高乌甲素联合奥施康定治疗中重度癌痛的临床观察

Clinical observation of Oxy Contin combined with Lappaconitine for pain on moderate and severe chronic cancer pain

目的:探讨高乌甲素联合奥施康定治疗中重度癌痛的疗效及安全性。方法:将50例患者随机分为两组,实验组(25例)接受奥施康定+高乌甲素治疗,对照组(25例)接受奥施康定治疗。实验组中高乌甲素片的用法为10mg tid,与奥施康定同日开始服用。实验组和对照组中都使用奥施康定止痛,以10mg每12h为开始计量,按照数字评分进行剂量调整,达到NRS≤3分,直到用药结束,观察用药7d后两组的镇痛疗效及不良反应。结果:实验组与对照组所有患者在用药7d内疼痛明显缓解。实验组使用高剂量奥施康定人数比例为16%,而对照组为48%,实验组高剂量人群比例低于对照组,差异有统计学意义(P<0.05)。实验组与对照组排便困难发生率分别为12%和40%,对照组的排便困难发生率高于实验组的患者,两组的差异有统计意义(P<0.05)。但两组在呕吐、呼吸困难、尿潴留、眩晕等不良反应方面差异均无统计学意义(P>0.05)。结论:高乌甲素联合奥施康定可以控制中重度癌痛;联合用药显著减少了高剂量奥施康定使用的人数,高乌甲素增加了止痛效果,减少了排便困难的发生率;奥施康定联合高乌甲素止痛治疗作为中重度癌痛的一种较好的理想选择。

Objective： To investigate the efficacy and safety of Oxy Contin combined with Lappaconitine on moderate and severe chronic cancer pain. Methods： A total of 50 patients were randomly divided into two groups. The experiment group（ 25 cases） received Oxy Contin combined with Lappaconitine,and the control group（ 25 cases） received only Oxy Contin. Lappaconitine was given 10 mg tid in experiment group at the same time as Oxy Contin was used. Initial dosage of Oxy Contin was 10 mg q12h for both groups. Dosage was adjusted according to the degree of pain relief（ NRS score≤3）. The efficacy and adverse reactions were observed 7 days after treatment. Results： Patients in both groups got pain released within 7 days. The experiment group（ 16%） had a lower proportion who need high dosage of Oxy Contin,compared with the control group（ 48%）,with statistically significant difference between the two groups（ P〈0. 05）. The occurrence of constipation was also lower in experiment group（ 12%） than the control group（ 40%）,with statistically significant difference（ P〈0. 05）. The two groups showed no statistically significant difference in the incidence of adverse effects including vomiting,dyspnea,dysuresia and dizziness. Conclusion： Combination of OxyContin and Lappaconitine has a significant reduction in proportion of high- dose populations,which enhances the analgesic effect and reduces the incidence of constipation,and serves as a better therapeutic choice for pain on moderate and severe chronic cancer pain.