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低剂量强效阿片类药物与非甾体抗炎药治疗轻度癌痛的临床疗效比较:一项随机试验

A Comparison of the Clinical Effectiveness Between Low-Dose Strong Opioids and Non-Steroidal Anti-Inflammatory Drugs in the Treatment of Mild Cancer Pain: A Randomized Trial.

作者信息

Liu Mei-Zuo, Ma Jian, Li Jun-Dong, Sun Jing, Zhou Hua, Guan Shuo, Han Ying, Zhang Xia, Bian Ji-Lai

机构信息

Department of Oncology, The Fifth People's Hospital of Dalian, Dalian, 116000, People's Republic of China.

Intensive Care Unit, The Fifth People's Hospital of Dalian, Dalian, 116000, People's Republic of China.

出版信息

J Pain Res. 2021 Nov 1;14:3411-3419. doi: 10.2147/JPR.S322893. eCollection 2021.

Abstract

OBJECTIVE

The present study aims to explore the effectiveness and safety of low-dose strong opioids compared with non-steroidal anti-inflammatory drugs (NSAIDs) in the treatment of mild cancer pain.

METHODS

From September 2016 to September 2018, 66 patients with a malignant tumor and mild cancer pain admitted to the Department of Oncology of Dalian Fifth People's Hospital were divided into the group A (treated with ibuprofen sustained-release tablets for pain relief) and the group B (treated with oxycodone hydrochloride sustained-release tablets for pain relief). After 7 days of treatment, the pain relief (Numeric Rating Scale [NRS]), physical strength, quality of life scores (Zubrod/ECOG/WHO [ZPS]), the Edmonton Symptom Assessment System [ESAS], and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core15-Palliative [EORTC QLQ-C15-PAL] scores), and the occurrence of adverse reactions between the two groups were compared. The occurrence of adverse reactions in the mid-term (after one month and three months of treatment) between the two groups were also compared.

RESULTS

Both groups had over 90% analgesic efficiency, but complete pain relief was more likely to be obtained in the group B (41.18%). The total analgesic efficiency in the group B was higher (100%) than in the group A (98.9%), and the difference was statistically significant (P < 0.05). The differences in the physical strength and quality of life scores in the two groups before and after treatment were statistically significant (P < 0.05). The differences in the ZPS scores between the two groups were statistically significant (P < 0.05). The differences in ESAS and EORTC QLQ-C15-PAL scores between groups were not statistically significant (P > 0.05).

CONCLUSION

The application of low-dose oxycodone hydrochloride sustained-release tablets as the initial medication for patients with mild cancer pain was safe and effective, and the adverse reactions were easy to manage.

摘要

目的

本研究旨在探讨低剂量强阿片类药物与非甾体抗炎药(NSAIDs)相比治疗轻度癌痛的有效性和安全性。

方法

选取2016年9月至2018年9月在大连市第五人民医院肿瘤科住院的66例恶性肿瘤伴轻度癌痛患者,分为A组(采用布洛芬缓释片止痛)和B组(采用盐酸羟考酮缓释片止痛)。治疗7天后,比较两组的疼痛缓解情况(数字评分法[NRS])、体力、生活质量评分(Zubrod/ECOG/WHO[ZPS])、埃德蒙顿症状评估系统[ESAS]、欧洲癌症研究与治疗组织生活质量问卷核心15项姑息治疗版[EORTC QLQ-C15-PAL]评分以及不良反应的发生情况。同时比较两组治疗中期(治疗1个月和3个月后)不良反应的发生情况。

结果

两组镇痛有效率均超过90%,但B组更易获得完全疼痛缓解(41.18%)。B组总镇痛有效率(100%)高于A组(98.9%),差异有统计学意义(P<0.05)。两组治疗前后体力和生活质量评分差异有统计学意义(P<0.05)。两组ZPS评分差异有统计学意义(P<0.05)。两组ESAS和EORTC QLQ-C15-PAL评分差异无统计学意义(P>0.05)。

结论

低剂量盐酸羟考酮缓释片作为轻度癌痛患者的初始用药安全有效,不良反应易于处理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8fbb/8570376/ddd57a173bb9/JPR-14-3411-g0001.jpg

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