盐酸羟考酮缓释片对急性放射性黏膜炎所致疼痛的应用效果评价
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摘要
目的探讨应用盐酸羟考酮缓释片处理急性放射性黏膜炎所致疼痛的效果。方法选择2014年12月～2018年9月我院肿瘤内科收治106例鼻咽癌放化疗患者,随机分为对照组和实验组,每组53例;对照组常规行口腔护理、雾化治疗、非甾体类止痛药物治疗、抗炎治疗及营养支持治疗,实验组在对照组基础上应用盐酸羟考酮缓释片替代非甾体类止痛药物,比较两组患者在放疗期间及结束时止痛效果、睡眠状态、体重变化、口腔黏膜损伤恢复情况及治疗过程中药物不良反应发生情况。结果实验组镇痛总有效率为88.68%,高于对照组的15.09%,差异有统计学意义(P<0.05);实验组治疗前后体重变化低于对照组,差异有统计学意义(P<0.05)。实验组中应用羟考酮缓释片期间15.09%的患者出现便秘,5.66%的患者有轻度的恶心头晕,副反应小可耐受。结论应用小剂量盐酸羟考酮缓释片对减轻急性放射性黏膜炎所致疼痛效果显著,药物不良反应小,无成瘾性,改善患者生活质量及治疗依从性,影响预后。
Objective To investigate the effect of oxycodone hydrochloride sustained-release tablets on pain caused by acute radiation mucositis.Methods From December 2014 to September 2018, 106 patients with radiotherapy and chemotherapy for nasopharyngeal carcinoma were enrolled in our hospital. They were randomly divided into control group and experimental group, with 53 cases in each group. The control group received routine oral care and aerosol therapy. Non-steroidal analgesic drugs, anti-inflammatory treatment and nutritional support treatment. The experimental group used oxycodone hydrochloride sustained-release tablets instead of non-steroidal analgesics on the basis of the control group. The two groups were compared during the radiotherapy period and at the end of the treatment. Effects, sleep status, weight changes, recovery of oral mucosal injury, and adverse drug reactions during treatment. Results The total effective rate of analgesia in the experimental group was 88.68%, which was higher than that in the control group 15.09%, the difference was statistically significant(P<0.05). The weight change of the experimental group before and after treatment was lower than that of the control group, the difference was statistically significant( P < 0.05). In the experimental group, constipation occurred in 15.09% of patients during the administration of oxycodone sustained-release tablets, and 5.66% of patients had mild nausea and dizziness, and the side effects were small tolerable. Conclusion Low-dose oxycodone hydrochloride sustained-release tablets have significant effects on relieving pain caused by acute radiation mucositis. The adverse drug reactions are small, no addiction, improve patients' quality of life and treatment compliance, and affect prognosis.
Objective To investigate the effect of oxycodone hydrochloride sustained-release tablets on pain caused by acute radiation mucositis.Methods From December 2014 to September 2018, 106 patients with radiotherapy and chemotherapy for nasopharyngeal carcinoma were enrolled in our hospital. They were randomly divided into control group and experimental group, with 53 cases in each group. The control group received routine oral care and aerosol therapy. Non-steroidal analgesic drugs, anti-inflammatory treatment and nutritional support treatment. The experimental group used oxycodone hydrochloride sustained-release tablets instead of non-steroidal analgesics on the basis of the control group. The two groups were compared during the radiotherapy period and at the end of the treatment. Effects, sleep status, weight changes, recovery of oral mucosal injury, and adverse drug reactions during treatment. Results The total effective rate of analgesia in the experimental group was 88.68%, which was higher than that in the control group 15.09%, the difference was statistically significant(P<0.05). The weight change of the experimental group before and after treatment was lower than that of the control group, the difference was statistically significant( P < 0.05). In the experimental group, constipation occurred in 15.09% of patients during the administration of oxycodone sustained-release tablets, and 5.66% of patients had mild nausea and dizziness, and the side effects were small tolerable. Conclusion Low-dose oxycodone hydrochloride sustained-release tablets have significant effects on relieving pain caused by acute radiation mucositis. The adverse drug reactions are small, no addiction, improve patients' quality of life and treatment compliance, and affect prognosis.
引文
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[4]陈思现,李汶珊.盐酸羟考酮缓释片与硫酸吗啡缓释片治疗阿片未耐受患者中、重度癌痛的效果比较[J].广东医学,2016,3(37):206-208.
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[6]Chethana,Rao PS,Madathil LP,et al.Quantitative Analysis of Acute Phase Proteins in Post Chemo-Radiation Mucositis[J]. J Clin Diagn Res,2015,9(10):28-31.
[7]曾春生,曾红学,黄作超,等."癌痛规范化治疗示范病房"创建前后癌痛药物使用分析[J].中国癌痛医学杂志,2015,21(4):312-316.
[2]尹珍珍,易俊林,黄晓东.鼻咽癌IMRT同期EGFR单抗和同期化疗与单纯IMRT的回顾对照研究[J]中华放射肿瘤学杂志,2014,23(6):495-498.
[3]梁艳芳,邵汛帆,莫志文.鼻咽癌调强放疗不良反应的预防及处理[J].中国医药科学,2014,4(1):178-180.
[4]陈思现,李汶珊.盐酸羟考酮缓释片与硫酸吗啡缓释片治疗阿片未耐受患者中、重度癌痛的效果比较[J].广东医学,2016,3(37):206-208.
[5]胡夕春,王杰军,常建华,等.癌症疼痛诊疗上海专家共识(2017年版)[J].中国癌症杂志,2017,27(4):312-319.
[6]Chethana,Rao PS,Madathil LP,et al.Quantitative Analysis of Acute Phase Proteins in Post Chemo-Radiation Mucositis[J]. J Clin Diagn Res,2015,9(10):28-31.
[7]曾春生,曾红学,黄作超,等."癌痛规范化治疗示范病房"创建前后癌痛药物使用分析[J].中国癌痛医学杂志,2015,21(4):312-316.