盐酸羟考酮缓释片治疗中重度癌痛的疗效观察

Observation of oxycodone hydrochloride prolonged-release tablets in treatment of patients with severe cancer pain

目的观察盐酸羟考酮缓释片治疗中重度癌性疼痛的效果和安全性,为临床镇痛方案的选择提供参考。方法选取自2012年1月至2013年12月我科收治的中重度癌痛患者136例,采用盐酸羟考酮缓释片口服治疗。以每次10 mg为初始计量,每12小时服用一次,并根据数字疼痛强度量表(NRS)的评估结果调整服药剂量。治疗14天后采用NRS量表评估患者疼痛症状的缓解情况,采用生活质量评分量表评价患者生活质量的改善情况,同时观察治疗过程中不良反应的发生情况。结果患者治疗后的NRS量表评分结果为(1.50±1.09)分,显著低于治疗前(P<0.05);经过治疗后,中度疼痛患者完全缓解率为70.51%,总缓解率为100%,重度疼痛患者的完全缓解率为29.31%,总缓解率为91.38%,中度疼痛患者的完全缓解率显著高于重度疼痛患者(P<0.05),而中度疼痛患者和重度疼痛患者的总缓解率对比,差异没有统计学意义(P>0.05);患者治疗后的食欲得分为(3.40±0.68)分,睡眠得分为(3.89±0.71)分,日常生活得分为(3.42±0.58)分,精神状态得分为(3.51±0.69)分,人际交往的得分为(3.43±0.68)分,均显著高于治疗前(均P<0.05);在治疗过程中,最常见的不良反应为便秘,发生率为27.94%,其次为恶心呕吐,发生率为14.71%。结论盐酸羟考酮缓释片可有效缓解中重度癌痛患者的疼痛程度,提高患者的生活质量,且具有良好的安全性。

Objective To observe the effect of oxycodone hydrochloride prolonged-release tablets in treatment of patients with severe cancer pain,and to provide the reference for the clinical analgesic options.Methods 136 patients with severe cancer pain were selected,they were accepted the treatment of oral administration of oxycodone hydrochloride prolonged-release tablets. The initial dosage was 10 mg,taken once every 12 hours,and according to the numeric pain intensity scale（ NRS） assessment results to adjust the dose.14 days after treatment,the relieving pain was evaluated with NRS scale assessment. The score of life quality improvement in patient quality of life scale evaluation,and observe the adverse reaction during the treatment situation. Results After treatment,NRS score was（ 1. 50 ± 1. 09） %,significantly lower than that before treatment（ P〈0. 05）; after treatment,patients with moderate to severe complete pain relief rate was 70. 51%,the total response rate was 100%,severe pain in patients with complete remission rate was 29. 31%,the total remission rate was 91. 38% in patients with moderate to severe pain,the complete remission rate was significantly higher than that in patients with severe pain（ P〈0. 05）,and in patients with moderate to severe pain and severe pain remission rate comparison,the difference was not statistically significant（ P〈0. 05）; patients after appetite score was（ 3. 40 ± 0. 68） %,（ 3. 89 ± 0. 71 sleep score）,daily living score（ 3. 42 ± 0. 58）,mental status score（ 3. 51 ± 0. 69） %,interpersonal score was（ 3. 43 ± 0. 68） %,significantly higher than that before treatment（ P〈0. 05）; in the treatment process,the most common adverse reactions seen as constipation,occurrence rate of27. 94%, followed by nausea and vomiting, the incidence rate was 14. 71%. Conclusions Oxycodone Hydrochloride Prolonged-release Tablets can effectively relieve the severe pain of cancer patients,improve the quality of life of patients,and has a good safety.