北京大学肿瘤医院门诊患者2008—2017年强阿片类药物使用分析
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摘要
目的:分析北京大学肿瘤医院(以下简称我院)门诊近10年强阿片类药物用量趋势。方法:采用等效剂量分析方法,比较2008—2017年总年人均用量及不同强阿片类药物年人均用量的趋势,并进一步分析短效与长效强阿片类药物的年人均用量差异。结果:近10年我院门诊强阿片类药物的年人均用量呈递增趋势,2017年为2008年的2. 11倍,其中长效制剂增长2. 21倍,短效制剂减少31%。羟考酮缓释片年人均用量逐年大幅增加,2017年羟考酮缓释片的人均用量最大,占总年人均用量的69. 79%;吗啡缓释片与吗啡片年人均用量趋势一致,表现为先增加后减少再趋于平稳;氨酚羟考酮片与芬太尼透皮贴剂的年人均用量均为逐年递增趋势。结论:2008—2017年我院门诊强阿片药物的使用趋于规范、合理。
Objective: To analyzing the trend of strong opioid drugs consumption in the outpatient department of Beijing Cancer Hospital(hereinafter referred to as our hospital) in last ten years. Methods : Equivalent dose analysis method was used to compare the trend of the total annual per capita consumption and the annual per capita consumption of different strong opioid drugs from 2008 to 2017, and the difference of the annual per capita consumption of ordinary and sustained-release strong opioid drugs were further analyze. Results: In last ten years, the annual per capita consumption of strong opioid drugs for outpatient in our hospital showed an increasing trend. The per capita consumption in 2017 was 2. 11 times as much as that in 2008. The sustained-release preparations increased by 2.21 times, while ordinary preparations decreased by 31%. The annual per capita consumption of oxycodone sustained-release tablets increased significantly year by year. In 2017, the per capita consumption of oxycodone sustainedrelease tablets was maximized, accounting for 69.79% of the total annual per capita consumption. The trend of per capita consumption of morphine sustained-release tablets and morphine tablets was the same, which showed that the annual per capita consumption was increased first, then decreased and stabilized. The annual per capita consumption of oxycodone tablets and fentanyl transdermal patches was increased year by year. Conclusion :From 2008 to 2017, the use of strong opioid drugs for outpatients of our hospital tends to be standardized and reasonable.
Objective: To analyzing the trend of strong opioid drugs consumption in the outpatient department of Beijing Cancer Hospital(hereinafter referred to as our hospital) in last ten years. Methods : Equivalent dose analysis method was used to compare the trend of the total annual per capita consumption and the annual per capita consumption of different strong opioid drugs from 2008 to 2017, and the difference of the annual per capita consumption of ordinary and sustained-release strong opioid drugs were further analyze. Results: In last ten years, the annual per capita consumption of strong opioid drugs for outpatient in our hospital showed an increasing trend. The per capita consumption in 2017 was 2. 11 times as much as that in 2008. The sustained-release preparations increased by 2.21 times, while ordinary preparations decreased by 31%. The annual per capita consumption of oxycodone sustained-release tablets increased significantly year by year. In 2017, the per capita consumption of oxycodone sustainedrelease tablets was maximized, accounting for 69.79% of the total annual per capita consumption. The trend of per capita consumption of morphine sustained-release tablets and morphine tablets was the same, which showed that the annual per capita consumption was increased first, then decreased and stabilized. The annual per capita consumption of oxycodone tablets and fentanyl transdermal patches was increased year by year. Conclusion :From 2008 to 2017, the use of strong opioid drugs for outpatients of our hospital tends to be standardized and reasonable.
引文
[1]中华人民共和国国家卫生健康委员会.癌症疼痛诊疗规范(2018年版)[J].临床肿瘤学杂志,2018,23(10):937-943.
[2] INCB. Report of the International Narcotics Control Board for2017[R]. Vienna:United Nations Office,2017.
[3] National Comprehensive Cancer Network(NCCN). NCCN clinical practice guidelines in oncology:adult cancer pain(version 1.2018)[EB/OL].(2018-10-12)[2018-12-08]. https://www. nccn. org/.
[4] Harrington C B,Hansen J A, Moskowitz M,et al. It's not over when it's over:long-term symptoms in cancer survivors:a systematic review[J]. Int J Psychiat Med,2010,40(2):163-181.
[5] Caraceni A,Hanks G,Kaasa S,et al. Use of opioid analgesics in the treatment of cancer pain:evidence-based recommendations from EAPC[J]. Lancet Oncol,2012,13(2):e58-e68.
[6]中华人民共和国卫生部.“癌痛规范化治疗示范病房”创建活动方案:卫办医政发[2011]43号[EB/OL].(2011-03-30)[2018-12-08]. https://wenku. baidu. com/view/c1626476f46527d3240ce097. html.
[7]李璐,刘一,钱文璟.羟考酮控释片与氨酚轻考酮在中重度疼痛治疗的临床疗效及安全性的Meta分析[J].深圳中西医结合杂志,2015,25(24):9-11.
[8]国家食品药品监管局.国家食品药品监管局印发《关于含麻醉药品复方制剂管理的通知》:国食药监安[2004]71号[J].中国药事,2004,18(4):207.
