奥施康定联合氟比洛芬酯治疗中重度肿瘤骨转移患者疼痛的临床观察

Observe on the clinical effect of oxycontin combined with flurbiprofen axetil in the treatment of pain of bone metastasis from moderate to severe tumors

目的探讨奥施康定联合氟比洛芬酯对中重度肿瘤骨转移患者疼痛的疗效,为临床提供参考。方法以2018年6月—2019年6月于浙江省肿瘤医院治疗的100例中重度肿瘤骨转移疼痛(NRS≥4)患者为研究对象,按随机数字表法分为研究组(50例)和对照组(50例)。对照组予以奥施康定,研究组予以奥施康定联合氟比洛芬酯。记录奥施康定服用剂量、爆发痛次数及药物不良反应,检测患者血清应激反应因子水平,评估镇痛疗效。结果研究组治疗后血清肾上腺素(E)、去甲肾上腺素(NE)和皮质醇(Cor)含量[(37.28±4.85)ng/mL、(41.08±5.74)mg/mL、(12.05±1.96)μg/dL]均低于对照组[(49.57±5.72)ng/mL、(66.63±6.55)mg/mL、(16.37±2.21)μg/dL,均P<0.001];研究组镇痛总体有效率(92.0%)显著高于对照组(76.0%,χ^2=4.762,P=0.029);研究组奥施康定服用剂量[(407.59±52.61)mg]显著低于对照组[(486.40±73.83)mg],爆发痛次数[(6.82±1.09)次]显著少于对照组[(12.74±2.31)次,t=-6.198、-15.776,均P<0.001];2组药物不良反应总体发生率(44.0%vs.52.0%)比较差异无统计学意义(χ^2=0.641,P=0.432)。结论奥施康定联合氟比洛芬酯可有效缓解中重度肿瘤骨转移疼痛患者应激反应,减少镇痛药物用量,提高镇痛疗效水平,且不增加药物不良反应。

Objective To observe the effect of oxycontin combined with flurbiprofen axetil in the treatment of bone me-tastasis pain from moderate to severe tumors.Methods Total 100 patients with moderate or severe tumors pain and bone metastasis(NRS≥4)were divided into study group and control group according to random number table method,50 pa-tients in each group.The patients in the control group were given oxcontin analgesia,and the patients in the study group were given oxcontin combined with flurbiprofen axetil analgesia.The dosage,times of pain outbreak and adverse drug re-actions were recorded,the level of serum stress-response factors were measured,and the analgesic effect was evaluated.Results The levels of serum E,NE and Cor in the study group[(37.28±4.85)ng/mL,(41.08±5.74)mg/mL,(12.05±1.96)μg/dL]were lower than those in the control group[(49.57±5.72)ng/mL,(66.63±6.55)mg/mL,(16.37±2.21)μg/dL)],all P<0.001.The total effective rate of pain relief in the study group(92.00%)was significantly higher than that in the control group(76.00%),χ^2=4.762,P=0.029.The dosage of oxycontin[(407.59±52.61)mg]was significantly lower than that in the control group[(486.40±73.83)mg],and the num-ber of outbreaks of pain in the study group(6.82±1.09)was significantly lower than that of the control group(12.74±2.31),t=-6.198,-15.776,all P<0.001.There was no significant difference in the overall incidence of adverse drug reactions(44.00%vs.52.00%)between the two groups,χ^2=0.641,P=0.432.Conclusion Oxycontin com-bined with flurbiprofen axetil can effectively alleviate the stress response of patients with moderate or severe bone metasta-sis pain,reduce the dosage of analgesic drugs,improve the analgesic effect level,and do not increase the adverse drug reactions.