical rating scale(NRS) in two groups.SF-36 scale was used to assess the quality of life.The frequency of additional administration and the incidence of adverse reactions were calculated.Results The complete remission rate of 24,48,72 h in the long-acting group were 53.2％,75.8％ and 83.9％,respectively,which were higher than 34.4％,41.0％ and 68.9％ of the short-acting group (P＜0.05).The total remission of 48 h in the long-acting group was 95.2％,which was higher than 83.6％ in the short-acting group,and the difference was statistically significant(P＜0.05).The proportion of patients who completed the titration in 1 cycle in the long-acting group was 58.1％,which was higher than 34.4％ in the short-acting group,and the difference was statistically significant (P＜0.05).Compared the short-acting group,number of extra administration was significantly reduced in long-acting group.The incidence of constipation in the long-acting group was 45.2％,which was equivalent to 52.5％ of the short-acting group.The incidence of nausea and vomiting in the long-acting group was 30.7％,which was lower than 52.5％ in the short-acting group (P＜0.05).The quality of life in the long-acting group was better than that in the short-acting group.Conclusion The total response rates of oxycodone hydrochloride prolonged-release tablets with immediate-release morphine tablets at 72 h were equivalent,but oxycodone hydrochloride can better control the pain in the short term,improve the patients quality of life,and reduce the workload of medical staff,worthy of clinical popularization and application.%目的 探讨盐酸羟考酮缓释片和即释吗啡片两种不同滴定方案治疗中重度癌痛的疗效及不良反应.方法 123例中重度癌痛患者采用随机数字表法分为长效组(盐酸羟考酮缓释片,初始剂量10～ 20 mg,q12 h)和短效组(口服即释吗啡片,初始剂量10 mg,q4 h),采用疼痛数字分级评分法(NRS)评定两组患者在24、48、72 h的疼痛缓解率及总缓解率,采用SF-36量表评估生活质量,同时统计额外给药次数及不良反应发生率.结果 长效组24、48、72 h内的完全缓解率分别为53.2％、75.8％和83.9％,均高于短效组的34.4％、41.0％和68.9％,差异有统计学意义(P＜0.05).长效组48 h的总缓解率为95.2％,高于短效组的83.6％(P＜0.05).长效组1周期完成滴定的患者比例为58.1％,高于短效组的34.4％,差异有统计学意义(P＜0.05),且额外给药次数明显减少.长效组便秘发生率为45.2％,与短效组的52.5％相当(P＞0.05),但长效组恶心、呕吐的发生率为30.7％,低于短效组的52.5％ (P＜0.05).长效组生活质量改善明显优于短效组.结论 盐酸羟考酮缓释片与即释吗啡片在72 h的总缓解率相当,但盐酸羟考酮缓释片能更好地在短期内控制癌痛,提高患者生活质量,且降低医务人员的工作量,安全性高,值得临床推广应用.
展开▼
