硫酸吗啡控释片口服与直肠给药控制癌痛疗效观察

The observation of curative effect in Cancer Pain controlled with the Morphine Sulphate modified release tablets by oral and rectal.

目的 :采用交叉设计研究的方法 ,观察硫酸吗啡控释片 (美施康定 )口服给药和直肠给药对中、重度癌性疼痛的止痛效果。方法 :5 0例中、重度癌性疼痛的患者 ,随机分为A、B两组。A组先口服给药后直肠给药 ,B组先直肠给药后口服给药 ,各用 5天 ,重度疼痛者剂量为 6 0mg·d-1,中度疼痛者剂量为 2 0mg/d 1。结果 :口服给药总的有效率为 88% ,直肠给药总的有效率为 90 % ,止痛效果明确 ,但两者之间的差异性不显著 (P >0 0 5 )。口服给药与直肠给药的副反应相同 ,主要为恶心呕吐、腹胀便秘、嗜睡、排尿困难等 ,未见其他严重的副作用如呼吸抑制、成瘾性等。口服给药副作用总的发生率为 6 8% ,直肠给药副作用总的发生率为 4 4 % ,两者之间的差异性显著 (P <0 0 2 5 )。结论 :直肠给药的止痛效果与口服给药相同 ,副作用少于口服给药 ,不易成瘾 。

Objective:To observe curative effect in moderate and severe cancer-related pain which controlled with the Morphine Sulphate modified release tablets(MS Contin)by oral or rectal.Methods:50 patients with moderate and severe cancer-related Pain were divided into groups randomly.25 patients with the MS Contin in A groups was treated by put oral before rectal,and 25 patients in B groups by put rectal before oral.Doses of MS Contin was 60 mg.d 1 in severe Pain groups,and 20 mg.d 1 in moderate Pain groups.Results:The total controlled-release(CR) of cancer-related Pain with MS Contin by oral and rectal was 88% and 90%( P >0 05).The side effect of MS Contin by oral and rectal that it was consist of the nausea,vomitus,abdominal distension,constipation,habit sleep and urinate dysuria was similar.The side effect of MS Contin was not a drug addict and severe respiratory inhibitory.The total ouurrent rate of side effect of MS Contin by oral and rectal was 68% and 44%( P <0 025).Conclusion:The CR of cancer-related pain with MS Contin by oral and rectal was similar.The side effect of MS Contin by rectal was marked lower than oral.The cancer-related pain was controlled with MS Contin by rectal it was practical that patients of oral difficulty and that of the side effect clear after MS Contin by oral.