美施康定治疗中重度癌痛的临床观察

A clinical Survey of MS Contin in the treatment on moderate to severe cancer pain

目的评价美施康定治疗癌性疼痛的效果并观察其毒副作用。方法1995.11～1998．6，103例病人接受美施康定治疗。男性78例，女性25例；年龄32～81岁（中位年龄58岁）。73例病人同时接受其他的抗癌姑息冶疗，其中化疗31例，放疗10例，内分泌治疗6例，抗骨溶解治疗（博宁、阿可达）14例，化疗与放疗相结合治疗12例。肿瘤病人以肿痛为主，其它有肝癌、乳癌、鼻咽癌和消化道肿瘤病人。结果止痛的有效率为8835％（91／103），平均止痛剂量为80mg／天，平均初始剂量和最大剂量分别为45．5mg／天／112．8mg／天。疼痛平均缓解时间为9周。21．39％（21/103）病人增加剂量（其中19例为单独止痛药运用组），16.51％（17／103）需要减少剂量（其中16例为联合其他抗癌治疗组）。主要副作用是便秘和恶心呕吐。结论每天两次中等剂量的美施康定治疗癌性疼痛是相当有效的．而且副作用轻，可以耐受，与其他抗癌姑息治疗联用有协同增效作用。

To assess the analgesic efficacy and side effects of MS Contin in the treatment of cacner pain. Methods Between November 1995 and June 1998, 103 patients were treat ed with MS Contin for pain caused by advanced cancer consisting of 78 males and 25 females,ranging from 32 - 81 years old (median age 58). 73 patients were treated with MS Contin, combined with other anticancer therapies,of which,chemotherapy for 31 patients,radiotherapy for 10 patients, hor monal treatment for 6 patients, anti-osteolytic treatment for 14 patients or combined chemoradio therapy for 12 patients. The patients had a wide variety of cancers,most commonly being lung cacner. Results This clinical survey showed that the total effectiveness was 88. 35% (61/103) and that the mean effective,intial and maximum dosage was 80mg/day,45. 5mg/day and 112- 8mg/day respective ly. The pain relief duration was 9 weeks. 21 patients (21. 39 % )required a decrease of dosage,of whom 16 patients were in combined therapy group. The most common side effects observed were constipa tion,vomiting,nausea and drowsiness. Conclusion Oral MS Contin twice a day can relieve pain with minimal, tolerable side effects in the majority of patients. The concurrent anticancer therapies en hanced analgesic efficacy of MS Contin.