羟考酮和吗啡对中晚期癌痛患者镇痛效果比较的Meta分析

摘要

目的：比较羟考酮和吗啡对中晚期癌痛患者的镇痛效果。方法系统检索中国知网、万方数据库、PubMed、EMBASE、EBMR、PHMC、ScienceDirect、CENTRAL ( the Cochrane Central Register of Controlled Tri-als)、ClinicalTrials. gov registry和the Current Controlled Trials等数据库中有关比较羟考酮和吗啡对中晚期癌痛患者镇痛效果的相关文献和研究,发表时间为2013年1月至今。由2名评价员独立筛选并提取数据资料,对符合标准的研究用RevMan 5．0软件进行统计分析。结果6项临床对照研究纳入分析( n=859),羟考酮组429例,吗啡组430例。羟考酮组的镇痛效果优于吗啡组(OR=1．29,95% CI：0．88~1．88,P=0．19),羟考酮组手术后总并发症发生率明显低于吗啡组(OR=0．14,95% CI：0．08~0．25,P0．05)。结论羟考酮对中晚期癌痛患者的镇痛效果优于吗啡,且安全性较高。%Objective To compare the analgesic effect of oxycodone and morphine on patients with moderate and advanced cancer pain. Methods The literatures and researches about the comparison of oxycodone and morphine on patients with moderate and advanced cancer pain was systematically retrieved from database CNKI,Wanfang data-base,PubMed,EMBASE,EBMR,PHMC,ScienceDirect,CENTRAL ( the Cochrane Central Register of Controlled Tri-als),ClinicalTrials. gov registry and the Current Controlled Trials since January 2013. The data was screened and select-ed independently by two reviewers,and the criterion was analyzed by RevMan 5. 0 software. Results Six controlled clinical trials (n=859) were involved in the analysis. There were 429 cases in oxycodone group,430 cases in morphine group. The results showed that the analgesic effect of oxycodone group was better than that of morphine group ( OR=1. 29,95% CI:0. 88 ~1. 88,P =0. 19),and the incidence rate of total complication in oxycodone group was lower than that of morphine group (OR=0. 14,95% CI:0. 08~0. 25,P0. 05) between the two groups in the incidence rate of nausea and vomiting (OR=0. 95,95% CI:0. 60~1. 45, P=0. 77),sleepiness (OR=0. 99,95%CI: 0. 65 ~1. 51,P =0. 96) or constipation (OR =0. 87,95% CI: 0. 58 ~1. 30,P=0. 50). Conclusion The analgesic effect of oxycodone on patients with moderate and advanced cancer pain is better than that of morphine and is safer.