芬太尼透皮贴剂与硫酸吗啡控释片治疗中重度慢性癌痛疗效及不良反应临床观察

Clinical evaluation of efficacy and side effects of transdermal fentanyl and sustained release morphine in treatment of moderate-severe chronic cancer-related pain

目的:比较芬太尼透皮贴剂(商品名:多瑞吉)与硫酸吗啡控释片(商品名:美施康定)治疗中重度慢性癌痛的疗效及不良反应。方法:将67例中、重度慢性癌痛患者随机分为两组,分别应用芬太尼透皮贴剂(34例)和硫酸吗啡控释片(33例)进行治疗。所有病例均观察至少15d,评价指标为两组的疼痛强度、疼痛缓解率及不良反应发生率。结果:芬太尼透皮贴剂的3度以上疼痛缓解率为82.35%,硫酸吗啡控释片为78.79%,两组间无显著性差异。前者恶心、呕吐、便秘的发生率低于后者,有统计学差异。结论:芬太尼透皮贴剂和硫酸吗啡控释片均可以有效地控制中重度慢性癌痛,但前者恶心、呕吐、便秘的发生率更低,它们各有优缺点,应根据患者个体情况合理选用。

Objective： To compare the efficacy and side effects of transdermal fentanyl （Durogesic） and sustained release morphine （MS-contin） in treatment of moderate-severe chronic cancer-related pain. Methods： 67 patients with moderate-severe chronic cancer-related pain were recruited into two groups randomly. 34 patients were in transdermal fentanyl group and 33 patients were in sustained release morphine group. All the patients were observed with a period of at least 15 days. The index of evaluation was the intensity of pain, the remission rate of pain and the incidence of side effects. Results： In treatment of moderate-severe chronic cancer-related pain the remission rate of pain above thirddegree of transdermal fentanyl group and sustained release morphine group is 82.35% and 78.79% respectively. There was no significant difference between the two groups. The incidence of nausea, vomiting and constipation in transdermal fentanyl group was lower than that in sustained release morphine group with a significant difference between them. Conclusion： The two drugs can treat the moderate-severe chronic cancer-related pain effectively. The incidence of nausea, vomiting and constipation of transdermal fentanyl was lower than that of sustained release morphine. Each of the two drugs has its advantages and disadvantages.An appropriate alternative between them in treatment of moderate-severe chronic cancer-related pain should be made according to actual individual situation of the patients.