盐酸吗啡缓释片直肠给药治疗癌症疼痛临床疗效观察

Clinical Effects of Rectal Administration of Morphine Hydrochloride Sustained-Release Tablets in Relieving Cancer Pain

目的探讨盐酸吗啡缓释片直肠给药治疗癌症疼痛的临床疗效及不良反应。方法 2009年10月—2010年12月就诊于我院的78例癌症患者,随机分为A组(39例)和B组(39例);A组经直肠给药,B组经口服给药,盐酸吗啡缓释片30～90 mg,早晚各1次/d,比较两组的疗效和不良反应。结果两组患者治疗前癌症疼痛程度比较,差异无统计学意义(P>0.05);治疗后癌症疼痛程度比较,差异亦无统计学意义(P>0.05);两组患者治疗前、后癌症疼痛视觉模拟评分(VAS)比较,差异均无统计学意义(P>0.05)。两组患者不良反应均有恶心呕吐、头晕、腹胀便秘等,不良反应均可使用相应的止吐药、通便药等得到缓解。两组恶心呕吐、头晕、腹胀便秘的发生率比较,差异均无统计学意义(P>0.05)。结论盐酸吗啡缓释片经直肠给药治疗癌症疼痛的疗效和不良反应与口服给药无明显差别,对于不能口服给药的患者,经直肠给药是不错的选择。

Objective To observe the efficacy and side effects of rectal administration of sustained-release tablet of morphine hydrochloride in relieving cancer pain. Methods Seventy-eight patients with cancer pain were enrolled and divided into two groups（group A：rectal administration and group B：oral administration）randomly.All patients were treated with sustained-release tablets of morphine hydrochloride（30～90 mg,once every 12 h）.Therapeutic effectiveness and side effects were recorded and compared. Results Degrees of cancer pain before treatment were not statistically different between the two groups of patients;VAS scores after treatment were not statistically different（P0.05）;degrees of cancer pain after treatment were not statistically different（P0.05）.Both groups displayed adverse reactions including nausea,vomiting,dizziness,abdominal distention and constipation,which could be alleviated by antiemetic drugs,laxatives,and so on.Incidence rates of adverse reactions were not statistically different（P0.05）. Conclusion No significant differences exist in efficacy and side effects between rectal administration and oral administration of sustained-release tablet of morphine hydrochloride in cancer pain management.Rectal administration is a good choice for patients who can not take drugs orally.