盐酸美沙酮片与硫酸吗啡缓释片治疗73例晚期癌症患者疗效比较.DOCVIP

临床医学论文-盐酸美沙酮片与硫酸吗啡缓释片治疗73例晚期癌症患者疗效比较 【摘要】? 目的： 比较盐酸美沙酮片与硫酸吗啡缓释片在治疗晚期重度癌痛患者的疗效和不良反应。方法： 对73例晚期癌症伴重度疼痛患者随机分为2组，其中A组（36例）采用盐酸美沙酮片治疗，B组(37例)采用硫酸吗啡缓释片治疗，观察镇痛效果和不良反应。结果： 镇痛效果A组患者总体缓解率为90.3%，B组患者总体缓解率为90.5%（P0.05）；不良反应主要包括恶心呕吐、便秘、头昏、嗜睡，不良反应的严重程度、发生率相似（P0.05）。结论： 盐酸美沙酮片与硫酸吗啡缓释片用于治疗晚期癌症重度癌痛疗效接近。对于吗啡耐受晚期重度癌痛患者，推荐使用盐酸美沙酮片。 【关键词】? 盐酸美沙酮片 硫酸吗啡缓释片 晚期癌症患者 镇痛 　　(Department of Radiochmotherapy, Zhongnan Hospital of Wuhan University，Wuhan 430071)Abstract? Objective: To compare therapeutic effect and adverse reaction of the Methadone Hydrochloride Tablets with the Morphine Sulfate Sustainedrelease Tablets in relieving pain of terminal cancer patients. Methods:? Seventy and three terminal cancer patients with severe pain were randomly divided into two groups. Group A, 36 cases being given Methadone Hydrochloride Tablets; Group B, 37 cases being given Morphine Sulfate Sustainedrelease Tablets. The effect of relieving pain and untoward reaction were observed. Results: On relieving pain, the total remission rate of patients in Group A and group B was 90.3% and 90.5%, (P0.05).The main adverse reactions were nausea, vomiting, constipation, dizziness and lethargy. The difference of severity and occurrence rate of adverse reactions between two groups also did not reach statistical significance? (P0.05). Conclusion:? The Methadone Hydrochloride Tablets and the Morphine Sulfate Sustainedrelease Tablets had the very similar therapeutic effects in relieving severe pain of terminal cancer patients .The Methadone Hydrochloride Tablets was recommended to use to those terminal cancer patients with severe pain who were morphine tolerance .??? 　　Key words?? methadone hydrochloride tablets;? morphine sulfate sustainedrelease tablets;? terminal cancer patients; pain control?? 　　盐酸美沙酮片与硫酸吗啡缓释片虽均属阿片类强镇痛药，但两者在药理作用、代谢、不良反应等方面有一定差异。我们于2005年3月～2007年12月采用随机对照研究方法，对盐酸美沙酮片与硫酸吗啡缓释片在治疗73例晚期癌症患者重度癌痛进行疗效对比，现报告如下。 　　1? 资料与方法 　　1.1? 一般资料 ??? 我院自2005年3月～2007年12月治疗晚期癌患者73例，年龄55～82岁，中位年龄62岁。采用视觉模拟评分法（visual analogu