多瑞吉对恶性肿瘤治疗相关性疼痛止痛作用的前瞻性研究

Relief severe pain in oral cavity caused by chemotherapy and radiation injury in cancer patients with transdermal fentanyl,

目的探讨用芬太尼贴剂(多瑞吉)治疗恶性肿瘤放化疗所致中重度口腔黏膜疼痛的可行性及安全性。方法采用前瞻性随机对照研究的方法,将恶性肿瘤放、放化后出现口腔疼痛视觉评分(VAS)≥4分的患者,随机分为研究组和对照组:对照组仅给予VitBco漱口水含漱;研究组在此基础上加用多瑞吉治疗,起始剂量为2.5 mg,每3天更换,据疼痛程度调整。结果研究组疼痛缓解率为87.8%,而对照组为43.48%,差异有统计学意义(P<0.05);多瑞吉平均起效时间2.78±0.96天。研究组和对照组在进食时疼痛评分、进食恐惧感、对普鲁卡因的依赖、对治疗的信心及睡眠等方面的差异有统计学意义(P<0.05)。不良反应主要表现为头昏、呕吐等,经对症治疗后可明显改善,未出现对多瑞吉成瘾及其他严重的不良反应。结论多瑞吉对恶性肿瘤放化疗所致口腔疼痛有较好的止痛效果,且较迅速、安全,对放化疗所致中重度口腔疼痛而服用止痛药物困难的患者又提供了一个好的止痛方法。

Objective To study its feasibility of relieving the severe pain in oral cavity caused by chemotherapy and radiation injury in cancer patients with transdermal fentanyl . Methods 87 cases cancer patients with the severe pain in oral cavity caused by chemotherapy and radiation injury were devided into two groups ： the treatment group were given transdermal fentanyl and mucous renovating drug , the control group were given mucous renovating drug only. Observe the relief of pain in oral cavity, and recor- ded the change of scores with VAS and recorded adverse reactions. Results The rate of relief in the treatment group was 87.8%, in the control group was 43.48% ,and with statistics difference （P 〈0.5）. We can get the effect in day 2.78 ± 0.96. In the treatment group and in the control group, there were statistics difference （ P 〈 0.05 ） in scores of VAS, adverse reactions were dizzy, , nausea and so on. Conclusion The severe pain in oral cavity caused by chemotherapy and radiation injury can be controlled with transdermal fentanyl. And it was safe. It is helpful to relieve depression in nasopharyngeal cancer patients by controlling the severe pain in oral cavity.