芬太尼透皮贴剂与口服硫酸吗啡缓释片治疗中重度癌痛的效果、成本及不良反应观察

Comparison of analgesia,cost and adverse reactions between fentanyl transdermal patches and oral morphine sulfate controlled-release tablets in patients with cancer pain

目的对比芬太尼透皮贴剂(多瑞吉)与硫酸吗啡缓释片(美施康定)治疗晚期癌症患者中度到重度癌痛的疗效。方法选取我院2014年1月至12月期间的258例中度至重度癌痛患者,按选择镇痛药物及用药途径不同,分芬太尼透皮贴剂治疗组(A组),吗啡缓释片对照组(B组),对比治疗前后的疼痛强度、生活质量评分、用药后不良反应发生情况。结果镇痛治疗3周后评估,2组癌痛患者的疼痛缓解程度相当;芬太尼组嗜睡、便秘、头晕、恶心呕吐等不良反应的发生率低于吗啡组,差异有统计学意义(P<0.05),2组均无危及生命的严重不良反应发生;芬太尼组治疗成本较吗啡组高。结论芬太尼透皮贴剂镇痛效果明显,不良反应发生几率较低,但治疗成本较高,宜在不方便使用口服止痛药的患者中推广使用。

Objective To compare the therapeutic effect between fentanyl transdermal patches （Durogesic） and morphine sulfate controlled-release tablets （MS Contin） in moderate to severe patients with advanced cancer pain. Methods 258 cases with cancer pain in our hospital from January to December 2014 were selected and divided into two groups treated with Durogesic and MS Contin, respectively. Pain severity, quality of life scores, and medication adverse events were analyzed. Results After three weeks of analgesia therapy, the degree of cancer pain relief was considerable in two groups. Compared with the MS Contintreated group, adverse drug reactions of sleepiness, constipation, dizziness and nausea were decreased in patients treated with Durogesie （ P〈0.05）. But the cost of treatment was more expensive in Durogesic group. Conclusion The analgesic effect of Durogesie is obvious with low adverse reactions, but expensive, which is suitable for these patients inconvenient to use oral analgesics.