合作药物治疗管理模式应用于癌痛规范化治疗的随机对照研究

Randomized controlled study of cooperative drug therapy management mode for standardized treatment of cancer pain

目的评价药学服务中合作药物治疗管理(CDTM)模式在癌痛规范化治疗中的应用效果。方法选取我院肿瘤科收治的80例癌痛患者为研究对象,随机分为2组,每组40例。对照组根据三阶梯药物止痛法进行止痛治疗,干预组在对照组的治疗基础上联合临床药师CDTM模式干预。比较两组疼痛评分变化、疼痛总有效率、等效吗啡消耗量、肿瘤患者生活质量评分量表(QOL)评分以及不良反应发生率。结果治疗后,两组疼痛NRS评分均较治疗前减少(P<0.05),干预组NRS评分低于对照组(P<0.05);干预组疼痛总有效率高于对照组(P<0.05);两组首日等效吗啡消耗量比较差异无统计学意义(P>0.05),但干预组全程等效吗啡消耗总量少于对照组(P<0.05);治疗后两组QOL评分均显著高于治疗前(P<0.05),且干预组高于对照组(P<0.05);治疗后干预组中恶心、呕吐、便秘、乏力不良反应发生率均低于对照组(P<0.05),头晕、皮疹不良反应发生率两组差异无统计学意义(P>0.05)。结论CDTM模式应用于癌痛规范化治疗中可提高癌痛治疗疗效,提高患者生活质量,降低药物的不良反应。CDTM模式在临床药师为癌痛规范化治疗提供药学服务过程中可以发挥积极的作用。

Objective To evaluate the effect of the cooperative drug therapy management(CDTM)mode in the standardized treatment of cancer pain.Methods Totally 80 patients with cancer pain in Oncology Department of our hospital were randomly divided into two groups,40 patients in each group.Control group received analgesic treatment according to three-step analgesia method,and intervention group also received clinical pharmacist CDTM mode intervention on the basis of the treatment for control group.The changes in pain scores,total effective rate of pain relief,equivalent morphine consumption,QOL scores,and incidence of adverse events were compared between the two groups.Results After treatment,the NRS score in the two groups was lower than that before treatment(P<0.05),and that in intervention group was lower than that in control group(P<0.05).The total effective rate of painrelief in intervention group was higher than that in control group(P<0.05).There was no significant difference in the equivalent morphine consumption on the first day between the two groups(P>0.05),but the total equivalent morphine consumption in intervention group was less than that in control group(P<0.05).After treatment,QOL scores of the two groups were significantly higher than those before treatment(P<0.05),and the score of intervention group was higher than that of control group(P<0.05).The incidence rates of nausea,vomiting,constipation and fatigue in intervention group were lower than those in control group(P<0.05),and there was no significant difference between the two groups in incidence rate of dizziness and rash(P>0.05).Conclusion The application of CDTM model in the standardized treatment of cancer pain can improve the therapeutic effect on cancer pain and quality of life of patients,and reduce the adverse reactions.CDTM mode plays an active role in the process of pharmaceutical care for standardized treatment of cancer pain by clinical pharmacists.