羟考酮控释片联合甲强龙对中重度肺癌癌痛的治疗效果分析

摘要

目的：探讨羟考酮控释片联合甲强龙控制中重度肺癌癌痛的疗效及安全性，同时观察镇痛前后患者生活质量的改变情况。方法104例中重度肺癌癌痛患者按住院号随机分为治疗组（52例）及对照组（52例）。对照组采用羟考酮控释片治疗，治疗组采用羟考酮控释片与甲强龙联合治疗。羟考酮控释片的起始剂量为5 mg·（12 h）-1或10 mg·（12 h）-1，根据疼痛缓解情况及时调整羟考酮控释片剂量，直到达到满意的止痛效果；甲强龙起始剂量为40 mg·d -1，疼痛缓解3 d 后可减至10 mg·d -1维持治疗；2组均以15 d 为1疗程；对2组镇痛疗效及毒副反应进行评估，采用 KPS 评分对2组镇痛前后生活质量进行评估。结果治疗组对中重度肺癌癌痛的缓解率为90.4%，高于对照组的86.5%，但差异无统计学意义（P ﹥0.05）。癌痛治疗期间，治疗组毒副反应的发生率为21.2%，明显低于对照组的44.3%，差异有统计学意义（P ﹤0.05），主要的毒副反应有恶心呕吐、便秘、嗜睡等，患者均可耐受，不影响癌痛治疗的进行。镇痛前后，2组患者生活质量的改善率分别为71.2%和51.9%，治疗组高于对照组，差异有统计学意义（P ﹤0.05）。结论羟考酮控释片可以有效控制中重度肺癌癌痛，联合使用甲强龙既能减轻其治疗期间的毒副反应，又能改善患者的生活质量，值得临床上进一步应用及研究。%Objective To observe the effect of oxycodone controlled release tablet combined with methylpred-nisolone in the treatment of lung cancer patients with cancer pain and the quality of life changes of patients before and after analgesic. Methods The 104 lung cancer patients with cancer pain were randomly divided into the treat-ment group(52 cases)and the control group(52 cases)by hospital number. The control group was administrated with oxycodone controlled release tablet,and the treatment group was treated by oxycodone controlled release tablet combined with methylprednisolone. The pain-relieving effect and toxicities of the two groups were compared. The changes of quality of life were assessed by KPS scores before and after the treatment. Results The cancer pain re-mission rate the treatment groups was 90. 4% ,which was higher than that of the control group(86. 5% ),but there was no statistically significant difference(P ﹥ 0. 05). The main toxicities were mainly nausea and vomiting,consti-pation,lethargy during the treatment of cancer pain;the incidence of toxicities of the treatment group(21. 2% )was lower than that of the control group(44. 3% )(P ﹤ 0. 05). The improvement rate of the quality of life of the two groups were 71. 2% and 52. 9% respectively,and the improvement rate of treatment group was higher than that of the control group(P ﹤ 0. 05). Conclusion Oxycodone controlled release tablets can effectively controlled lung cancer pain,joint use of methylprednisolone can mitigate its toxicities during treatment and improve the quality of life of patients.