盐酸吗啡缓释片联合塞来昔布治疗晚期肺癌伴中重度癌痛的临床分析

doi:10.3760/cma.j.issn.1673422X.2017.03.002

国际肿瘤学杂志 ›› 2017, Vol. 44 ›› Issue (3): 165-168.doi: 10.3760/cma.j.issn.1673422X.2017.03.002

盐酸吗啡缓释片联合塞来昔布治疗晚期肺癌伴中重度癌痛的临床分析

李雪芹,陈曦,龚泉,石围,张利娟,董蕙,王存德

650118 昆明医科大学第三附属医院（云南省肿瘤医院）姑息医学科云南省肿瘤姑息医学研究中心

出版日期:2017-03-08 发布日期:2017-02-28
通讯作者: 王存德 E-mail:wcd69@foxmail.com
基金资助:
云南省卫生科技计划（2014NS025、2014NS027）

Clinical analysis of morphine hydrochloride sustainedrelease tablets combined with celecoxib in the treatment of advanced lung cancer with moderate to severe cancerinduced pain

Li Xueqin, Chen Xi, Gong Quan, Shi Wei, Zhang Lijuan, Dong Hui, Wang Cunde

Department of Palliative Medicine, Yunnan Tumor Hospital, Third Affiliated Hospital of Kunming Medical University, Cancer Palliative Medicine Research Center of Yunnan Province, Kunming 650118, China

Online:2017-03-08 Published:2017-02-28
Contact: Wang Cunde E-mail:wcd69@foxmail.com
Supported by:
Health Science and Technology Project of Yunnan Province of China (2014NS025, 2014NS027)

摘要/Abstract

摘要： 目的探讨盐酸吗啡缓释片联合塞来昔布治疗晚期肺癌伴中重度癌痛的疗效、安全性及患者生命质量改善情况。方法研究观察247例中晚期肺癌伴中重度癌痛患者，采用单纯随机抽样数字表法，随机分为联合治疗组（127例）和吗啡单药治疗组（120例），分析两组患者在吗啡剂量、疗效、药物不良反应、生命质量方面的差异。结果在达到相近的镇痛效果时，联合治疗组吗啡平均维持剂量（52.51±19.92）mg/d低于单药治疗组（58.75±20.64）mg/d（t=-2.414，P=0.017）。联合治疗组便秘发生率较单药治疗组减少（34.6%∶47.5%，χ2=4.218，P=0.040）。两组患者的生命质量均有所改善，且联合治疗组生命质量改善率较单药治疗组提高（59.8%∶43.3%，χ2=6.736，P=0.009）。结论盐酸吗啡缓释片联合塞来昔布能有效治疗中重度癌痛，可减少吗啡用量，减轻不良反应，从而改善晚期肺癌患者的生命质量。

关键词: 肺肿瘤, 生活质量, 吗啡, 塞来昔布, 癌性疼痛

Abstract: ObjectiveTo explore the efficacy, safety and life quality of patients of morphine hydrochloride sustainedrelease tablets combined with celecoxib in the treatment of advanced lung cancer with moderate to severe cancerinduced pain. MethodsA total of 247 patients of advanced lung cancer with moderate to severe cancerinduced pain were randomly divided into combination therapy group (n=127) and morphine monotherapy group (n=120) using simple random sampling digital table method. The differences of dose, efficacy, adverse drug reactions and life quality between the two groups were analyzed. ResultsIn achieving similar analgesic effect, the average maintenance dose of morphine in combination therapy group was (52.51±19.92)mg/d, lower than that in monotherapy group ［(58.75±20.64)mg/d, t=-2.414, P=0.017］. The incidence of constipation in combination therapy group was 34.6%, lower than that in monotherapy treatment group (47.5%, χ2=4.218, P=0.040). The life quality of the two groups were improved, and the life quality improvement rate in combination therapy group was 59.8%, higher than that in monotherapy treatment group (43.3%, χ2=6.736, P=0.009). ConclusionMorphine hydrochloride sustainedrelease tablets combined with celecoxib is effective in the treatment of moderate to severe cancer pain, which can reduce the dosage of morphine and reduce adverse reaction, so as to improve the life quality of the patients with advanced lung cancer.

