羟考酮缓释片20mg起始剂量在重度癌痛滴定治疗中的疗效观察

Clinical Effect of Titration Therapy with Initial Dose of 20 mg Oxycodone Release Tablets for Severe Cancer Pain

目的探讨起始剂量20 mg盐酸羟考酮缓释片在重度癌性疼痛滴定治疗中的效果和安全性。方法选择我院2013年1月至2014年12月收治的重度癌痛患者98例（NRS评分7-10分）分为两组各49例,观察组进行起始剂量20 mg羟考酮缓释片与吗啡片联合滴定治疗,对照组进行起始剂量10 mg羟考酮缓释片与吗啡片联合滴定治疗,比较两组给药1 h、24 h的疼痛缓解率、滴定周期数及不良反应发生情况。结果观察组给药1 h的疼痛缓解率为73.5%,显著高于对照组的53.1%（P〈0.05）;两组给药24 h的疼痛缓解率无统计学差异（P〉0.05）。观察组患者平均（1.4±0.9）周期完成滴定治疗,对照组患者平均（3.2±1.5）周期完成滴定治疗,两组比较具有统计学差异（t=7.203,P〈0.05）;两组滴定过程中出现的不良反应发生率差异无统计学意义（P〉0.05）。结论在重度癌痛患者中运用起始剂量20 mg羟考酮缓释片与吗啡片联合滴定缩短了滴定周期,可在短时间内有效缓解患者的疼痛症状,且不良反应可以耐受。

Objective To study the clinical effect and safety of initial dose of 20 mg oxycodone release tablets for titration therapy for severe cancer pain. Methods A total of 98 cases of patients with severe cancer pain（NR S score 7 - 1 0） in our hospital from January 201 3 to D ecember 201 4 were randomly divided into two groups equally. The observation group received titration therapy with oxycodone release tablets（initial dose of 20 mg） and morphine tablets, while the control group received titration therapy with oxycodone release tablets（initial dose of 1 0 mg） and morphine tablets. The pain relief rates at 1 hour and 24 hours of administration, titration cycles and adverse reactions of two groups were compared. Results The pain relief rate at 1 hour of administration of observation group was 73.5%, significantly higher than 53.1 % of control group（P〈0.05）; No statistical difference was found between two groups in the pain relief rate at 24 hours of administration（P〉0.05）. The average titration cycle of observation group was（1.4 ± 0.9） cycles, significantly fewer than（3.2 ± 1.5） cycles of control group（t = 7.203, P〈0.05）. The incidences of adverse reactions during therapy of two groups had no statistically significant difference（P〉0.05）.Conclusions Initial dose of 20 mg oxycodone release tablets for titration therapy for patients with severe cancer pain can shorten the titration cycle, and effectively relieve patient＇s pain within a short period; also, the adverse reactions can be tolerated.