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中国人民解放军总医院
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中国人民解放军总医院老年心血管病研究所
中国科技出版传媒股份有限公司
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中华老年多器官疾病杂志编辑委员会
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E-mail: zhlndqg@mode301.cn
创刊人 王士雯
总编辑 范利
副总编辑 陈韵岱
执行主编 叶大训
编辑部主任 王雪萍
ISSN 1671-5403
CN 11-4786
创刊时间 2002年
出版周期 月刊
邮发代号 82-408
友情链接
孙红梅,陈文彰,鲍云华.吗啡缓释片和即释片在中重度癌痛患者滴定中的临床效果[J].中华老年多器官疾病杂志,2020,19(8):599~604
吗啡缓释片和即释片在中重度癌痛患者滴定中的临床效果
Clinical efficacy of morphine sustained-release tablets and ready-release tablets for titration in patients with moderate or severe cancer pain
投稿时间:2019-08-23  
DOI:10.11915/j.issn.1671-5403.2020.08.140
中文关键词:  癌症;疼痛;滴定;吗啡
英文关键词:cancer; pain; titration; morphine Corresponding author:SUN Hong-Mei, E-mail:shm7479@163.com〖FL
基金项目:
作者单位
孙红梅 首都医科大学石景山教学医院·北京市石景山医院肿瘤科,北京100043 
陈文彰 首都医科大学石景山教学医院·北京市石景山医院肿瘤科,北京100043 
鲍云华 解放军总医院第五医学中心肿瘤科,北京100071 
摘要点击次数: 38
全文下载次数: 45
中文摘要:
      目的 观察硫酸吗啡缓释片和盐酸吗啡片2种不同的滴定方法在中重度癌痛患者中的临床效果。方法 选取未使用过阿片类药物的中重度癌痛患者140例,随机分为试验组和对照组,每组各70例。试验组给予硫酸吗啡缓释片进行剂量滴定,期间疼痛评估时给予盐酸吗啡片。对照组给予盐酸吗啡片进行剂量滴定。分别观察2组的药物剂量、疼痛缓解率、不良反应以及活动能力评分改变。采用SPSS21.0统计软件进行数据分析,根据数据类型,分别采用t检验、秩和检验或χ2检验进行组间比较。结果 试验组达到疼痛有效缓解天数少于对照组(Z=1.985,P=0.047)。在滴定1~3h内,对照组的疼痛缓解率高于试验组(P<0.05),4h之后2组疼痛缓解率差异无统计学意义。滴定第1~2天,试验组重度疼痛次数少于对照组(P<0.05);第3天,2组重度疼痛次数差异无统计学意义。滴定第1天服药次数试验组少于对照组(P<0.05),第1天以后2组差异无统计学意义(P>0.05)。2组常见不良反应为恶心、呕吐、便秘、头晕、嗜睡、排尿困难,组间差异无统计学意义(P>0.05)。2组第1~3天活动能力评分差异无统计学意义(P>0.05),每组滴定后卡氏评分(KPS)均较前一天改善(P<0.05)。结论 吗啡缓释剂型作为初始滴定药物并不劣于盐酸吗啡片,可以在临床推广。
英文摘要:
      Objective To evaluate efficacy of morphine sulfate sustained-release tablets and morphine hydrochloride tablets titrated in patients with moderate or severe cancer pain. Methods A total of 140 patients with moderate or severe cancer pain, who had never taken opioid drugs before, were randomized into study group (n=70) and control group (n=70). In the study group, morphine sulfate sustained-release tablets were titrated, and morphine hydrochloride tablets were used during pain evaluation. In the control group, morphine hydrochloride tablets were initially titrated. Both groups were observed for the dose, pain relief rate, adverse effects and changes in Karnofsky Performance Status (KPS). SPSS statistics 21.0 was used for data analysis. According to different date type, t test, rank-sum test or χ2 test was used for data comparison between two groups. Results The time to effective pain relief in the study group was significantly shorter than that in the control group (Z=1.985,P=0.047). In 1-3h of titration, pain relief rate of the control group was higher than that of the study group (P<0.05). After 4 hours, pain relief rates were of no significant differences. Severe cancer pains in the first to second day of titration were less frequent in the study group than in control group (P<0.05) and were as frequent in both groups in the third day. Medication frequency was lower in the study group than in the control group (P<0.05) in the first day and was the same in both groups after the first day (P>0.05). The common adverse reactions were nausea, vomiting, constipation, dizziness, drowsiness, and dysuria in both groups without significant difference between two groups (P>0.05). Karnofsky performance status(KPS) was not significantly different between two groups from the first to third day (P>0.05) but was improved on the previous day in each group (P<0.05). Conclusion Morphine sustained-release tablets used for initial titration was no worse than morphine ready-release tablets and was worth being used for cancer pain.
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