缓释芬太尼透皮贴剂对比控释盐酸吗啡在癌痛治疗中的临床研究

A Clinical Study between Transdermal Fentanyl and Sustained-release Oral Morphine in the Management of Cancer Pain

目的:比较缓释芬太尼透皮贴剂(多瑞吉)与控释盐酸吗啡(美菲康)对中重度癌痛患者的止痛效果、不良反应和生活质量改善情况。方法:42例癌痛患者随机分为两组,分别应用缓释芬太尼透皮贴剂和控释盐酸吗啡进行治疗,用药15天后评价疼痛缓解率、生活质量改善情况及不良反应。结果:芬太尼透皮贴剂组(治疗组)20例患者疼痛缓解有效率为90.0%,控释吗啡组(对照组)22例患者疼痛缓解有效率为81.8%,两组无统计学差异(P>0.05);不良反应方面,两组便秘发生率分别为30.0%和63.6%,有统计学意义(P<0.05),两组恶心呕吐发生率分别为25.0%和54.5%,有统计学意义(P<0.05);两组之间在生活质量改善方面无显著性差异。结论:芬太尼透皮贴剂及控释盐酸吗啡对中、重度癌痛疗效相似,但使用芬太尼透皮贴剂患者便秘、恶心及呕吐现象发生率更低。

Objective：To compare efficacy,side-effects and improvement of Quality of Life（QOL） after therapy by transdermal fentanyl（TDF）（Duragesic） and sustained-release oral morphine（SRM）（Morphine Hydrochloride-Southwest Pharm） for cancer pain（CP）.Methodes：42 patients were randomized into TDF group（therapy group） and SRM group（control group）.The two groups were administered with TDF and SRM respectively,then the efficacy,side-effects and QOL were estimated after 15 days.Results：The analgesic efficacy was 90.0%（18/20） in therapy group compared with 81.8%（18/22） in control group,two groups had no significant difference（P〉0.05）.As to side-effects,the incidences of constipation was 30.0%,nausea and vomiting was 25.0% in Duragesic group,they were significantly lower than 63.6% and 54.5% in SRM group respectively（P〈0.05）.The improvement of QOL had no difference.Conclusion：Using of TDF and SRM for CP had similiar efficacy,but TDF had less side-effects such as constipation,nausea and vomiting than SRM.