Key words: Lung neoplasms, Quality of life, Morphine, Celecoxib, Cancer pain

李雪芹,陈曦,龚泉,石围,张利娟,董蕙,王存德. 盐酸吗啡缓释片联合塞来昔布治疗晚期肺癌伴中重度癌痛的临床分析[J]. 国际肿瘤学杂志, 2017, 44(3): 165-168.

Li Xueqin, Chen Xi, Gong Quan, Shi Wei, Zhang Lijuan, Dong Hui, Wang Cunde. Clinical analysis of morphine hydrochloride sustainedrelease tablets combined with celecoxib in the treatment of advanced lung cancer with moderate to severe cancerinduced pain[J]. Journal of International Oncology, 2017, 44(3): 165-168.

参考文献

［1］ Yu HS, Qu Y, Shang QJ, et al. The clinical effects of lowdose splenic irradiation combined with chest threedimensional conformal radiotherapy on patients with locally advanced nonsmallcell lung cancer: a randomized clinical trial［J］. Onco Targets Ther, 2016, 9(9): 55455552. DOI: 10.2147/OTT.S95992. ［2］ Masel EK, Schur S, Nemecek R, et al. Palliative care units in lung cancer in the realworld setting: a single institution′s experience and its implications［J］. Ann Palliat Med, 2016, 2017， 6（1）： 613. DOI: 10.21037/apm.2016.08.06. ［3］ Gartner R, Kroman N, Callesen T, et al. Multimodal prevention of pain, nausea and vomiting after breast cancer surgery［J］. Minerva Anestesiol, 2010, 76(10): 805813. ［4］ Trabulsi EJ, Patel J, Viscusi ER, et al. Preemptive multimodal pain regimenreduces opioid analgesia for patients undergoing roboticassistedlaparoscopic radical prostatectomy［J］. Urology, 2010, 76(5): 11221124. DOI: 10.1016/j.urology.2010.03.052. ［5］ Freedman BM, Balakrishnan TP, O′hara EL. Celecoxib reduces narcotic use and pain following augmentation mammaplasty［J］. Aesthet Surg J, 2006, 26(1): 2428. DOI: 10.1016/j.asj.2005.11.001. ［6］蔡讯, 薛鹏, 宋卫峰, 等. 硫酸吗啡控释片联合塞来昔布个体化治疗中重度癌痛的临床疗效及安全性［J］. 中国癌症杂志, 2009, 19(4): 270273. DOI: 10.3969/j.issn.10073639.2009.04.007. ［7］ Hida T, Kozaki K, Ito H, et al. Significant growth inhibition of human lung cancer cells both in vitro and in vivo by the combined use of a selective cyclooxygenase 2 inhibitor, JTE522, and conventional anticancer agents［J］. Clin Cancer Res, 2002, 8(7): 24432447. ［8］ Vaish V, Rana C, Piplani H, et al. Sulindac and celecoxib regulate cell cycle progression by p53/p21 up regulation to induce apoptosis during initial stages of experimental colorectal cancer［J］. Cell Biochem Biophys, 2014, 68(2): 301319. DOI: 10.1007/s1201301397118. ［9］ Yang Y, Yan J, Huang Y, et al. The cancer pain related factors affected by celecoxib together with cetuximab in head and neck squamouscell carcinoma［J］. Biomed Pharmacother, 2015, 70: 181189. DOI: 10.1016/j.biopha.2015.01.018.

