盐酸羟考酮缓释片不同给药途径治疗中重度癌痛的临床观察

Clinical observation of Oxycodone Hydrochloride Prolonged-release Tablets on moderate to severe cancer pain following different routes of administration

目的:比较盐酸羟考酮缓释片直肠给药与口服给药两种途径治疗癌痛的临床疗效和不良反应。方法:选择2015年1月至2016年6月在勉县医院肿瘤血液科治疗的68例癌症伴有中、重度疼痛患者,随机分为观察组34例和对照组34例,两组患者均给予盐酸羟考酮缓释片进行治疗,观察组采用直肠给药,对照组采用口服给药。观察比较两组患者用药后缓解疼痛的疗效、患者生活质量的改善以及不良反应的发生情况。结果:观察组和对照组用药后的止痛有效率分别为85.3%和88.2%,两组1 h、12 h、1周、2周的NRS评分及疼痛缓解有效率比较差异均无统计学意义(P>0.05);观察组和对照组KPS的改善率分别为91.2%和88.2%,差异亦无统计学意义(P>0.05);但观察组便秘发生率(17.6%)和恶心呕吐发生率(11.8%)明显低于对照组(41.2%和26.5%),差异均有统计学意义(P<0.05)。结论:对中重度癌痛患者使用盐酸羟考酮缓释片经直肠途径给药与口服给药相比,具有相同的镇痛效果,但便秘和恶心呕吐的不良反应发生率明显减少。

Objective： To observe the clinical efficacy and side effect of Oxycodone Hydrochloride Prolonged-release Tablets in the treatment of cancer pain by rectal administration and oral administration. Methods： 68 patients with moderate to severe cancer pain who were treated in the ward of Internal Medical Oncology and Hematology,Mianxian Hospital from January 2015 to June 2016 were randomly divided into observation group（34 cases） and control group（34 cases）.Both groups were given Oxycodone Hydrochloride Prolonged-release Tablets for treatment,the observation group using rectal administration,the control group using oral administration.Compare the efficacy of pain relief,quality of life and the incidence of adverse reactions in the two groups. Results： The effective rate of pain relief was 85.3% in the observation group and 88.2% in the control group.There were no statistically significant differences in the NRS score of two groups after medication at 1 h,12 h,1 week,2 weeks and total pain effective rate.The improvement rate of KPS in the observation group and the control group was 91.2% and 88.2%,there was no significant difference.However,in the observation group,the incidence of constipation was 17.6%,incidence of nausea and vomiting was 11.8%,they were significantly lower than 41.2% and 26.5% in the control group,the differences were statistically significant（P〈0.05）. Conclusion： The use of Oxycodone Hydrochloride Prolonged-release Tablets in the treatment of moderate to severe cancer pain by rectal route has the same analgesic effect as oral administration,but the adverse reactions of constipation and nausea and vomiting are significantly reduce.