羟考酮缓释片联合吗啡片在重度癌痛滴定治疗中的应用

The dosage titration application with combination of controlled-release oxycodone and oral immediate release morphine in severe cancerous pain

目的:对比羟考酮缓释片联合吗啡即释片与单用吗啡即释片在重度癌痛滴定中的镇痛效果、安全性及对免疫功能的影响。方法:选取2017年12月至2019年2月在我科住院的重度癌痛患者60例,按1∶1随机分为对照组(吗啡即释片滴定)与实验组(羟考酮缓释片联合吗啡即释片滴定),对比两组的疼痛缓解率、平均滴定时间、功能状态、不良反应及免疫功能。结果:滴定24小时后实验组的疼痛缓解率明显高于对照组(P<0.05),在滴定3天及1周后,两组疼痛缓解率无明显差异(P>0.05);实验组平均滴定时间明显短于对照组(P<0.05);滴定治疗3天后实验组功能状态评分明显高于对照组(P<0.05);与对照组相比,实验组对细胞免疫功能抑制较轻(P<0.05)。结论:羟考酮缓释片联合吗啡即释片在重度癌痛滴定中能更快达到疼痛缓解,且对免疫功能抑制较轻。

Objective:To evaluate the efficacy and safety as well as the immunologic function of dosage titration with controlled-release oxycodone tablets compared with immediate-release morphine tablets in cancer patients with severe pain.Methods:A total of 60 patients with severe cancer pain admitted from December 2017 to February 2019 were randomly divided into control group(given oral immediate-release morphine for dosage titration) and experiment group(given controlled-release oxycodone as background drug and added with oral immediate-release morphine for dosage titration).The titration effect and safety as well as the immunologic function were compared between the two groups.Results:The experiment group achieved a much higher rate of pain relief than that of the control group at hour 24 after titration(P<0.05),however,the rates were insignificant different at day 3 and 7 between the two groups.The titration time were 4.1±0.9 in control group and 3.6±0.7 in experiment group(P<0.05).There were no statistical differences in incidence rates of adverse reaction.The quality of life in the experiment group was higher than that of the control group.Compared with the control group,the experimental group showed less inhibition of cellular immune function.Conclusion:The dosage titration therapy with combination of controlled-release oxycodone has a faster analgesic effect and less inhibition of immune function than that of immediate-release morphine tablets.