软坚止痛膏联合芬太尼外用治疗60例中重度癌痛的临床疗效观察

Clinical observation on 60 cases of moderate and severe cancer pain treated by soft firm acetanilide plaster with transdermal fentany

关键词:  软坚止痛膏  芬太尼透皮贴剂  癌痛  疗效

Key words:  soft firm acetanilide plaster  transdermal fentany  cancer pain  curative effect

摘要:

[目的] 观察芬太尼联合软坚止痛膏外用治疗中重度癌痛的临床疗效.[方法] 选取中重度癌痛患者122例,按随机数字表法随机分为两组,对照组(62例)在常规中西医结合治疗基础上给予芬太尼透皮贴剂治疗,治疗组(60例)在对照组的基础上联合软坚止痛膏外敷治疗,两组均以7 d为1个疗程,共观察2个疗程.比较两组疼痛缓解程度、芬太尼透皮贴剂用量、爆发痛次数、解救爆发痛的吗啡用量、视觉模拟评分(VAS)以及生活质量评分(Karnofsky 评分)等.[结果] 治疗第1、2个疗程,两组癌痛缓解总有效率比较差异无统计学意义(P>0.05),两组VAS评分较治疗前有明显下降(P<0.05),两组比较差异无统计学意义(P>0.05),但治疗组芬太尼透皮贴剂增加量较对照组少(P<0.05),两组Karnofsky评分比较差异具有统计学意义(P<0.05).治疗第7天,对照组癌痛爆发次数与解救爆发痛吗啡用量较治疗前有明显增加(P<0.05),治疗组没有明显变化(P>0.05),两组比较差异具有统计学意义(P<0.05),治疗第14天,两组癌痛爆发次数及即释吗啡用量较治疗前均增加(P<0.05),但治疗组癌痛爆发次数较对照组少(P<0.05).[结论] 软坚止痛膏联合芬太尼透皮贴剂治疗中重度癌痛具有协同作用,能有效减少芬太尼透皮贴剂用量,减少爆发痛次数,提高患者生存质量.

Abstract:

[Objective] To investigate the clinical efficacy of soft firm acetanilide plaster combining transdermal fentany on moderate and severe cancer pain. [Methods] One hundred and twenty-two cancer pain patients were randomized divided into two groups according to the random number table, sixty cases and sixty-two cases respectively. In treatment group, patients were treated by soft firm acetanilide plaster combining transdermal fentany; in control group, patients were only treated by transdermal fentany, 7 days for the therapeutic period, and treat for 2 periods. Record mass pain relief, dosage of transdermal fentany, number of breakthrough pain and morphine consumption for breakthrough pain, pain scores with visual analogue scale and Karnofsky performance status(KPS, every 7 days). [Results] The total effective rates of the pain relief has no different(P>0.05) and VAS scores in two groups were better than testing before treating(P<0.05), but there was no different between two groups(P>0.05).But the increase in dosage of transdermal fentany, and the treatment group was lesser than the control group(P<0.05). In KPS, the treatment group was better than that in control group in the 7th day, 14th day(P<0.05). In number of breakthrough pain and morphine consumption for breakthrough pain, the control group was more than testing before treating(P<0.05), and the treatment group was no more than testing before treating(P>0.05). The control group was more than the treatment group(the 7th day) (P<0.05). Two groups were more than testing before treating(P<0.05), but the treatment group was less than the control group(P<0.05, the 14th day). [Conclusion] The efficacy of soft firm acetanilide plaster can decrease the dosage of transdermal fentany and improve quality of life on moderate and severe cancer patients.