盐酸羟考酮缓释片简化滴定法滴定和治疗中重度癌痛的有效性和安全性观察

Efficacy and Safety of Oxycodone Hydrochloride Sustained-Release Tablets in Simplified Titration in Patients with Moderate and Severe Cancer Pain

目的:观察盐酸羟考酮缓释片简化滴定法滴定治疗中重度癌痛的临床疗效及安全性,为癌痛患者合理用药提供参考。方法:对我院胸部肿瘤科2017年5月20日至2019年7月20日收治的125例中重度癌性疼痛患者,采用盐酸羟考酮缓释片简化滴定法进行剂量滴定。观察用药后1h、12h、24h疼痛缓解率、前3日滴定完成率及1周后患者疼痛数字分级评分、疼痛缓解率、体力状况评分、生活质量评分及不良反应等。结果:125例中重度癌痛患者使用盐酸羟考酮缓释片后1h、12h、24h疼痛缓解率分别为61.6%、74.4%、88.8%,前1日、2日、3日滴定完成率分别为88.8%、93.6%、96.0%;治疗前、治疗1周后疼痛评分为4.15±1.71、1.39±0.84,差异有统计学意义(P<0.01),疼痛总缓解率为98.4%;治疗1周后患者体力状况、生活质量评分均较治疗前增加(P<0.01);不良反应发生率为84.0%。结论:采用盐酸羟考酮缓释片简化滴定法进行中重度癌痛的滴定和治疗能达到快速成功滴定并有效镇痛,治疗后患者的体力状况及生活质量明显改善,不良反应轻微,可作为临床上滴定和治疗中重度癌痛的优选方式。

Objective:To observe the clinical efficacy and safety of oxycodone hydrochloride sustained-release tablets in the simplified titration in patients with moderate and severe cancer pain,and provide experience for rational use of drugs in patients with cancer pain.Methods:125 patients with moderate or severe cancer pain who received treatment in the Department of Thoracic Oncology in Public Health Clinical Center of Chengdu from May 20,2017 to July 20,2019 were titrated with oxycodone hydrochloride sustained-release tablets.Pain relief rates 1,12 and 24 hours after titration,completion rates in the first three days after titration,and Numerical Rating Score(NRS)scores,pain relief rates,Karnofsky Performance Status(KPS)scores,quality of life(QOL)and adverse reactions 1 week after titration were observed.Results:The pain relief rates 1,12 and 24 hours after titration were 61.6%,74.4%and 88.8%,respectively,and the completion rates in the first three days were 88.8%,93.6%and 96.0%,respectively.NRS scores before and one week after titration were 4.15±1.71 and 1.39±0.84,respectively,and the difference was statistically significant(P<0.01).The total pain relief rate was 98.4%.KPS scores and QOL improved significantly after titration(P<0.01).The incidence of adverse reactions was 84.0%.Conclusion:Simplified titration with oxycodone hydrochloride sustained-release tablets for moderate and severe cancer pain is a rapid,successful and effective analgesic method with significantly improved KPS scores and QOL and few adverse reactions,which is a preferred treatment for moderate and severe cancer pain.