盐酸羟考酮缓释片联合地佐辛治疗癌性疼痛患者阵发痛效果分析
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摘要
目的分析盐酸羟考酮缓释片联合地佐辛治疗癌性疼痛患者阵发痛的效果,探讨其临床应用价值。方法将本院2014年7月至2016年7月收治的150例癌性疼痛患者采用随机数表法分为观察组和对照组,每组各75例,所有患者均给予地佐辛肌内注射治疗,观察组患者联合口服盐酸羟考酮缓释片,对照组患者加用等量安慰剂。两组患者治疗均持续2周,比较两组患者疼痛强度、生活质量变化,以疼痛强度差(pain intensity difference,PID)判断患者阵发痛改善情况,并观察治疗期间不良反应发生情况。结果治疗后两组患者视觉模拟评分法(visual analogue scale,VAS)评分较治疗前均显著降低(P<0.05),治疗1、3、5、7、14天后观察组患者VAS评分均显著低于对照组(P<0.05),PID显著高于对照组(P<0.05)。治疗后两组患者各项生活质量评分和总分较治疗前均显著升高(P<0.05),观察组患者各项生活质量评分和总分升高均显著高于对照组(P<0.05)。观察组患者临床总有效率显著高于对照组(P<0.05)。两组患者不良反应均以恶心、呕吐、头晕为主,停药后均自行好转。观察组患者治疗期间不良反应发生率显著高于对照组(χ~2=5.182,P<0.05)。结论盐酸羟考酮缓释片联合地佐辛治疗癌性疼痛,可明显改善患者阵发痛症状,提高生活质量,虽然该方案的不良反应发生率较高,但多以恶心、呕吐为主,对治疗的耐受性无明显影响,临床疗效与安全性均值得肯定。
Objective To analyze the effect of Oxycodone hydrochloride controlled-release tablets combined with Dezocine in the treatment of cancer pain in patients with pain relief, to explore its clinical application value. Method 150 cases of patients with cancer pain in our hospital from July 2014 to July 2016 were randomly divided into observation group and control group, 75 cases in each group. All the patients were given intramuscular injection of Dezocine, observation group patients added Oxycodone hydrochloride controlled-release tablets orally, control group patients were treated with equal volume of placebo. Two groups of patients were treated for 2 weeks, the quality of life, changes in pain intensity, pain intensity difference(PID) patients pain to improve the situation, and the occurrence of adverse reactions during the treatment were compared between the two groups. Result After treatment, the visual analogue scale(VAS) scores of the two groups were decreased(P < 0.05), and the VAS score of observation group was lower than control group(P < 0.05), the PID score was higher than control group(P < 0.05). The quality life scores of the two groups were higher than before treatment(P < 0.05), the quality life scores of observation group increased more significantly(P < 0.05). The total effective rate of observation group was higher than that of control group(P < 0.05). The incidence of adverse reactions in observation group was higher than control group(χ~2=5.182, P < 0.05). The adverse reactions of the two groups were mainly nausea, vomiting, dizziness, but got self improvement after withdrawal. Conclusion Oxycodone hydrochloride controlled-release tablets combined with Dezocine in the treatment of cancer pain has more obvious analgesic effect, is of positive significance to the quality of life of patients and improve the symptoms of pain, although the adverse reaction rate of this scheme is higher, but the adverse reactions of patients with nausea and vomiting, no obvious effect of tolerance to the treatment, the clinical efficacy and safety are worthy of recognition.
Objective To analyze the effect of Oxycodone hydrochloride controlled-release tablets combined with Dezocine in the treatment of cancer pain in patients with pain relief, to explore its clinical application value. Method 150 cases of patients with cancer pain in our hospital from July 2014 to July 2016 were randomly divided into observation group and control group, 75 cases in each group. All the patients were given intramuscular injection of Dezocine, observation group patients added Oxycodone hydrochloride controlled-release tablets orally, control group patients were treated with equal volume of placebo. Two groups of patients were treated for 2 weeks, the quality of life, changes in pain intensity, pain intensity difference(PID) patients pain to improve the situation, and the occurrence of adverse reactions during the treatment were compared between the two groups. Result After treatment, the visual analogue scale(VAS) scores of the two groups were decreased(P < 0.05), and the VAS score of observation group was lower than control group(P < 0.05), the PID score was higher than control group(P < 0.05). The quality life scores of the two groups were higher than before treatment(P < 0.05), the quality life scores of observation group increased more significantly(P < 0.05). The total effective rate of observation group was higher than that of control group(P < 0.05). The incidence of adverse reactions in observation group was higher than control group(χ~2=5.182, P < 0.05). The adverse reactions of the two groups were mainly nausea, vomiting, dizziness, but got self improvement after withdrawal. Conclusion Oxycodone hydrochloride controlled-release tablets combined with Dezocine in the treatment of cancer pain has more obvious analgesic effect, is of positive significance to the quality of life of patients and improve the symptoms of pain, although the adverse reaction rate of this scheme is higher, but the adverse reactions of patients with nausea and vomiting, no obvious effect of tolerance to the treatment, the clinical efficacy and safety are worthy of recognition.
引文
[1]Campbell G,Nielsen S,Bruno R,et al.The Pain and Opioids IN Treatment study:characteristics of a cohort using opioids to manage chronic non-cancer pain[J].Pain,2015,156(2):231-242.
[2]诸葛晓红,严小俊.社区家庭病床晚期癌痛患者使用镇痛泵的临床观察[J].转化医学电子杂志,2015,2(11):32.
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[10]李静,庄雪梅,杨宗凡,等.奥施康定联合罗通定治疗老年晚期癌痛患者中重度疼痛的临床研究[J].现代肿瘤医学,2014,22(9):2191-2194.
