【摘要】 目的观察盐酸美沙酮片用于难治性癌痛的镇痛效果及其安全性。方法对重度癌痛患者给予吗啡即释片或羟考酮滴定,滴定期间每日使用吗啡剂量≥120 mg或羟考酮剂量≥60 mg且疼痛强度评分仍然NRS>3分,属于难治性癌痛,给予转换为盐酸美沙酮片止痛,用药满2周者为合格病例。结果筛选出39例难治性癌痛患者接受盐酸美沙酮片止痛治疗时间为2~9周。接受盐酸美沙酮片2周治疗后,疼痛强度明显下降(P<0.05),疼痛治疗有效率为84.61%。39例患者使用盐酸美沙酮片第2周末平均剂量(51.67±52.81)mg,其中34例患者(87.18%)仅需分2次给药即可。不良事件有头晕、疲乏、嗜睡、恶心、呕吐、便秘等,便秘发生率在25.64%,其余不良反应发生率均在3%以下。未发生与美沙酮相关的严重不良事件,实验室检查未发现对肝、肾功能和心电图有影响的病例。结论盐酸美沙酮片对吗啡耐受或羟考酮耐受的难治性癌痛仍有较好的止痛效果,用量明显低于吗啡或羟考酮,在镇痛剂量稳定后,每日2次用药即可,不良反应的临床表现及发生率与吗啡等其他阿片类药物相似。更多还原

【Abstract】 Objective To evaluate the efficacy and safety of Methadone Hydrochloride Tablets as therapy for patients with refractory cancer pain. Methods Advanced cancer with cancer pain were consecutively enrolled in this study. Patients were applied oral morphia or oxycodone titration, when their pain intensity still NRS>3, then replace Methadone Hydrochloride Tablets to treatment. Use a medicine for full 2 weeks, is a qualified case. Results39 patients with refractory cancer pain who accept Methadone Hydrochloride Tablets treatment, the treatment time is 2-9 weeks. After treatment of Methadone Hydrochloride Tablets two weeks, their pain intensity has decreased(P<0.05), pain treatment efficient is 84.61%. An average dose of Methadone Hydrochloride Tablets is(51.67±52.81)mg by the second weekend, 87.18% of patients within 2 times to take medicine in the 39 patients by the second weekend. The incidence of adverse events under 3% of dizziness, drowsiness, fatigue, nausea, vomiting, constipation rate is 25.64%.There are no case of serious adverse events correlative with Methadone Hydrochloride Tablets, laboratory examination found no effect on liver and kidney function and no electrocardiogram(ecg) change. Conclusions Methadone Hydrochloride Tablets has definite analgesic effect for refractory cancer pain, dosage is significantly lower than that of morphine or oxycodone. As the stable analgesic dose, 2 times daily medication only. The clinical manifestations of the adverse reactions and the incidence is similar to morphine and other opioids.更多还原