因卡膦酸二钠治疗癌症骨转移的疗效观察

Clinical observation of various nmtastatic bone cancers treated with incadronate

目的观察因卡膦酸二钠治疗各种癌症骨转移的临床疗效。方法选择2009年3月至2010年5月就诊中国医科大学附属盛京医院疼痛科门诊及住院的各种恶性肿瘤骨转移患者66例，将其随机分为研究组（40例）与对照组（26例），分别给予静脉因卡膦酸二钠制剂配合爆发痛时口服氨酚羟考酮及单纯氨酚羟考酮片剂口服治疗，比较2组患者用药后7、15、30、60d临床症状改善情况、骨密度和视觉模拟评分（VAS评分）、睡眠质量评分（QS）、活动能力评分及镇痛药的应用情况。结果研究组镇痛有效率优于对照组[92．5％（37例）比42．3％（11例），P〈0．01]；研究组治疗后腰椎正位骨密度、腰椎侧位骨密度及骨密度均较治疗前及对照组治疗后明显改善[分别为（0．4109±0．1067）比（0．73024±0．0675）、（0．71754±0．0907），（0．4105±0．0877）比（0．7334±0．0712）、（Q7175±Q0963），（-2．02±2．01）比（-413±2．03）、（-3．13±2．05），P〈0．05]；治疗后7、15、30、60d研究组的VAS评分明显低于治疗前及对照组治疗后。研究组治疗后7、15、30、60d睡眠Qs评分均较治疗前明显改善，对照组治疗后7、15d睡眠Qs评分与治疗前比较，差异无统计学意义，治疗后30、60d睡眠Qs评分较治疗前明显改善。研究组治疗后7、15、30、60d睡眠Qs评分均较对照组改善明显（均P〈0．05）。结论因卡膦酸二钠可明显改善癌症骨转移致骨痛，且能改善食欲、睡眠、日常活动能力，减低镇痛药物剂量，增强患者自信心，延长癌症患者生存期，有效提高患者的生活质量。

Objective To investagete the clinical efficacy and safety of incadronate in treatment of patients with pain of various matastatic bone cancer. Methods A randomized and parallel comparative trial was performed in 66 patients with pain of various matastatic bone cancers. The patients were randomly divided into study group and control group： study group were given intravenous injection of acid disodium and acetaminophen xycodone; control group were given service acetaminophen oxycodone only. The efficacy and the allevated satus of incadronate and oxycodone and acetaminophen tablets were observed on seventh day, fifteenth day, thirtieth day and sixtieth day respectively. Results Compared with eontral group （42. 3 % ）, the rate of pain relief was 92. 5 % （ P 〈 O. O1 ）. Visual analogue scales（VAS） decreased （P 〈 0. 05 ）in two groups. Lumbar bone mineral density （BMD） improvement was observed in the test group（P 〈 0. 05 ）. There were significant differences between the two groups regarding pain relief and VAS improvement after incadornate. Conclusion Incadornate is an effective drug in the treatment of patients with various matastatic bone cancers.