奥施康定治疗中重度癌性疼痛60例的临床观察

Clinical Observation of Oxycontin in the Treatment of 60 Cases with Moderate and Severe Cancer Pain

目的：观察奥施康定通过剂量滴定治疗中重度癌性疼痛的疗效及不良反应。方法：在60例中重度癌性疼痛患者中，用剂量滴定的方法使用奥施康定进行止痛治疗。依据疼痛程度给与口服，初始剂量lOmg／次～20mg／次，q12h，根据疼痛缓解程度调整剂量。连续用药至少2周，同时进行止痛效果、生活质量及不良反应的观察。结果：经剂量滴定后60例中重度癌性疼痛患者口服奥施康定剂量范围lOmg／次～220mg／次，q12h。患者中疼痛完全缓解17例（28．3％），部分缓解42例（70．0％），轻微缓解1例（1．7％），总的疼痛缓解率98．3％，其中中度疼痛缓解率为100％，重度疼痛缓解率为90．9％。患者生活质量明显提高，不良反应轻微。主要不良反应为便秘，其次为恶心、呕吐、腹胀、头晕、嗜睡、厌食、瘙痒、排尿困难。结论：奥施康定通过剂量滴定的方法，不良反应较少，个体化给药可以更有效地控制中重度癌性疼痛，能显著地改善癌症患者的生活质量。

Objective： To observe the analgesic efficacy as well as adverse effects of oxycontin with dose titration therapy on moderate and severe cancer pain. Methods： Sixty patients with moderate and severe cancer pain were treated with oxycontin. Oxycon- tin with dose titration therapy was administered at an initial dose of 10 -20mg every 12 hours according to the degree of pain, and was titrated upwards according to the extent of pain relief. All patients were treated for at least 2 weeks, simultaneously the analgesic effica- cy, quality of life and adverse effects were investigated. Results： Among the 60 patients with moderate and severe cancer pain, the do- ses of oxycontin ranged from 10mg/12h to 220mg/12h after dose titration. Seventeen cases（28.3% ） achieved complete remission,42 （70. 0% ） achieved partial remission and 1 （1.7%）achieved minor remission. Total pain relief was 98.3% , and it was 100% in pa- tients with moderate cancer pain while 90. 9% in patients with severe pain. The quality of life was significantly improved after the treat- ment with mild adverse effects. The main adverse effects were constipation, followed by nausea and vomiting, abdominal distention, diz- ziness,lethargy, anorexy, itching and transient dysuria. Conclusion： With dose titration therapy, individual oxycontin administration dose can be more effective in controlling moderate and severe cancer pain, and improve the quality of life of patients significantly with mild adverse effects.