CAJ | 학술논문

目的评价氟比洛芬酯用于骨转移癌痛患者爆发痛(BTP)治疗的效果.方法骨转移癌痛并发BTP患者97例,采用随机数字表法,将其分为2组:吗啡组(M组,n=51)和氟比洛芬酯组(F组,n=46).M组口服速释吗啡,单次挽救剂量为每日缓释剂量的10％～ 15％,重复给药,直至控制BTP;F组静脉输注氟比洛芬酯,单次剂量50 mg,给药时间30 min,最大剂量150 mg.记录治疗BTP首次起效时间及随后1个月内BTP发生频率.记录患者口服治疗背景痛药物用量及不良反应的发生情况.结果与M组比较,F组治疗BTP首次起效时间缩短及便秘发生率降低(P＜0.05),BTP发生频率差异无统计学意义(P＞0.05).与BTP治疗前比较,治疗后M组背景痛治疗药物用量显著性增加(P＜0.05),F组差异无统计学意义(P＞0.05).结论与速释吗啡相比,氟比洛芬酯用于骨转移痛患者BTP的治疗更安全有效,且对治疗背景癌痛药物的耐受性无明显影响.
목적 평개불비락분지용우골전이암통환자폭발통(BTP)치료적효과.방법 골전이암통병발BTP환자97례,채용수궤수자표법,장기분위2조:마배조(M조,n=51)화불비락분지조(F조,n=46).M조구복속석마배,단차만구제량위매일완석제량적10％～ 15％,중복급약,직지공제BTP;F조정맥수주불비락분지,단차제량50 mg,급약시간30 min,최대제량150 mg.기록치료BTP수차기효시간급수후1개월내BTP발생빈솔.기록환자구복치료배경통약물용량급불량반응적발생정황.결과 여M조비교,F조치료BTP수차기효시간축단급편비발생솔강저(P＜0.05),BTP발생빈솔차이무통계학의의(P＞0.05).여BTP치료전비교,치료후M조배경통치료약물용량현저성증가(P＜0.05),F조차이무통계학의의(P＞0.05).결론 여속석마배상비,불비락분지용우골전이통환자BTP적치료경안전유효,차대치료배경암통약물적내수성무명현영향.
Objective To evaluate the efficacy of flurbiprofen axetil for treatment of break-through pain (BTP) in patients with metastatic bone cancer pain.Methods Ninety-seven patients with metastatic bone cancer pain complicated with BTP were randomly divided into morphine group (M group,n =51) and flurbiprofen axetil group (F group,n =46).In group M,immediate release morphine sulfate was given orally,and the single dose for pain relief was about 10％ to 15％ of the daily slow-release dose,and the administration was repeated until BTP was relieved.In group F,flurbiprofen axetil 50 mg was infused intravenously over 30 min,and the maximum dose was 150 mg.The BTP frequency was recorded within one month after the first BTP relief.The drug consump-tion for treatment of primary cancer pain,and adverse reaction were recorded.Results The onset time of flurbiprofen axetil and immediate release morphine sulfate was (18± 9) and (35± 11) min,respectively (P ＜ 0.05).The onset time of BTP treatment was significantly shorter,and the incidence of constipation was lower in group F than in group M (P ＜ 0.05).There was no statistical significance in the BTP frequency between the two groups (P ＞ 0.05).As compared with that before BTP treatment,the drug consumption for treatment of primary cancer pain was significantly increased after treatment in group M (P ＜ 0.05) and no significant changes were found after treatment in group F (P ＞ 0.05).Conclusion Flurbiprofen axetil is safer and more effective in relieving BTP in patients with metastatic bone cancer pain than immediate release morphine sulfate,and it does not affect the drug tolerance for treatment of primary pain.