盐酸羟考酮和硫酸吗啡控释片治疗癌性内脏痛的疗效比较

Conparision of the effect of Oxycodone and Morphine controlled-release tablets in the treatment of visceral cancer pain

目的:比较盐酸羟考酮控释片及硫酸吗啡控释片对癌性内脏痛的治疗效果。方法:72例癌性内脏痛患者随机分为2组。OO组应用盐酸羟考酮控释片治疗,MO组应用硫酸吗啡控释片治疗。根据NCCN(2008年)原则,应用即释吗啡进行药物剂量滴定,后转换为控释剂。整个过程保持患者疼痛视觉模拟评分(VAS)≤3分。记录应用控释剂后15d的解救药用量及副作用,分析控释药物的成本—效果比,评价盐酸羟考酮控释片及硫酸吗啡控释片对癌性内脏痛的治疗效果。结果:解救药用量OO组少于MO组(P<0.05)。OO组便秘、恶心呕吐发生率低于MO组(P<0.05),疼痛治疗有效率及成本—效果比2组差异无统计学意义(P>0.05)。结论:盐酸羟考酮和硫酸吗啡控释片都具有显著的镇痛作用,但盐酸羟考酮控释片在解救药用量及减少胃肠道副作用方面优于硫酸吗啡控释片,可作为癌性内脏痛治疗的优选药物。

Objective： To research and compare the therapeutic effect of oxycodone hydrochloride controlled--release tablets and morphine sulfate controlled--release tablets on the visceral cancer pain. Methods： Total of 72 patients with visceral cancer pain were randomly assigned into two groups： OO group was treaded by oxycodone hydrochloride controlled--release tablets, MO Group was given morphine sulfate controlled--release tablets, According to the principle of NCCN （2008）, the two groups were titrated by morphine, and then diverted to controlled-release agent. The visual analogue scale （VAS） was kept smaller than 4. The side effects of two groups＇ and the rescue analgesic doses were recorded after the application of the controlled-release agent for 15 days, and the cost-effectiveness was analysed. Results： The rescue analgesic doses of the OO group were smaller than that of the MO group （P〈0,05）, The occurrence rate of constipation, nausea/vomiting of the OO group were lower than that of the MO group（P〈0.05）. There was no statistical difference in effective rate of relieving pain and cost-effectiveness （P〉0.05）. Conclusion： The two drugs have notable analgesic effect in the visceral cancer pain. Considered gastrointestinal tract side effects and the rescue analgesic dose, Oxycodone hydrochloride controlled--release tablets surpass the Morphine sulfate controlled-release tablets. Oxycodone hydrochloride controlled-release tablets may be a potential regimen for visceral cancer pain.