2025 年第 1 期 第 20 卷

盐酸羟考酮缓释片治疗原发性肺癌患者放化疗期间神经病理性疼痛的临床观察

Clinical observation of oxycodone hydrochloride sustained-release tablets on neuropathic pain in patients with primary lung cancer during radiotherapy and chemotherapy

作者：白云波1 范志刚1 刘瑾2

英文作者：Bai Yunbo1 Fan Zhigang1 Liu Jin2

单位：1三二〇一医院肿瘤内科,汉中723000；2西安国际医学中心医院肿瘤内科，西安710038

英文单位：1Department of Oncology 3201 Hospital Hanzhong 723000 China; 2Department of Oncology Xi′an International Medical Center Hospital Xi′an 710038 China

关键词：原发性肺癌；  放化疗；  神经病理性疼痛；  盐酸羟考酮缓释片；  盐酸吗啡片

英文关键词：Primarylungcancer;  Radiotherapyandchemotherapy;  Neuropathicpain;  Oxycodonehydrochloridesustained-releasetablets;  Morphinehydrochloridetablets

• 摘要：

• 目的  探讨盐酸羟考酮缓释片治疗原发性肺癌患者放化疗期间神经病理性疼痛的临床效果。方法  选取2019年6月至2022年6月三二〇一医院收治的原发性肺癌放化疗期间神经病理性疼痛患者108例，按照随机数字表法分为对照组（54例）、12 h滴定组（26例）及24 h滴定组（28例）。对照组给予盐酸吗啡片口服治疗，12 h滴定组及24 h滴定组采用盐酸羟考酮缓释片口服治疗。比较3组患者的一般资料、治疗后不同时点疼痛缓解率及暴发痛次数、治疗前后睡眠质量及生存质量和不良反应发生率。结果  3组患者性别、年龄、TNM分期及疼痛数字评分法评分比较，差异均无统计学意义（均P>0.05）。12 h滴定组、24 h滴定组治疗1 d后疼痛缓解率均高于对照组，差异均有统计学意义（均P <0.05）。3组治疗1、2、3 d后暴发痛次数比较，差异均有统计学意义（均P<0.05），3组治疗2、3、7 d后暴发痛次数均少于治疗1 d后（均P<0.05），治疗1、2、3 d后，12 h滴定组和24 h滴定组暴发痛次数均少于对照组，12 h滴定组少于24 h滴定组（均P<0.05）。3组治疗前匹兹堡睡眠质量指数（PSQI）、晚期癌症患者生活质量量表（EORTC QLQ-C15-PAL）评分比较，差异均无统计学意义（均P>0.05），治疗7 d后PSQI、EORTC QLQ-C15-PAL评分比较，差异均有统计学意义（均P<0.05）。3组间不良反应发生率比较，差异无统计学意义（P>0.05）。结论  原发性肺癌患者放化疗期间神经病理性疼痛应用盐酸羟考酮缓释片尤以间隔12 h作滴定剂量调整治疗可获得良好的疼痛缓解率，使暴发痛次数有所减少，且不提高不良反应发生率，具有较高安全性。

• Objective  To investigate the clinical effect of oxycodone hydrochloride sustained-release tablets on neuropathic pain in patients with primary lung cancer during radiotherapy and chemotherapy. Methods   From June 2019 to June 2022, 108 patients with neuropathic pain who were treated in 3201 Hospital were collected for prospective study, and they were divided into control group (54 cases), 12 h titration group (26 cases) and 24 h titration group (28 cases) according to random number table method. The control group was given oral morphine hydrochloride tablets, 12 h titration group and 24 h titration group were given oral oxycodone hydrochloride sustained-release tablets. General data, pain relief rate and number of breakthrough pain at different time points after treatment, quality of sleep and quality of life before and after treatment, and incidence of adverse reactions were compared among the three groups. Results   There were all no statistically significant differences in gender, age, TNM stage and numerical rating scale score among the three groups (all P>0.05). The pain relief rates in the 12 h titration group and the 24 h titration group 1 d after treatment were both higher than that in the control group (both P<0.05). There were statistically significant differences in the numbers of breakthrough pain 1, 2 and 3 d after treatment among the three groups (all P<0.05), the numbers of breakthrough pain 2, 3 and 7 d after treatment were all less than that 1 d after treatment (all P<0.05). The numbers of breakthrough pain in 12 h titration group and 24 h titration group were both less than those in control group 1, 2 and 3 d after treatment, and that in the 12 h titration group was less than that in the 24 h titration group (all P<0.05). There were no statistically significant differences in comparison of Pittsburgh sleep quality index (PSQI) and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 15 Palliative (EORTC QLQ-C15-PAL) scores among the three groups before treatment (both P>0.05), but there were statistically significant differences in comparison of PSQI and EORTC QLQ-C15-PAL scores 7 d after treatment (both P<0.05). There were no significant differences in the incidences of adverse reactions among the three groups (P>0.05). Conclusion   Oxycodone hydrochloride sustained-release tablets for neuropathic pain during radiotherapy and chemotherapy in patients with primary lung cancer, especially 12 h as titration dose adjustment treatment, can achieve good pain relief rate, reduce the number of breakthrough pain, and do not increase the incidence of adverse reactions, with high safety.