[1]	刘娜, 寇介丽, 杨枫, 刘桃桃, 李丹萍, 韩君蕊, 杨立洲. 血清miR-106b-5p、miR-760联合低剂量螺旋CT诊断早期肺癌的临床价值[J]. 国际肿瘤学杂志, 2024, 51(6): 321-325.
[2]	王丽, 刘志华, 杨伟洪, 蒋凤莲, 李全泳, 宋浩杰, 鞠文东. ROS1突变肺腺鳞癌合并脑梗死为主要表现的Trousseau综合征1例[J]. 国际肿瘤学杂志, 2024, 51(6): 382-384.
[3]	贺嘉慧, 胡钦勇. 基于GBD数据的中国和美国肺癌发病和死亡趋势及危险因素对比分析[J]. 国际肿瘤学杂志, 2024, 51(1): 29-36.
[4]	李雄安, 颜艳艳. 丙戊酸镁用于治疗继发癫痫的晚期肺癌脑转移患者1例报道[J]. 国际肿瘤学杂志, 2023, 50(3): 191-192.
[5]	杨俊, 李荣, 曾建昌. 复方苦参注射液联合SOX方案治疗老年晚期胃癌的临床疗效[J]. 国际肿瘤学杂志, 2023, 50(2): 82-86.
[6]	左小平, 刘晓川, 吴西强, 李周, 夏天, 刘国凤. 老年早期肺癌患者经胸腔镜肺切除术后心律失常发生的危险因素及预测模型构建[J]. 国际肿瘤学杂志, 2023, 50(12): 711-716.
[7]	陈郁, 许华, 刘海, 陈士新. 基于CT影像学特征的恶性肺纯磨玻璃结节患者病理分型预测模型构建[J]. 国际肿瘤学杂志, 2023, 50(11): 655-660.
[8]	张万芳, 王尤, 苏晶, 陈刚, 周福祥. 肺原发尤文肉瘤/原始神经外胚层瘤1例[J]. 国际肿瘤学杂志, 2023, 50(1): 62-64.
[9]	杨莎, 杨晓华, 王苏华, 薛晓燕, 徐俊. 老年肺癌胸腔镜手术后下肢深静脉血栓的危险因素分析及预测模型的建立和验证[J]. 国际肿瘤学杂志, 2022, 49(9): 532-536.
[10]	王津, 张耀圣, 孙婷婷, 王丹, 胡乃东. 以前胸壁聚集性多发蕈状肿物为表现的肺腺鳞状细胞癌皮肤转移1例[J]. 国际肿瘤学杂志, 2022, 49(9): 575-576.
[11]	陈煌婧, 朱鹏飞, 张晴, 陈桂芳, 杨春林, 何英. 超声造影和CT引导下经皮穿刺活检在周围型肺肿块诊断中临床价值的比较[J]. 国际肿瘤学杂志, 2022, 49(8): 459-463.
[12]	蔡刚祥, 李境, 许斌. 肺癌新辅助免疫治疗研究进展[J]. 国际肿瘤学杂志, 2022, 49(6): 366-370.
[13]	韩丛丛, 付帅, 谢超, 张建军, 张秋景, 祝情情, 刘杰. 吉非替尼、培美曲塞和贝伐珠单抗一线治疗EGFR突变晚期肺腺癌的有效性和安全性[J]. 国际肿瘤学杂志, 2022, 49(6): 376-379.
[14]	王永洪, 何弢, 李星, 罗启余, 王乔羽. 信迪利单抗致晚期鳞状细胞肺癌患者致死性中毒性表皮坏死松解症1例[J]. 国际肿瘤学杂志, 2022, 49(6): 380-382.
[15]	张静娴, 易丹, 李小江. 抗体偶联药物在非小细胞肺癌中的应用[J]. 国际肿瘤学杂志, 2022, 49(5): 296-301.

盐酸吗啡缓释片联合塞来昔布治疗晚期肺癌伴中重度癌痛的临床分析

Clinical analysis of morphine hydrochloride sustainedrelease tablets combined with celecoxib in the treatment of advanced lung cancer with moderate to severe cancerinduced pain

PDF

可视化

被引次数

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 15

编辑推荐

Metrics

本文评价