摘要
目的探讨在老年中度癌痛患者中,羟考酮与曲马多作为初始止痛治疗方案的疗效。方法 96例老年中度癌痛患者,按治疗方式不同分为观察组(n=49)和对照组(n=47)。观察组患者初始治疗直接采用盐酸羟考酮缓释片10 mg q12 h口服;对照组先采用盐酸曲马多缓释片100 mg q12 h口服,根据疼痛控制情况逐渐加量改用盐酸羟考酮缓释片20 mg q12 h继续止痛治疗,两组患者观察时间为14天。分别采用数字评分法(NRS)、卡氏功能状态(KPS)评分、汉密尔顿抑郁量表(HAMD)、生活质量评分量表对患者的疼痛情况、功能状态、抑郁情况、生活质量进行评估。结果治疗前两组患者NRS、HAMD及KPS评分比较,差异均无统计学意义(P﹥0.05);治疗后两组患者NRS、HAMD评分均下降,与治疗前比较,差异均有统计学意义(P﹤0.05),且观察组患者NRS、HAMD评分均明显低于对照组,差异均有统计学意义(P﹤0.01);治疗后两组患者KPS评分均提高,与治疗前比较,差异均有统计学意义(P﹤0.05),且观察组患者KPS评分明显高于对照组,差异有统计学意义(P﹤0.01)。观察组患者疼痛缓解总有效率为95.9%(47/49),明显高于对照组患者的72.3%(34/47),差异有统计学意义(P﹤0.01)。治疗后观察组患者生活质量优于对照组,差异有统计学意义(P﹤0.05)。治疗过程中,观察组患者便秘发生率明显高于对照组,差异有统计学意义(P﹤0.01);而两组患者其他不良反应发生率比较,差异均无统计学意义(P﹥0.05)。结论以羟考酮作为老年中度癌痛患者的初治用药,与曲马多比较,能明显减轻患者的痛苦,改善患者体力,有效消除患者负面情绪,降低患者的心理困扰程度,改善患者的生活质量,提高癌痛治疗效果,对老年肿瘤患者的中度癌痛初始治疗选择策略具有重要意义。
Objective To investigate the efficacy of oxycodone and tramadol as initial therapy for elderly patients with moderate cancer pain. Method The clinical profiles of 96 elderly patients with moderate cancer pain were divided into observation group (n=49) and control group (n=47) by respective therapy. The observation group was treated initially with oral oxycodone hydrochloride sustained release tablets 10 mg q12 h. The control group was first treated with tramadol hydrochloride sustained release tablets 100 mg q12 h, according to the situation of pain control, higer dose or switched to oxycodone hydrochloride sustained release tablets 20 mg q12 h, and patients were observed for 14 days. Numeric rating scale (NRS), Karnofsky performance status (KPS) scale, Hamilton depression scale (HAMD), and quality of life scale (QOLS) were used to evaluate the pain severity, functional status, depression status, and quality of life of cancer patients, respectively. Result The NRS, HAMD and KPS scores were similar between the two groups before treatment (P>0.05);after treatment, the scores of NRS and HAMD in both groups were decreased, and there were significant differences compared with those before treatment (P<0.05), besides, the NRS and HAMD scores in observation group were significantly lower than those in control group (P<0.01). After treatment, the KPS scores in both groups were improved, and there were significant differences compared with those before treatment (P<0.05), additionally, the observation group had significantly higher KPS score compared with control group (P<0.01). The overall pain response rate was 95.9%(47/49) in observation group, which was significantly higher than the 72.3%(34/47) in control group (P<0.01). Better QOLS score was noted in observation group compared with control group after treatment, with statistically significant difference noted (P<0.05). In the course of treatment, the incidence of constipation in observation group was significantly higher than that in control group (P<0.01), while th
作者
杨婧
裴文仲
杨建东
刘义
孔曼
高芸菲
孔斌
程瑜蓉
李雪冰
YANG Jing;PEI Wenzhong;YANG Jiandong;LIU Yi;KONG Man;GAO Yunfei;KONG Bin;CHENG Yurong;LI Xuebing(Department of Medical Oncology,Beijing Luhe Hospital,Capital Medical University,Beijing 101100,China)
出处
《癌症进展》
2019年第6期697-700,703,共5页
Oncology Progress
关键词
老年人
癌痛
初始治疗
疼痛
心理困扰
生活质量
elderly
cancer pain
initial therapy
pain
psychological distress
quality of life
