双氯灭痛栓和曲马多治疗晚期肝癌疼痛的比较

COMPARISON OF DICLOFENAC SUPPOSITORY AND TRAMADOL FOR ADVANCED LIVER CANCER PAIN

目的 比较双氯灭痛栓与曲马多对晚期肝癌疼痛的镇痛效果。方法 5 2例晚期肝癌重度疼痛病人 (男性 4 3例 ,女性 9例。年龄 2 8～ 81岁 ,平均年龄 5 6 .8岁 )。随机分为双氯灭痛栓组 (双氯灭痛栓 10 0 mg,塞入肛门内 5 cm ,q12 h)和曲马多组 (曲马多 10 0 mg,肌注 ,q12 h) ,两组各用药 4天 ,再交换用药 4天。结果 双氯灭痛栓组止痛作用优于曲马多组 ,总有效率分别为 92 .31%和 76 .92 %(P<0 .0 5 )。双氯灭痛栓组平均镇痛有效持续时间为 10 .4± 4 .7h,优于曲马多组 7.2± 3.1h(P<0 .0 0 1)。两组不良反应发生率无差异。结论 双氯灭痛栓治疗晚期肝癌疼痛疗效满意 。

Objective To compare the clinical efficacy of diclofenac suppository and tramadol in the treatment of advanced liver cancer pain.Methods Fifty-two advanced liver cancer patients(M43,F9,age ranging from 28 to 81 years,mean age was 56.8 years)suffering from severe pain,were randomly divided into 2 groups:Diclofenac suppository(100 mg,rectal medication,q12 h) and tramadol(100 mg,im q12 h)groups.Twenty six patients received diclofenac suppository in first 4 day and tramadol in next 4 day,while another 26 patients received tramadol first 4 day and diclofenac suppository in the next 4 day.Results The pain-relief effective rate in diclofenac suppository group was 92.31%,higher than those(76.92%) of tramadol group(p<0.05).The pain-relief lasting-time in diclofenac suppository group was 92.31%,higher than those(76.92%) of tramadol group(p<0.05).The pain-relief lasting -time in diclofenac suppository group was 10.4±4.7 h,longer than those(7.2±3.1 h)of tramadol group(p<0.001).The adverse reactions were not much different between two groups(P>0.05).Conclusion The efficacy of diclofenac suppository in treating advanced liver cancer pain is satisfactory and superiority to tramadol.It could be the first choice in the control of severe liver cancer pain.