[11]何世保,方国全,王义平.奥施康定治疗慢性癌痛的疗效观察[J].淮海医药,2014,32(1):7-9.
[12]Baker TA,O'Connor ML,Krok JL.Experience and knowledge of pain management in patients receiving outpatient cancer treatment:what do older adults really know about their cancer pain?[J].Pain Med,2014,15(1):52-60.
[13]Wieder R,De La Rosa N,Bryan M,et al.Prescription coverage in indigent patients affects the use of long-acting opioids in the management of cancer pain[J].Pain Med,2014,15(1):42-51.
[14]许建林,袁彬,陈晓泉,等.大剂量奥施康定治疗癌性疼痛临床安全性评估[J].现代肿瘤医学,2015,23(23):3513-3515.
[15]Riley J,Branford R,Droney J,et al.Morphine or oxycodone for cancer-related pain?A randomized,open-label,controlled trial[J].J Pain Symptom Manage,2015,49(2):161-172.
[16]侯睿,林进.阿片类药物为主联合治疗慢性骨癌痛的临床进展[J].中国临床医生杂志,2015,43(8):23-25.
[17]陈佳权,赖琳.奥施康定治疗45例儿童重度癌痛临床疗效及安全性观察[J].现代肿瘤医学,2015,23(15):2204-2205.
[18]周进,卢俊,石莉,等.癌性疼痛规范化治疗共识解读[J].中国医刊,2015,50(9):18-22.
[19]Novak SP,Bluthenthal R,Wenger L,et al.Initiation of heroin and prescription opioid pain relievers by birth cohort[J].Am J Public Health,2016,106(2):298-300.
[20]Hoegi J,Maiers A,Smith E,et al.(419)Analysis of adverse events of interest reported to the FDA before and after the introduction of abuse deterrent formulation of extended-release oxycodone(Oxy Contin)[J].J Pain,2015,16(4):80.
[2]诸葛晓红,严小俊.社区家庭病床晚期癌痛患者使用镇痛泵的临床观察[J].转化医学电子杂志,2015,2(11):32.
[3]Turner BJ,Liang Y.Drug Overdose in a retrospective cohort with non-cancer pain treated with opioids,antidepressants,and/or sedative-hypnotics:interactions with mental health disorders[J].J Gen Intern Med,2015,30(8):1081-1096.
[4]Michna E,Cheng WY,Korves C,et al.Systematic literature review and meta-analysis of the efficacy and safety of prescription opioids,including abuse-deterrent formulations,in noncancer pain management[J].Pain Med,2014,15(1):79-92.
[5]李季,李巍,夏群,等.美施康定与奥施康定直肠给药治疗癌痛的对比研究[J].淮海医药,2014,32(5):423-424.
[6]Ahmedani BK,Peterson EL,Wells KE,et al.Policies and events affecting prescription opioid use for non-cancer pain among an insured patient population[J].Pain physician,2014,17(3):205.
[7]孙燕,顾慰萍.癌症三阶梯止痛指导原则[M].北京:北京医科大学出版社,2002:15-17.
[8]Degenhardt L,Bruno R,Lintzeris N,et al.Agreement between definitions of pharmaceutical opioid use disorders and dependence in people taking opioids for chronic non-cancer pain(POINT):a cohort study[J].Lancet Psychiatry,2015,2(4):314-322.
[9]Stefani S,Saggia M,Naves A,et al.Extended-Release Oxycodone Hydrochloride(Oxycontin?)for Cancer Pain Management:a Cost Analysis from the Brazilian Public and Private Heal thcare Systems Perspectives[J].Value Health,2015,18(7):A445.
[10]李静,庄雪梅,杨宗凡,等.奥施康定联合罗通定治疗老年晚期癌痛患者中重度疼痛的临床研究[J].现代肿瘤医学,2014,22(9):2191-2194.
[11]何世保,方国全,王义平.奥施康定治疗慢性癌痛的疗效观察[J].淮海医药,2014,32(1):7-9.
[12]Baker TA,O'Connor ML,Krok JL.Experience and knowledge of pain management in patients receiving outpatient cancer treatment:what do older adults really know about their cancer pain?[J].Pain Med,2014,15(1):52-60.
[13]Wieder R,De La Rosa N,Bryan M,et al.Prescription coverage in indigent patients affects the use of long-acting opioids in the management of cancer pain[J].Pain Med,2014,15(1):42-51.
[14]许建林,袁彬,陈晓泉,等.大剂量奥施康定治疗癌性疼痛临床安全性评估[J].现代肿瘤医学,2015,23(23):3513-3515.
[15]Riley J,Branford R,Droney J,et al.Morphine or oxycodone for cancer-related pain?A randomized,open-label,controlled trial[J].J Pain Symptom Manage,2015,49(2):161-172.
[16]侯睿,林进.阿片类药物为主联合治疗慢性骨癌痛的临床进展[J].中国临床医生杂志,2015,43(8):23-25.
[17]陈佳权,赖琳.奥施康定治疗45例儿童重度癌痛临床疗效及安全性观察[J].现代肿瘤医学,2015,23(15):2204-2205.
[18]周进,卢俊,石莉,等.癌性疼痛规范化治疗共识解读[J].中国医刊,2015,50(9):18-22.
[19]Novak SP,Bluthenthal R,Wenger L,et al.Initiation of heroin and prescription opioid pain relievers by birth cohort[J].Am J Public Health,2016,106(2):298-300.
[20]Hoegi J,Maiers A,Smith E,et al.(419)Analysis of adverse events of interest reported to the FDA before and after the introduction of abuse deterrent formulation of extended-release oxycodone(Oxy Contin)[J].J Pain,2015,16(4):80.
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