奥施康定用于慢性癌性中重度疼痛的疗效观察(1)VIP专享VIP免费

2008年第35卷第13期中国肿瘤临床·733·奥施康定用于慢性癌性中重度疼痛的疗效观察摘要目的：观察奥施康定(盐酸羟考酮控释片)治疗慢性癌性中重度疼痛的疗效及不良反应。方法：对50例慢性癌性中重度疼痛患者进行治疗，其中男26例，女24例；平均年龄(54．21±12．26)岁。无重要并发症及肝肾损害。无药物滥用史。疼痛类型：主要为骨痛，其次为胸痛、腹痛、神经疼痛、髋骶部疼痛等。奥施康定剂型为10mg，由患者主诉疼痛明显时给药，且均为首次服用奥施康定。奥施康定必须整片吞服，不得掰开、咀嚼或研磨。初始剂量10mg·12h～，服用24小时如疼痛分级下降不到1级．则第二天加量至20mg·12h～。服用24小时如疼痛分级仍下降不到l级，第三天加量至30rag·12h～，以此类推，最多至60mg·12h～。在用药过程中根据疼痛缓解程度调整剂量，所有患者均连续用药4周。结果：50例慢性癌性中重度疼痛患者使用的奥施康定最小剂量lOmg·12h，最大剂量60mg·12h～。治疗效果：完全缓解19例(38．0％)，部分缓解29例(58．0％)，轻度缓解2"N(4．0％)。其中中度疼痛患者的显效率为100．0％(7／7)，重度疼痛患者的显效率为95。3％(41／43)，全部患者总的显效率为96．0％(48／50)。不良反应有：便秘9例，恶心呕吐6例，腹胀3例，厌食2例，嗜睡2例，头晕1例。结论：奥施康定治疗慢性癌性中重度疼痛疗效确切，有效率高，不良反应轻，服用安全。关键词奥施康定慢性疼痛疗效观察不良反应CurativeEffectof0xycontinonModerateandSevereChronicCancerPainZHANGGuanghua，LIJinchengCorrespondingauthor：ZHANGGuanghua，E—mail：zghtt@sohu．comDepartmentofAneslrlesioIogy，CancerInstituteandHospitalofTianjinMedicalUniversity,Tianjin300060，Chinaobjective：ToobservetheanalgesiceffectandadverseeffectsofOxycontin(OxycodoneHydrochlorideControlled-releaseTablets)onmoderateandseverechroniccancerpain．Methods：Atotalof50patientswithmoderateandseverechroniccancerpainwereselected．Therewere26malesand24females，withanaver-ageageof54．21+12．26years，andtheyhadnomajorcomplications，liverorkidneydamageorhistoryofdrugabuse．Themostcommontypeofpainwasbonepain．Othertypesofpainincludedchestpain，abdominalpain，nervepainandhipsacralpain．ThedosageofOxycodoneHydrochlorideControlled—releaseTabletswas10mg．administeredwhenthepatientscomplainedofpain．Itwasthefirsttimefora¨ofthepatientstolakeOxycodoneHydrochlorideControlled-releaseTaNets．Thismedicinemustbeswallowedwholeandwasnottobeseparated，chewedorground．OxycodoneHydrochlorideControlled—releaseTabletswereadminis-teredatanjnitialdoseof10mgevery12hoursandthedosewasincreasedtoachievepainrelief．Ifthepainwasdecreasedlessthanonegradeafter24hours，thedosagewasincreasedto20mg·12h～thenextday．Ifthepainwasstilldecreasedlessthanonegrade，thedosageonthethirddaywasincreasedto30mg·12h～．Themaximumdosagewas60mg·12h～．Allpatientsreceivedthistherapyfor4weeks．Results：Thedos—esrangedbetween10mg·12h～and60mg·12h～．Amongthe50patientssufferingmoderateandseverechroniccancerpain，19(38．0％)achievedcompleteremission，29(58．0％)achievedpartialremission，and2(4．O％)achievedminorremission．PainreliefprovidedbyOxycodoneHydrochlorideControlled—release"labletswas100％(7／7)inpatientswithmoderatechroniccancerpain，95．3％(41／43)inpatientswithseverechroniccancerpain，and96．0％(48／50)forallpatientscombined．Theadversereactionswereconstipation(9cases)，nauseaandvomiting(6cases)，abdominaldistention(3cases)，anorexy(2cases)，lethargy(2cases)anddizziness(1case)．Conclusion：OxycodoneHydrochlorideControlled．releaseTabletsaresafeandeffec—tiveformoderateandseverechroniccancerpain．Theyworkquicklywithfewsi...