吗啡转盐酸美沙酮片维持治疗难治性癌性疼痛患者的临床疗效观察

Clinical Observation on Morphine-modified Methadone Tablets in the Treatment of Refractory Cancer Pain

目的探讨吗啡转盐酸美沙酮片维持治疗难治性癌性疼痛患者的临床疗效。方法给予80例晚期癌症患者吗啡即释片镇痛,用药剂量≥120 mg/d,当NRS≤3分后药物转换为口服盐酸美沙酮片(用药疗程≥2周)。结果患者由吗啡转换为盐酸美沙酮片后疼痛强度差异有统计学意义(P<0.05),使用盐酸美沙酮片第2周末NRS≤3分的患者有72例,NRS 4~6分的患者8例,盐酸美沙酮片有效率为90%,不良反应为便秘的患者比重最高(26.25%)。患者未出现肝、肾功能以及心电图方面的不良反应。结论盐酸美沙酮片对于难治性癌性疼痛的晚期癌症患者止痛效果明显,其日使用剂量低于吗啡,不良反应发生率相似。

Objective To investigate the clinical efficacy of morphine- modified methadone tablets in the treatment of refractory cancer pain. Methods 80 cases of advanced cancer patients were given morphine release analgesic, the dose was ≥ 120 mg / d, the drug was converted to oral methadone tablets after NRS ≤ 3 points （medication ≥ 2 weeks）. Results The difference in pain intensity was statistically significant after conversion of morphine to methadone hydrochloride tablets in patients （P 〈 0.05）. The use of methadone hydrochloride tablets at the end of the second week of NRS ≤ 3 points in patients were 72 cases, NRS 4 - 6 points were 8 patients, the effective rate of methadone hydrochloride tablets was 90%. Adverse reactions were the highest proportion of patients with constipation （26.25%）. No adverse reaction was observed in liver, renal function and electrocardiogram. Conclusion Methadone hydrochloride tablets have significant analgesic effect on advanced cancer patients with refractory cancer pain. The daily dose is lower than that of morphine and the incidence of adverse reactions is similar.