硫酸吗啡控释片直肠、阴道给药治疗女性癌痛的疗效

Therapeutie Effects of Rectal and Vaginal Administration of Morphine Sulfate in Female Cancer Pain Management

目的比较硫酸吗啡控释片(商品名:美施康定)直肠、阴道给药治疗女性癌痛的临床疗效。方法将入选的97例口服给药困难的女性癌痛患者按随机数字表法分成两组,直肠给药组48例,阴道给药组49例,两组均给予硫酸吗啡控释片,1次/12 h,并在用药过程中根据疼痛缓解程度调整剂量;5 d后比较两组镇痛效果、不良反应发生率、硫酸吗啡控释片用量以及治疗前后生活质量评分变化情况。结果硫酸吗啡控释片直肠、阴道给药治疗中重度癌痛女性总有效率分别为93.8%和91.7%,组间比较差异无统计学意义(P>0.05);两组生活质量治疗后均有提高,差异有统计学意义,但组间比较差异无统计学意义(P>0.05);阴道给药组便秘发生率较直肠给药组明显降低,硫酸吗啡控释片用量少(P<0.05)。结论对于各种原因所致不能口服或直肠给药的女性癌痛患者,阴道给药是一种安全、有效、简便的给药途径。

Objective To compare the clinical efficacy of rectal and vaginal administration of morphine sulfate in female cancer pain management.Methods Ninety-seven female patients with difficulty in oral administration of morphine sulfate were randomized into rectal administration group（n=48） and vaginal administration group（n=49）.The patients in the two groups were treated by vaginal administration or rectum administration per 12 hour.The dose was adjusted according to pain relief levels during medication.After five days＇ treatment,comparisons were conducted on the efficacy,the incidence of adverse reactions,the dosage of morphine sulfate controlled-release tablets and the scores of quality of life（QOL） before and after surgery.Results The total efficacy rate of rectum administration and vaginal administration for moderate-severe female cancer pain were 93.8% and 91.7% respectively,with no significant difference between two groups（P0.05）.The quality of life was significantly improved in both groups but no significant difference was observed between the two groups（P0.05）.The QOL levels of all the patients were sigmficantly improved after treatment.The incidence of constipation in the vaginal administration group was significantly lower than that in the rectal administration group,with less morphine sulfate tablets（P0.05）.Conclusion For female patients with cancer pains who have difficulty in oral or rectal administration due to various reasons,vaginal administration is a safe,effective and convenient route of medication.