硫酸吗啡缓释片联合锝[^(99)Tc]亚甲基二膦酸盐治疗骨转移癌痛疗效观察

Clinical observation on the therapeutic efficacy of morphine sulfate sustained-release tablets combined with technetium [^(99)Tc]methylene bisphosphonates in the treatment of bone metastases pain

目的观察硫酸吗啡缓释片联合锝[99Tc]亚甲基二膦酸盐治疗骨转移癌痛的临床效果。方法将100例骨转移癌痛患者随机分为对照组和观察组,每组50例,对照组患者采用硫酸吗啡缓释片治疗,观察组患者采用硫酸吗啡缓释片联合锝[^(99)Tc]亚甲基二膦酸盐治疗。两组患者均以15 d为1个观察周期,比较两组患者疼痛治疗效果、生活质量改善情况及不良反应发生率;比较两组患者1个观察周期内止痛起效时间、止痛持续时间、硫酸吗啡缓释片日均用量。结果观察组患者疼痛治疗效果优于对照组,差异有统计学意义(P<0.01),疼痛治疗总有效率高于对照组(P<0.05),止痛起效时间短于对照组、止痛持续时间长于对照组(P<0.05);观察组患者生活质量改善率(68.0%)显著高于对照组(38.0%),差异有统计学意义(P<0.01);观察组患者硫酸吗啡缓释片日均用量显著小于对照组(P<0.05)。结论硫酸吗啡缓释片联合锝[^(99)Tc]亚甲基二膦酸盐治疗骨转移癌痛,能够明显提高患者的疼痛治疗效果和生活质量,显著减小硫酸吗啡缓释片的日均用量。

Objective To explore the clinical effect of morphine sulfate sustained-release tablets combined with technetium [ ^99Tc ] methylene bisphosphonates in the treatment of bone metastases pain. Methods A total of 100 patients with bone metastases pain were randomly divided into control group and observation group, with 50 cases each group. The control group was treated with MS-contin, while the observation group received MS-contin combined with 99Tc-MDP. Fifteen days was an observation cycle, the pain relief, quality of life and the incidence of adverse reactions were compared between two groups; and the analgesic onset time, analgesic duration and daily dosage of morphine sulfate sustained release tablets were compared between two groups during observation cycle. Results The pain relief in the observation group was significantly superior to that in the control group （P〈0.01）, the total effective rate of pain in the observation group was significantly higher than that of the control group （ P 〈 0.05 ）, the observation group achieved a significantly shorter analgesic onset time and significantly longer analgesic duration compared with the control group （ P 〈 0.05 ） ; the improvement rate of quality of life in the observation group （ 68.0% ） was significantly higher than that in the control group （38.0% , P 〈 0.01 ）, the daily dose of morphine sulfate sustained-release tablets in the observation group was significantly less than that in the control group （P 〈 0.05 ）. Conclusions Morphine sulfate sustained- release tablets combined with technetium [ 99Tc] methylene diphosphonate in the treatment of patients with bone metastases pain can significantly improve the curative effects and quality of life, and reduce the average daily dose of morphine sulfate sustained-release tablets.