摘要目的 探讨羟考酮对重度癌痛患者疼痛抑制的最佳剂量,以减轻癌痛患者痛苦.方法 将本院135例伴有重度癌痛的晚期癌症患者按随机数字表法分为三组,每组45例,A、B、C三组分别给予盐酸羟考酮缓释片20～ 140 mg/d,150～290 mg/d,300～ 640 mg/d止痛,2周后评价疼痛控制情况及不良反应发生率.结果 A、B、C三组用药后疼痛程度评分(NRS)比较差异有统计学意义(P＜0.05);B、C组疼痛缓解率与A组比较差异有统计学意义(P＜0.05);C组食欲、精神、睡眠、日常活动及人际交往5个生活质量评分与A组、B组比较差异有统计学意义(P＜0.05).C组不良反应发生率略高于A组、B组,但三组比较差异无统计学意义(P＞0.05).结论 大剂量、超大剂量盐酸羟考酮缓释片均可有效抑制重度癌痛患者疼痛,超大剂量给药可改善患者生活质量,虽然不良反应发生率较高,但患者可耐受.

abstractsObjective To investigate the optimal dose of oxycodone for severe pain in cancer patients so as to try to alleviate the suffering rapidly.Methods Totally 135 cases with severe pain in terminal cancer patients were randomly divided into groups A,B,and C,45 cases in each group.Groups A,B,and C were treated with oxycodone hydrochloride sustained-release tablets 20 ～ 140 mg/d,150 ～ 290 mg/d,300 ～ 640 mg/d,respectively.Pain relief and incidence of adverse reactions were evaluated 2 weeks later.Results Pain intensity scores (numerical rating scale,NRS) in 3 groups dropped with statistical difference (P ＜ 0.05).Pain relief rates in groups B and C were statistically significant compared to group A (P ＜ 0.05).Quality of life score (appetite,mental status,sleep,daily activities,and interpersonal life) in group C had statistical significance compared to groups A and B (P ＜ 0.05).Group C had slightly higher incidence of adverse reactions than that of groups A and B without significant difference (P ＞ 0.05).Conclusions Large dose and extra large dose of oxycodone hydrochloride sustained-release tablets can effectively relieve severe pain in advanced cancer patients.Extra large dosage can improve patient's quality of life in spite of the higher incidence of adverse reactions,and patients can still be tolerated well.