软坚止痛膏联合芬太尼外用治疗60例中重度癌痛的临床疗效观察

Clinical observation on 60 cases of moderate and severe cancer pain treated by soft firm acetanilide plaster with transdermal fentany

[目的]观察芬太尼联合软坚止痛膏外用治疗中重度癌痛的临床疗效。[方法]选取中重度癌痛患者122例,按随机数字表法随机分为两组,对照组(62例)在常规中西医结合治疗基础上给予芬太尼透皮贴剂治疗,治疗组(60例)在对照组的基础上联合软坚止痛膏外敷治疗,两组均以7 d为1个疗程,共观察2个疗程。比较两组疼痛缓解程度、芬太尼透皮贴剂用量、爆发痛次数、解救爆发痛的吗啡用量、视觉模拟评分(VAS)以及生活质量评分(Karnofsky评分)等。[结果]治疗第1、2个疗程,两组癌痛缓解总有效率比较差异无统计学意义(P>0.05),两组VAS评分较治疗前有明显下降(P<0.05),两组比较差异无统计学意义(P>0.05),但治疗组芬太尼透皮贴剂增加量较对照组少(P<0.05),两组Karnofsky评分比较差异具有统计学意义(P<0.05)。治疗第7天,对照组癌痛爆发次数与解救爆发痛吗啡用量较治疗前有明显增加(P<0.05),治疗组没有明显变化(P>0.05),两组比较差异具有统计学意义(P<0.05),治疗第14天,两组癌痛爆发次数及即释吗啡用量较治疗前均增加(P<0.05),但治疗组癌痛爆发次数较对照组少(P<0.05)。[结论]软坚止痛膏联合芬太尼透皮贴剂治疗中重度癌痛具有协同作用,能有效减少芬太尼透皮贴剂用量,减少爆发痛次数,提高患者生存质量。

[Objective] To investigate the clinical efficacy of soft firm acetanilide plaster combining transdermal fentany on moderate and severe cancer pain. [Methods] One hundred and twenty-two cancer pain patients were randomized divided into two groups according to the random number table, sixty cases and sixty-two cases respectively. In treatment group, patients were treated by soft firm acetanilide plaster combining transdennal fentany; in control group, patients were only treated by transdermal fentany,7 days for the therapeutic peri- od, and treat for 2 periods. Record mass pain relief, dosage of transdermal fentany, number of breakthrough pain and morphine consump- tion for breakthrough pain, pain scores with visual analogue scale and Karnofsky performance status （KPS, every 7 days）. [Results] The total effective rates of the pain relief has no different （P〉0.05） and VAS scores in two groups were better than testing before treating （P〈 0.05 ）, but there was no different between two groups （P〉0.05）.But the increase in dosage of transdermal fentany, and the treatment group was lesser than the control group （P〈0.05）. In KPS, the treatment group was better than that in control group in the 7th day, 14th day （P〈 0.05 ）. In number of breakthrough pain and morphine consumption for breakthrough pain, the control group was more than testing before treating （P〈0.05）, and the treatment group was no more than testing before treating （P〉0.05）. The control group was more than the treat- ment group（the 7th day） （P〈0.05）. Two groups were more than testing before treating （P〈0.05）, but the treatment group was less than the control group （P〈0.05, the 14th day）. [Conclusion] The efficacy of soft firm acetanilide plaster can decrease the dosage of transdcrmal fentany and improve quality of life on moderate and severe cancer patients.