盐酸羟考酮与硫酸吗啡治疗晚期癌痛的疗效观察(1)
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[摘要] 目的：探讨盐酸羟考酮与硫酸吗啡对晚期癌痛的疗效及安全性。方法：将120例晚期癌痛患者随机分为A、B两组，A组62例采用盐酸羟考酮进行治疗，B组58例采用硫酸吗啡进行治疗，两组均进行4周以上的疗效对比观察。结果：A组总有效率为93.5%，B组总有效率为91.4%，两组差异无统计学意义(P>0.05)。两组治疗后生活质量均较治疗前明显改善(P<0.05)。两组不良反应相似，但A组便秘较B组明显减少(P<0.05)。结论：在治疗各种不同程度的癌痛时，盐酸羟考酮的镇痛效果比硫酸吗啡更有效，毒性反应更低，可作为吗啡的替代品，值得临床上进一步推广使用。
[关键词] 盐酸羟考酮；硫酸吗啡；晚期癌痛；止痛
[中图分类号] R730.5 [文献标识码] A [文章编号] 1674-4721(2012)01(a)-042-02
The effect observation of Oxycodone hydrochloride and Morphine sulfate in the treatment of cancer pain
MA Enqi, ZOU Lile, LI Zhiqiang
Department of Oncology, the Second Hospital of Zhuzhou City, Hunan Province, Zhuzhou 412005, China
[Abstract] Objective: To investigate the effect and safety of Oxycodone hydrochloride and Morphine sulfate in the treatment of cancer pain. Methods: One hundred and twenty cases of patients with cancer pain were randomly divided into group A and B, 62 cases of group A were given Oxycodone hydrochloride, 58 cases of group B were given Morphine sulfate, the effect of two groups in more than 4 weeks were observed. Results: The total effective rate of group A was 93.5%, and group B was 91.4%, the difference of two groups was not statistically significant (P>0.05). The life quality of two groups improved obviously after treatment (P<0.05). There were no serious adverse reactions in two groups, but the constipation of group A was lower than that of group B (P<0.05). Conclusion: In the treatment of various degrees of cancer pain, the analgesic effect of Oxycodone hydrochloride is more effective than Morphine sulfate, and can be used as substitute of Morphine sulfate, be worthy of further using.
[Key words] Oxycodone hydrochloride; Morphine sulfate; Cancer pain; Relieve pain
疼痛是晚期癌症患者的常见症状，也是影响患者生活质量的重要因素，WHO已将癌痛控制列为癌症综合防治的四个重点之一[1]。阿片类止痛药治疗是缓解中重度癌痛的主要手段。本科2007年1月～2009年2月进行了盐酸羟考酮与硫酸吗啡治疗中重度癌痛的随机研究，结果总结如下：
1 资料与方法
1.1 入选标准
①有病理确诊的中重度癌性疼痛患者(NRS疼痛评分≥4分)；②预期生存时间3个月以上；③患者年龄≥18岁；④无肝、肾功能衰竭；⑤无阿片类药物滥用史；⑥能合作配合好疼痛评价者；⑦排除放化疗对镇痛作用的影响。
1.2 一般资料
入选的120例均为本院治疗的晚期中重度疼痛患者，其中，男72例，女48例。年龄26～76岁，平均56岁。随机将研究对象分为A、B两组，A组62例中，肺癌24例，肝癌8例，乳腺癌8例，胃癌7例，食道癌6例，大肠癌5例，鼻咽癌4例；B组58例中，肺癌20例，肝癌10例 ......
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