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目的 :采用交叉设计研究的方法 ,观察硫酸吗啡控释片 (美施康定 )口服给药和直肠给药对中、重度癌性疼痛的止痛效果。方法 :5 0例中、重度癌性疼痛的患者 ,随机分为A、B两组。A组先口服给药后直肠给药 ,B组先直肠给药后口服给药 ,各用 5天 ,重度疼痛者剂量为 6 0mg·d-1,中度疼痛者剂量为 2 0mg/d 1。结果 :口服给药总的有效率为 88% ,直肠给药总的有效率为 90 % ,止痛效果明确 ,但两者之间的差异性不显著 (P >0 0 5 )。口服给药与直肠给药的副反应相同 ,主要为恶心呕吐、腹胀便秘、嗜睡、排尿困难等 ,未见其他严重的副作用如呼吸抑制、成瘾性等。口服给药副作用总的发生率为 6 8% ,直肠给药副作用总的发生率为 4 4 % ,两者之间的差异性显著 (P <0 0 2 5 )。结论 :直肠给药的止痛效果与口服给药相同 ,副作用少于口服给药 ,不易成瘾 ,适用于不能口服或口服副反应较多的患者
OBJECTIVE: To observe the analgesic effect of morphine sulphate controlled release tablets (Meishi Kangding) administered orally and rectally on moderate and severe cancerous pain by means of crossover design. Methods: Fifty patients with severe cancerous pain were randomly divided into A and B groups. Group A was given orally and rectally. Group B was given orally rectally for 5 days. The patients with severe pain were treated with 60 mg · d-1 and the patients with moderate pain were treated with 20 mg / d 1 . Results: The total effective rate of oral administration was 88% and the total effective rate of rectal administration was 90%. The analgesic effect was clear, but the difference was insignificant (P> 0.05). Oral administration and rectal administration of the same side effects, mainly nausea and vomiting, abdominal distension and constipation, lethargy, dysuria, etc., no other serious side effects such as respiratory depression, addiction and so on. The overall incidence of side effects of oral administration was 68%, the overall incidence of side effects of rectal administration was 44%, the difference was significant (P <0 025). CONCLUSION: The analgesic effect of rectal administration is the same as that of oral administration, with less side effects than oral administration and less addictive. It is suitable for patients who can not orally or orally take more side effects