盐酸羟考酮缓释片治疗中重度癌痛60例临床观察

Clinical study of oxycodone hydrochloride sustained release tablets in the treatment of 60 patients with moderate and severe cancer pain

目的:观察盐酸羟考酮缓释片治疗中重度癌痛患者的镇痛效果和安全性。方法:应用盐酸羟考酮缓释片治疗60例中重度癌痛患者,评价镇痛效果、生活质量、不良反应。对于初次使用阿片类药物的患者,滴定方法:起始剂量为10mg,给药1小时后评估镇痛效果,反复滴定,直至NRS 0-3分,维持此剂量,每12小时口服1次。出现爆发痛,予以前日盐酸羟考酮缓释片总固定量的10%-20%。阿片耐受的患者,则将前24小时的累积剂量换算成短效阿片(每4小时量),在此基础上再增加50%-100%剂量。结果:60例中重度癌痛患者口服盐酸羟考酮缓释片剂量在20-760mg/天之间,平均剂量154.3mg/天,滴定达有效剂量的平均天数为2.5天。疼痛总缓解率95.0%,其中完全缓解13例,部分缓解44例。中、重度癌痛患者生活质量总有效率分别为92.9%、93.8%。不良反应主要为便秘、恶心、呕吐、头晕。结论:盐酸羟考酮缓释片治疗中重度癌痛患者疗效稳定,不良反应少,安全性高。

Objective：To observe the analgesic effect and safety of Oxycodone hydrochloride sustained release tablets in treatment of patients with moderate and severe cancer pain.Methods：A total of 60 patients with moderate and severe cancer pain were selected.The analgesic effects,quality of life （QOL） and adverse effects were observed and evaluated.For the first time the use of opioids in patients,titration method：starting dose 10mg,1 hour after dosing to assess the analgesic effect,repeated titration,until NRS 0-3,maintain this dose,administered orally every 12 hours for 1 times.If appeared to be breakthrough pain,the dosage may increased 10%-20%.If opioid tolerance in patients,it will be 24 hours before the cumulative doses were converted into a short-acting opioid （every 4 hours）,on the basis of increasing 50%-100% dose.Results：The doses ranged between 20-760mg/d.The average dose of 154.3mg/day.Titration of the effective dose and the average number of days for 2.5 days.Among the 60 patients with moderate and severe cancer pain,the overall rate of pain relief was 95.0%,13 cases achieved complete remission,44 cases achieved partial remission.Quality of life in patients with moderate and severe cancer pain,the total effective rate were 92.9%,93.8%.The mainly adverse reactions were constipation,nausea and vomiting,dizziness.Conclusion：Oxycodone hydrochloride sustained release tablets are effective and safe for the management of cancer patients with moderate and severe pain,with less adverse reactions.