盐酸羟考酮缓释片与硫酸吗啡缓释片治疗阿片未耐受患者中、重度癌痛的效果比较

Comparison of Oxycodone Hydrochloride Sustained-release Tablets and Morphine Sulfate Sustained-release Tablets in the Treatment of Moderate and Severe Cancer Pain in Patients with Opioid Intolerance

目的比较盐酸羟考酮缓释片与硫酸吗啡缓释片治疗阿片未耐受患者中、重度癌痛的效果。方法选取2017年2月-2021年2月都昌县人民医院收治的68例恶性肿瘤伴中、重度癌痛的阿片未耐受患者,经随机数字表法分为A、B组,各34例,分别应用盐酸羟考酮缓释片与硫酸吗啡缓释片治疗,比较两组止痛效果、实验室指标(血浆P物质、β-内啡肽、5-羟色胺)、止痛起效时间、不良反应、生存质量[肿瘤生存质量调查表(QLQ-C30)评分]。结果A组与B组止痛有效率、不良反应总发生率比较,差异无统计学意义(P>0.05);A组止痛起效时间为(1.32±0.54)d,短于B组的(1.71±0.89)d,差异有统计学意义(P<0.05);两组治疗后血浆P物质含量低于治疗前,β-内啡肽、5-羟色胺水平高于治疗前(P<0.05),但组间比较,差异无统计学意义(P>0.05);两组治疗后QLQ-C30评分低于治疗前(P<0.05),但组间比较,差异无统计学意义(P>0.05)。结论盐酸羟考酮缓释片与硫酸吗啡缓释片在恶性肿瘤伴中、重度癌痛的阿片未耐受患者中具有良好的止痛作用,二者疗效相当,且不良反应相似,均可有效改善患者生存质量,但前者起效较快。

Objective To compare the effect of oxycodone hydrochloride sustained-release tablets and morphine sulfate sustained-release tablets in the treatment of moderate and severe cancer pain in patients with opioid intolerance.Methods A total of 68 patients with malignant tumor accompanied by moderate to severe cancer pain and opioid intolerance admitted to Duchang County People's Hospital from February 2017 to February 2021 were selected and divided into group A and group B according to random number table method,with 34 cases in each group.Oxycodone hydrochloride sustained-release tablets and morphine sulfate sustained-release tablets were used for treatment.The analgesic effect,laboratory indexes(plasma substance P,β-endorphin,5-hydroxytryptamine),analgesic onset time,adverse reactions and quality of life[quality of life questionnaire for cancer(QLQ-C30)score]were compared between the two groups.Results There was no significant difference in the effective rate of analgesia and the total incidence of adverse reactions between group A and group B(P>0.05).The analgesic onset time of group A was(1.32±0.54)d,which was shorter than(1.71±0.89)d of group B,and the difference was statistically significant(P<0.05).After treatment,the plasma substance P content in the two groups was lower than that before treatment,and the levels ofβ-endorphin and 5-hydroxytryptamine were higher than those before treatment(P<0.05),but there was no significant difference between the two groups(P>0.05).The QLQ-C30 score of the two groups after treatment was lower than that before treatment(P<0.05),but there was no significant difference between the two groups(P>0.05).Conclusion Oxycodone hydrochloride sustained-release tablets and morphine sulfate sustained-release tablets have good analgesic effect in malignant tumor patients with moderate to severe cancer pain and opioid intolerance.The efficacy and adverse reactions are similar,and both can effectively improve the quality of life of patients,but the former one works more faster.