Objective: To evaluate effects of morphine dosage titration via oral and vein for the treatment of cancer-induced pain. Methods.- 60 patients with cancer pain were divided into two groups: dosage titration of oral morphine (n1 = 30), dosage titration of intravenous morphine (n2= 30). The degree of pain relief, global quality of life, adverse reactions, completion time and degree of deviation were recorded and studied. Results: Two methods relieved pain well. Pain remission rate of oral morphine dosage titration was 96.7% while intravenous morphine dosage titration was 93.3%. The remission rate of titration of oral morphine in physical function (PF), role function (RF), emotional function (EF) and cognitive function (CF) increased 6.8%, 13.6%, 8.5% and 5.3%. The remission rate of titration of intravenous morphine increased 8.5%, 13.0%, 11.5% and 7.7% respectively. The higher incidence of adverse effects in the oral titration was observed. Completion time and degree of deviation of oral morphine titration was 3.7 ± 2.9 d and 12%, while intravenous morphine titration was 2.9 ± 2.3 d and 19.2%. Conclusion: Contrast to the intravenous titration, oral morphine titration accurately reflects the degree of pain, has more adverse reactions and takes longer time to complete. Both methods have advantages and disadvantages. A favorable treatment method should be choosed according to the actual situation.%目的:探讨阿片类药物治疗癌性疼痛,口服吗啡滴定和静脉吗啡滴定这两种方法的完成时间,不良反应,偏移程度及生活质量的改善情况.方法:两组癌性疼痛患者(n1=n2=30)分别进行口服吗啡滴定和静脉吗啡滴定.记录疼痛缓解程度,生活质量,不良反应,完成时间及偏移程度.结果两种方法均能很好地缓解疼痛,口服和静脉滴定的缓解率[完全缓解(complete remission,CR)+部分缓解(partial remission,PR)]分别达到96.7％和93.3％.口服吗啡滴定在躯体功能(physical function,PF)、角色功能(role function,RF)、情感功能(emotional function,EF)和认知功能(cognitive function,CF)提高率分别为6.8％、13.6％、8.5％和5.3％;静脉吗啡滴定组评分提高率分别为8.5％、13.0％、11.5％和7.7％;口服滴定时不良反应的发生率高于静脉滴定组(P＜0.05).口服吗啡滴定完成时间3.7±2.9天,静脉吗啡滴定完成时间2.9±2.3天(P＜0.01),平均偏移程度分别是12％和19.2％.结论:口服滴定反应的吗啡消耗量准确,不良反应稍多,完成时间长,提高生活质量稍逊;而静脉滴定则相反.两种滴定方法各有优缺点,可根据患者实际情况选择使用.
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