硫酸吗啡控释片直肠给药控制癌痛疗效观察

Efficacy of Rectal Administration of Controlled-release Morphine Sulfate for Treatment of Cancer Pain

目的 :观察硫酸吗啡控释片 (MST)直肠给药对中、重度癌性疼痛的镇痛疗效 ,并以口服MST做自身对照。方法 :39例伴有中、重度癌性疼痛的患者先口服MST5天 ,后改为MST直肠给药连用 5天。结果 :MST直肠给药有效率和显著有效率 (明显缓解 +完全缓解 )分别为 94.9%和 82 .1%。治疗后疼痛程度明显减轻 ,生活质量明显提高 ,直肠给药与口服给药相比疗效无显著性差异 (P >0 .0 5 )。副作用与口服给药相同 ,主要为便秘、恶心、呕吐、嗜睡 ,且由口服给药改为直肠给药无需增加剂量。结论 :MST直肠给药具有良好的镇痛效果 ,尤其适用于不能口服给药的晚期癌症患者。

Purpose: To evaluate the analgesic effect of controlled-release morphine sulfate (MST) administered rectally in patients with moderate or severe cancer pain and it was compared with oral administration of MST. Methods: Thirty-nine patients with moderate or severe cancer pain were treated with controlled-release MST for 10 days. MST was given orally for the first 5 days and then rectally for the next 5 days. Results: The effective and excellent rates of the rectally administered group were 94.9% and 82.1% respectively. After treatment, the pain alleviated significantly and life quality improved markedly. Rectal administration had no significant difference as compare with oral administration in efficacy ( P > 0.05 ) and they had the same side effects as constipation, nausea, vomiting and lethargy. No more dosage should be added when oral administration was changed by rectal administration. Conclusion: Rectal administration of MST has remarkable efficacy in cancer pain relief, especially for those late cancer patients to whom oral administration is not available.