中重度癌痛患者应用盐酸羟考酮缓释片联合硫酸吗啡片滴定治疗的临床效果及对睡眠质量的影响

Clinical Effect of Oxycodone Hydrochloride Sustained-release Tablets Combined with Morphine Sulfate Tablets Titration in Patients with Moderate to Severe Cancer Pain and Its Effect on Sleep Quality

目的 探讨联用盐酸羟考酮缓释片、硫酸吗啡片滴定在中重度癌痛患者中的效果。方法 便利选取2021年1月—2023年12月黔西南布依族苗族自治州人民医院收治的82例中重度癌痛患者为研究对象,根据不同镇痛方案将其分为对照组和观察组,各41例。对照组口服硫酸吗啡片滴定,观察组加用盐酸羟考酮缓释片。对比两组患者临床疗效、疼痛评分、血清疼痛介质、生活质量、睡眠质量及安全性。结果 观察组总有效率高于对照组,差异有统计学意义(P<0.05)。治疗后,观察组疼痛数字评分、匹兹堡睡眠质量指数评分分别为(1.65±0.23)分、(5.53±1.04)分,低于对照组的(2.27±0.35)分、(7.09±1.12)分,差异有统计学意义(t=9.479、6.536,P均<0.05)。治疗后,观察组前列素E2、P物质、5-羟色胺水平低于对照组,且生活质量评分高于对照组,差异有统计学意义(P均<0.05)。两组患者不良反应总发生率对比,差异无统计学意义(P>0.05)。结论联用盐酸羟考酮及硫酸吗啡片滴定治疗中重度癌痛可有效抑制疼痛,减轻睡眠障碍,且安全性良好。

Objective To explore the significance of titration of oxycodone hydrochloride prolonged-release tablets and morphine sulfate tablets in moderate to severe patients with cancer pain.Methods A total of 82 patients with moderate to severe cancer pain admitted to the People's Hospital of Qianxinan Buyi and Miao Autonomous Prefecture from January 2021 to December 2023 were conveniently selected as the research objects,and they were divided into control group and observation group according to different analgesia schemes,with 41 cases in each group.The control group was treated with oral morphine sulfate tablets titration,and the observation group was treated with oxycodone hydrochloride sustained-release tablets.The clinical effects,pain scores,serum pain mediators,quality of life,sleep quality and safety were compared between patients in two groups.Results The total effective rate of the observation group was higher than that of the control group,and the difference was statistically significant(P<0.05).After treatment,the pain digital score and Pittsburgh Sleep Quality Index score in the observation group were(1.65±0.23)points and(5.53±1.04)points,respectively,which were lower than(2.27±0.35)points and(7.09±1.12)points in the control group,and the differences were statistically significant(t=9.479,6.536,both P<0.05).After treatment,the levels of prostaglandin E2,substance P and 5-hydroxytryptamine in the observation group were lower than those in the control group,and the quality of life score was higher than that in the control group,the differences were statistically significant(all P<0.05).There was no significant difference in the total incidence of adverse reactions between patients in two groups(P>0.05).Conclusion The combination of oxycodone hydrochloride and morphine sulfate tablets titration in the treatment of moderate to severe cancer pain can effectively inhibit pain,reduce sleep disorders,and has good safety.