三种阿片类镇痛药治疗重度癌痛的成本效果分析

1、三种阿片类镇痛药治疗重度癌痛的成本效果分析DOI：【 Abstract 】 Objective To compare cost effectiveness by morphine hydrochloridesustained-release tablets， morphine sulfatesustained-releasetabletsand oxycodonehydrochloridesustained-release tablets in the treatment of cancerpain. Methods A totalof 210 patients withsevere canc

2、erpain were randomly divided into groups A， B and C，with 70 cases in each group. Group A received morphinehydrochloride sustained-release tablets， group Breceived morphinesulfatesustained-releasetablets，and group C received oxycodone hydrochloridesustained-release tablets. Their treatment lasted for

3、28 d， and observationwas made on curativeeffects andadverse reactions between three groups forpharmacoeconomics cost effectiveness analysis.Results There was no statistically significantdifference of pain relief rates as 88.6%， 90.0% and91.4% across the threegroups （ P>0.05 ）.The differenceof inc

4、idence of adverse reactions had no statisticalsignificancebetween thethreegroups（ P>0.05 ） . Costeffectiveness ratio（ C/E） in three groups wasrespectively（15.44 ±8.53 ）， （16.37 ±8.48 ） and（25.98 ±8.07 ） . Conclusion Morphine hydrochloridesustained-release tablets， morphine sulfates

5、ustained-releasetabletsand oxycodone hydrochloridesustained-releasetabletsallprovidesimilarcurativeeffects in treating cancer pain， and morphinehydrochloride sustained-release tablets is moreeconomical for treatment.【Key words 】 Cancerpain ； Morphine hydrochloridesustained-release tablets； Morphine

6、sulfatesustained-release tablets； Oxycodone hydrochloridesustained-release tablets； Cost effectiveness疼痛是癌症患者最常见的症状之一，严重影响癌症患者的生活质量 1。自 2011年卫计委（原卫生部）开展“癌痛规范化治疗示范病房”创建活动以来，80% 90%的癌痛患者通过药物治疗能得到满意镇痛2 。目前， 选择经济有效的阿片类药物是医生和患者面临的重要课题。因此，本文从药物经济学角度对临床上常见的三种口服长效阿片类药物治疗重度癌痛的效果进行分析，现报告如下。1 资料与方法1. 1一般资料选取 2

7、014 年 2 月 2016 年 2 月本院收治的经病理学确诊的重度癌痛患者210 例，其中男 103 例，女 107 例， 数字分级法 （ NRS）评分 7 10 分， 包括肺癌、乳腺癌、结直肠癌、卵巢癌、食管癌、胰腺癌、胃癌、肝癌及骨转移癌等所致疼痛。患者KPS>50分， 既往未应用过阿片类药物，预期生存时间3 个月以上，近 1 个月未行化放疗等抗肿瘤治疗，肝肾功能及血常规基本正常，无明显的呼吸抑制或呼吸道梗阻症状，否认有药物过敏史，既往未应用阿片类镇痛药物。210 例患者随机分为A、B、C 三组， 各70 例。 A 组中男 34 例，女 36 例，年龄 38 70 岁，平均年龄（ 59.2 ±3.6 ）岁；B 组中男 33 例，女 37 例，年龄36 72 岁， 平