CAJ | 학술논문

目的：系统评价芬太尼透皮贴剂或吗啡缓释片治疗国人中重度癌痛的疗效及安全性。方法计算机检索中国期刊全文数据库（CNKI）、中国医院知识总库（CHKD）、中国生物医学文献数据库（CBM）、中文科技期刊全文数据库（VIP）、万方数据知识服务平台（WANFANG）等相关随机对照试验( RCT )。各数据库检索时间均从创建至2014年7月。由2名数据员按纳入与排除标准独立筛选试验，并对纳入研究的方法学质量进行评价，提取资料；用RevMan 5.16统计软件对数据进行Meta分析。结果纳入14项RCT共1440例患者；芬太尼透皮贴剂对疼痛缓解有效率优于吗啡缓释片[ OR=1.18，95% CI（0.84，1.65），P=0.34]；芬太尼透皮贴剂对生活质量评分改善优于吗啡缓释片[ MD=-1.38，95% CI（0.76，2.00），P﹤0.05]；芬太尼透皮贴剂嗜睡、恶心呕吐、便秘、头晕及尿潴留等不良反应发生率均显著低于吗啡缓释片，仅瘙痒发生率显著高于后者，差异均有统计学意义（ P﹤0.05）。结论芬太尼透皮贴剂在国人中重度癌痛治疗中可有效缓解疼痛，改善生活质量评分，且安全性良好。
목적：계통평개분태니투피첩제혹마배완석편치료국인중중도암통적료효급안전성。방법계산궤검색중국기간전문수거고（CNKI）、중국의원지식총고（CHKD）、중국생물의학문헌수거고（CBM）、중문과기기간전문수거고（VIP）、만방수거지식복무평태（WANFANG）등상관수궤대조시험( RCT )。각수거고검색시간균종창건지2014년7월。유2명수거원안납입여배제표준독립사선시험，병대납입연구적방법학질량진행평개，제취자료；용RevMan 5.16통계연건대수거진행Meta분석。결과납입14항RCT공1440례환자；분태니투피첩제대동통완해유효솔우우마배완석편[ OR=1.18，95% CI（0.84，1.65），P=0.34]；분태니투피첩제대생활질량평분개선우우마배완석편[ MD=-1.38，95% CI（0.76，2.00），P﹤0.05]；분태니투피첩제기수、악심구토、편비、두훈급뇨저류등불량반응발생솔균현저저우마배완석편，부소양발생솔현저고우후자，차이균유통계학의의（ P﹤0.05）。결론분태니투피첩제재국인중중도암통치료중가유효완해동통，개선생활질량평분，차안전성량호。
Objective To evaluate the effectiveness and safety of fentanyl transdermal patches and morphine sustained-release tablets for Chinese tumor patients with moderate-to-severe cancer pain. Methods CNKI,CHKD,CBM,VIP and WF(from their inception to July 2014)were searched for RCTs. Two reviewers independently retrieved RCTs,assessed the methodological quality of included trials, and extracted data. The data analyses was performed by RevMan 5. 16. Results Totally 14 RCTs involving 1 440 patients were in-cluded. The results of meta-analyses showed that effective rate of analgesia of fentanyl transdermal patches was superior to morphine sustained-release tablets [ OR=1. 18,95% CI(0. 84,1. 65),P=0. 34 ] . The improvement of life quality of fentanyl transdermal patches was superior to morphine sustained-release tablet [ MD= -1. 38,95% CI(0. 76,2. 00),P ﹤ 0. 05 ] . Fentanyl transdermal patches had lower ADR rate on narcolepsy,nausea,vomiting,constipation,dizziness and uroschesis,and higher ADR rate on pruritus ( P ﹤ 0. 05 ) . Conclusion The results of meta-analyses indicate that fentanyl transdermal patches can relieve pain effectively,improve life quality and has good safety.