奥施康定联合度洛西丁治疗晚期癌痛疗效分析

The Curative Effect Analysis of Oxycontin Combined with Cymbalta on the Treatment of Terminal Cancer with Pain

目的：探讨奥施康定联合度洛西丁治疗晚期癌痛的疗效。方法：选取晚期癌症合并疼痛的患者60例,治疗前使用数字评价量表（NRS）评分,按随机数字表法分为治疗组30例给予奥施康定＋度洛西丁治疗,对照组30例仅给予奥施康定治疗。通过规范化、个体化止痛治疗,研究治疗后疼痛药物使用情况、控制爆发痛情况及药物不良反应。结果：两组均取得良好的止痛效果,但治疗组奥施康定使用剂量平均为（55.6±1.2）mg,对照组为（80.2±0.7）mg,两组比较差异有统计学意义（P〈0.05）;治疗组2～5 d,2～7 d及2～14 d的爆发痛次数与对照组比较差异均有统计学意义（P〈0.05）;两组均未出现药物相关性肝肾功能异常;两组药物不良反应主要为便秘、恶心呕吐,两组药物不良反应发生率比较差异无统计学意义（P〉0.05）;两组均给予止吐、缓泻等对症治疗后症状可明显好转,不影响持续用药。结论：奥施康定＋度洛西丁治疗晚期癌痛疗效显著,且不增加药物不良反应。

Objective： To discuss the curative effect of oxycontin combined with duloxetine for pain of advanced cancer. Method： 60 cases of advanced cancer with pain were chosen, and given a mark with the digital evaluation scale（NRS） before treatment. They were divided into the treatment group for 30 patients（oxycontin ＋ duloxetine） and the control group for 30 patients（oxycontin） according to random number table method. Normalized and individualized analgesia treatment were carried out, and the usage of pain medication, the situation of breakthrough pain control and the adverse drug reactions after treatment were studied. Result： Both of the two groups had achieved good analgesic effect, but the average usage of oxycontin of the treatment group was（55.6±1.2）mg and that of the control group was（80.2±0.7）mg. There was a statistical difference between the two groups（P〈0.05）. The average amounts of breakthrough pain of the treatment group in 2-5 days, 1 week and 2 weeks were compared with the control group, the differences were statistically significant（P〈0.05）. Neither of the two groups had shown drug related liver and kidney dysfunction. Adverse drug reactions of the two groups were mainly constipation, nausea and vomiting. There was no difference of the incidence rate of adverse drug reactions between the two groups（P〉0.05）. Symptoms of the two groups could be obviously better after symptomatic treatment such as stopping vomiting and postponing diarrhea, which would not affect sustained medication. Conclusion： Oxycontin ＋ duloxetine have significant effect in treatment for pain of advanced cancer and will not increase adverse drug reactions.