盐酸羟考酮控释片联合氟比洛芬酯对中重度肿瘤骨转移疼痛患者的疗效观察

Clinical Efficacy of Oxycodone Hydrochloride Controlled-release Tablets Combined with Flurbiprofen Axetil for Moderate and Severe Cancer Pain Caused by Bone Metastasis

目的研究盐酸羟考酮控释片(奥施康定)联合氟比洛芬酯治疗中重度肿瘤骨转移疼痛的疗效及其对患者心理和生活的影响。方法对128例患有中重度疼痛的恶性肿瘤骨转移患者的疼痛强度采用数字分级法(NRS)进行评估,经盐酸羟考酮控释片联合氟比洛芬酯注射液治疗,观察患者疼痛控制的有效率、显效率以及不良反应,并使用汉密尔顿抑郁量表(HDRS)、汉密尔顿焦虑量表(HAMA)和世界卫生组织生存质量测定量表(WHOQOL-100)评价患者治疗前后的心理状况和生活质量的变化。结果128例患者中疼痛完全缓解26例,明显缓解53例,疼痛控制的有效率为90.6%,显效率为61.7%;不良反应主要为便秘、恶心呕吐、腹胀、头晕、厌食,均可耐受。通过HDRS、HAMA和WHOQOL-100量表评估,治疗后疼痛患者在心理及生活质量方面均较治疗前有改善,并且重度疼痛组患者获得的改善更加明显。结论盐酸羟考酮控释片联合氟比洛芬酯治疗肿瘤骨转移中重度疼痛有较好的临床效果,患者的疼痛缓解率较高,联合用药的安全性也较好,且能明显缓解患者的抑郁和焦虑情绪,提高患者的生活质量,值得在临床广泛应用。

Objective To investigate the clinical efficacy of oxycodone hydrochloride controlled-release tablets combined with flurbiprofen axetil for patients with moderate and severe cancer pain caused by bone metastasis,and the effects of the treatment program on the psychology and quality of life（QOL）of the patients.Methods The pain intensity of 128 cancer patients with moderate and severe pain due to bone metastasis was evaluated by number rating scale（NRS）.The effective rate,obvious effective rate and adverse reactions were observed after patients were treated with oxycodone hydrochloride controlled-release tablets combined with flurbiprofen axetil injection.Hamilton Depression Rating Scale（HDRS）,Hamilton Anxiety Rating Scale（HAMA）and world health organization quality of life assessment instrument（WHOQOL-100）were adopted to evaluate the mental condition and QOL.Results After treatment,26 patients achieved complete remission and 53 patients had obvious remission in the 128 patients,with the effective rate being 90.6% and the obvious effective rate being 61.7%.The main side effects were constipation,nausea and vomiting,abdominal distension,dizzy and anorexia,and they could be tolerated well by the patients.HDRS,HAMA and WHOQOL-100 showed that the mental condition and QOL were greatly improved after treatment,especially in the severe cancer pain group（P〈0.05）.Conclusion Oxycodone hydrochloride controlled-release tablets combined with flurbiprofen axetil injection are effective in the treatment of patients with moderate and severe cancer pain caused by bone metastasis,with high pain remission rate and good safety achieved.Meanwhile,the mental disorders,like depression and anxiety,and QOL of the patients are greatly improved.