目的 探討天蟾膠囊聯(lián)合鹽酸羥考酮緩釋片治療中度癌痛的臨床療效。方法 選取2015年6月-2017年12月在鄭州市第六人民醫(yī)院呼吸內(nèi)科由于各種類(lèi)型的癌癥出現(xiàn)中度疼痛的167例住院患者，入組患者按照隨機(jī)表法隨機(jī)分為對(duì)照組（83例）和治療組（84例）。對(duì)照組口服鹽酸羥考酮緩釋片，按患者疼痛程度調(diào)整每次服用量，2次/d。治療組在對(duì)照組治療的基礎(chǔ)上口服天蟾膠囊，1粒/次，3次/d?；颊咴诜幥坝肰SA評(píng)分評(píng)價(jià)其疼痛強(qiáng)度，作為基線的疼痛強(qiáng)度，給藥5 d后評(píng)價(jià)其疼痛強(qiáng)度。比較兩組患者止痛起效時(shí)間、鹽酸羥考酮日均服用量、疼痛強(qiáng)度、生活質(zhì)量改善情況和鎮(zhèn)痛效果。結(jié)果 治療組止痛起效時(shí)間明顯短于對(duì)照組，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療第2天時(shí)，治療組患者服用羥考酮的量比對(duì)照組略少，但二者不存在統(tǒng)計(jì)學(xué)差異。治療第5天時(shí)，治療組患者服用羥考酮少于對(duì)照組，二者存在統(tǒng)計(jì)學(xué)差異（P<0.05）。治療后，兩組患者VAS評(píng)分均有明顯下降（P<0.05）。治療后，治療組患者的VAS評(píng)分與對(duì)照組相比更低，差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療組、對(duì)照組KPS評(píng)分增加大于10分例數(shù)比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。對(duì)照組、治療組的疼痛緩解率分別為79.52%、94.05%，治療組疼痛緩解率與對(duì)照組相比，差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。對(duì)照組、治療組的不良事件發(fā)生率分別為21.7%、20.2%，治療組和對(duì)照組相比，不良反應(yīng)差異沒(méi)有統(tǒng)計(jì)學(xué)意義。結(jié)論 天蟾膠囊聯(lián)合鹽酸羥考酮緩釋片治療中度癌痛具有良好的臨床效果，可以改善患者生活質(zhì)量，降低疼痛強(qiáng)度，同時(shí)安全性良好。

Objective To investigate the clinical effect of Tianchan Capsules combined with Oxycodone Hydrochloride Prolonged-release Tablets in treatment of moderate cancer pain. Methods Patients (167 cases) with moderate cancer pain in Department of Respiratory Medicine of Zhengzhou Sixth People's Hospital from June 2015 to December 2017 were randomly divided into control group (83 cases) and treatment group (84 cases) according to random table method. Patients in the control group were po administered with Oxycodone Hydrochloride Prolonged-release Tablets, the dosage adjusted according to the degree of pain, twice daily. Patients in the treatment group were po administered with Tianchan Capsules on the basis of the control group, 1 grain/time, three times daily. The pain intensity was evaluated by VSA score before medication as the baseline pain intensity. The pain intensity was evaluated 5 d after administration. The onset time of pain relief, daily dosage of oxycodone hydrochloride, pain intensity, improvement of quality of life and analgesic effect were compared between the two groups. Results The onset time of pain relief in the treatment group was significantly shorter than that in the control group with statistical significance (P<0.05). On the second day of treatment, the amount of oxycodone in the treatment group was slightly less than that in the control group, but there was no statistical difference between the two groups. On the 5th day of treatment, the dosage of patients in the treatment group was less than that in the control group with statistical significance (P<0.05). After treatment, the VAS score of two groups were significantly decreased (P<0.05), and the VAS score of the treatment group were significantly lower than those of the control group (P<0.05). Patients of KPS score increased more than 10 points in the treatment group were higher than those in the control group, and the difference was statistically significant (P<0.05). The pain relief rates of the control group and the treatment group were 79.52% and 94.05%, respectively, and there was statistically significant between two groups (P<0.05). The incidences of adverse reaction in two groups were 21.7% and 20.2%, respectively, but there was no significant difference in the incidence of adverse reactions between two groups. Conclusion Tianchan Capsules combined with Oxycodone Hydrochloride Prolonged-release Tablets has good clinical effect in treatment of moderate cancer pain, can improve the quality of life of patients, reduce the intensity of pain, and has good safety.

R978

鄭州市科技計(jì)劃項(xiàng)目（141PPTGG315）