奥施康定和芬太尼透皮贴治疗中-重度癌痛的临床观察

The Clinical Study for the Effect of Oxycontin or Transdermal Fentanyl on Moderate and Severe Cancer Pain

目的对比观察奥施康定(盐酸羟考嗣控释片)和芬太尼透皮贴治疗慢性中、重度癌痛的疗效和不良反应。方法 84例中、重度癌痛患者随机分为奥施康定治疗组或芬太尼透皮贴组。奥施康定组初始剂量10mg/12h,正在用吗啡镇痛者,按照吗啡0.5剂量换算。芬太尼透皮贴组初始剂量为25μg/h,正在用吗啡镇痛者,按照芬太尼透皮贴(μg/h)=每日吗啡剂量(mg)×0.5换算。根据疼痛情况调整剂量,每位患者至少治疗两周,同时进行疼痛强度、生活质量评分及不良反应观察。结果奥施康定组41例疼痛缓解率为92.68%;多瑞吉组43例为93.02%。两组患者生活质量均明显提高,主要不良反应为便秘。结论奥施康定和多瑞吉治疗中、重度癌痛疗效均显著,不良反应较少,能显著改善癌症患者的生活质量。

Objective To observe the analgesic efficacy and adverse effects of oxycontin （oxycodone hydrechlonde controlled-release tables） or transdermal fentanyl on moderate and severe chronic cancer pain by contrast. Methods 84 patients with moderate or severe chronic cancer pain were randomly divided into oxycontin group or fentanyl group. Oxycontin was administrated at an initial dose of 10 mg every 12 hours, the patients taking morphine switched to oxycontin with dose equal to half of morphine; The transdermal fentanyl was given 25/μg/h initially, and those treating with morphine would swith to transdermal fentanyl with dose （μg/h） according to multiplying morphine dose （mg/day） by half; and dosage was adjusted according to the degree of pain relief. All cases received therapy not less than 2 weeks, and the pain intensity, quality of life, and adverse effects were observed. Results The pain relief rate of oxycontin group was 92.68% for 41 cases, while it was 93.02% of the transdermal fentanyl group for 43 cases. The quality of life of patients in both groups was improved significantly. The most common side-effect was constipation. Conclusions Both oxycontin and transdermal fentanyl are effective for moderate and severe cancer pain with few side effects and can improve the quality of life significantly.