[9] Caraceni A,Pigni A,Brunelli C. Is oral morphine still the first choice opioid for moderate to severe cancer pain? A systematic review within the European Palliative Care Research Collaborative guidelines project[J]. Palliat Med,2010,25(5):402-409.
[10] Olkkola K T,Kontinen V K,Saari T I,et al. Does the pharmacology of oxycodone justify its increasing use as an analgesic[J].Trends Pharmacol Sci,2013,34(4):206-214.
[11]曾春生,曾红学,黄作超.“癌痛规范化治疗示范病房”创建前后癌痛药使用分析[J].中国疼痛医学杂志,2015,21(4):312-316.
[12]孙薏,李莉,张明慧,等.超大剂量盐酸羟考酮缓释片与硫酸吗啡缓释片治疗重度癌痛的疗效及安全性比较[J].现代肿瘤医学,2017,25(22):3683-3687.
[13]胡夕春,王杰军,常建华,等.癌症疼痛诊疗上海专家共识(2017年版)[J].中国癌症杂志,2017,27(4):312-320.
[14]刘勇,宋正波,梁军,等.羟考酮缓释片和吗啡即释片在中重度癌痛滴定中疗效及安全性比较的Meta分析[J].临床肿瘤学杂志,2016,21(7):585-592.
[15]陈衍智,李萍萍,杨丽芳,等.芬太尼透皮贴剂治疗中重度癌性疼痛的疗效观察[J].肿瘤防治杂志,2005, 12(7):545-546.
[16]程志祥,王科明.芬太尼透皮贴剂治疗癌痛的药理特点及其临床应用[J].中国肿瘤临床,2013,40(24):1495-1497.
[17] Tassinari D, Sartori S, Tamburini E, et al. Adverse effects of transdermal opiates treating moderate-severe cancer pain in comparison to long-acting morphine:a meta-analysis and systematic review of the literature[J]. J Palliat Med, 2008, 11(3):492-501.
[2] INCB. Report of the International Narcotics Control Board for2017[R]. Vienna:United Nations Office,2017.
[3] National Comprehensive Cancer Network(NCCN). NCCN clinical practice guidelines in oncology:adult cancer pain(version 1.2018)[EB/OL].(2018-10-12)[2018-12-08]. https://www. nccn. org/.
[4] Harrington C B,Hansen J A, Moskowitz M,et al. It's not over when it's over:long-term symptoms in cancer survivors:a systematic review[J]. Int J Psychiat Med,2010,40(2):163-181.
[5] Caraceni A,Hanks G,Kaasa S,et al. Use of opioid analgesics in the treatment of cancer pain:evidence-based recommendations from EAPC[J]. Lancet Oncol,2012,13(2):e58-e68.
[6]中华人民共和国卫生部.“癌痛规范化治疗示范病房”创建活动方案:卫办医政发[2011]43号[EB/OL].(2011-03-30)[2018-12-08]. https://wenku. baidu. com/view/c1626476f46527d3240ce097. html.
[7]李璐,刘一,钱文璟.羟考酮控释片与氨酚轻考酮在中重度疼痛治疗的临床疗效及安全性的Meta分析[J].深圳中西医结合杂志,2015,25(24):9-11.
[8]国家食品药品监管局.国家食品药品监管局印发《关于含麻醉药品复方制剂管理的通知》:国食药监安[2004]71号[J].中国药事,2004,18(4):207.
[9] Caraceni A,Pigni A,Brunelli C. Is oral morphine still the first choice opioid for moderate to severe cancer pain? A systematic review within the European Palliative Care Research Collaborative guidelines project[J]. Palliat Med,2010,25(5):402-409.
[10] Olkkola K T,Kontinen V K,Saari T I,et al. Does the pharmacology of oxycodone justify its increasing use as an analgesic[J].Trends Pharmacol Sci,2013,34(4):206-214.
[11]曾春生,曾红学,黄作超.“癌痛规范化治疗示范病房”创建前后癌痛药使用分析[J].中国疼痛医学杂志,2015,21(4):312-316.
[12]孙薏,李莉,张明慧,等.超大剂量盐酸羟考酮缓释片与硫酸吗啡缓释片治疗重度癌痛的疗效及安全性比较[J].现代肿瘤医学,2017,25(22):3683-3687.
[13]胡夕春,王杰军,常建华,等.癌症疼痛诊疗上海专家共识(2017年版)[J].中国癌症杂志,2017,27(4):312-320.
[14]刘勇,宋正波,梁军,等.羟考酮缓释片和吗啡即释片在中重度癌痛滴定中疗效及安全性比较的Meta分析[J].临床肿瘤学杂志,2016,21(7):585-592.
[15]陈衍智,李萍萍,杨丽芳,等.芬太尼透皮贴剂治疗中重度癌性疼痛的疗效观察[J].肿瘤防治杂志,2005, 12(7):545-546.
[16]程志祥,王科明.芬太尼透皮贴剂治疗癌痛的药理特点及其临床应用[J].中国肿瘤临床,2013,40(24):1495-1497.
[17] Tassinari D, Sartori S, Tamburini E, et al. Adverse effects of transdermal opiates treating moderate-severe cancer pain in comparison to long-acting morphine:a meta-analysis and systematic review of the literature[J]. J Palliat Med, 2008, 11(3):492-501.