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目的:进一步评价芬太尼透皮贴剂治疗中、重度疼痛的疗效、安全性及对生活质量的影响,为临床合理用药提供参考资料。方法:采用多中心随机开放方法,对433例中、重度疼痛患者使用芬太尼透皮贴剂进行观察,芬太尼的初始剂量是2.5mg或参照吗啡芬太尼折算表计算,贴膜每3日更换1次,在使用期间根据疼痛情况进行剂量调整,直到患者无痛或基本无痛。结果:可评价患者336例,其癌痛缓解率100%,41.6%的患者第1次使用后未再进行剂量调整,57.3%的患者调整过1～3次。芬太尼的中位剂量7.5mg,其中92.9%患者在2.5～10mg之内。不良反应轻,主要为恶心、便秘、头晕、呕吐、嗜睡、排尿困难等。治疗后生活质量有明显改善。结论:芬太尼透皮贴剂治疗中、重度疼痛的疗效显著,使用方便,不良反应轻,能明显改善患者的生活质量,绝大多数患者的调整次数在3次以内,大多数患者的使用剂量在每3天2.5～10mg。
Objective: To further evaluate the efficacy, safety and quality of life of fentanyl transdermal patches in the treatment of moderate and severe pain, and to provide references for clinical rational drug use. Methods: A multicentre randomized open-label method was used to observe the use of fentanyl transdermal patch in 433 patients with moderate to severe pain. The initial dose of fentanyl was 2.5mg or according to the conversion table of morphine fentanyl, Daily replacement 1, according to the pain during the dose adjustment, until the patient is painless or almost painless. Results: 336 evaluable patients had a pain relief rate of 100%. No dose adjustment was performed after the first use in 41.6% of the patients, and 57.3% of the patients were adjusted one to three times. Median dose of fentanyl 7.5mg, of which 92.9% of patients within 2.5 ~ 10mg. Adverse reactions were mild, mainly nausea, constipation, dizziness, vomiting, lethargy, dysuria and so on. After treatment, the quality of life has been significantly improved. Conclusion: The effect of transdermal fentanyl in the treatment of moderate-severe pain is significant, easy to use and mild adverse reactions. It can significantly improve the quality of life of patients. Most patients are adjusted within 3 times, and most patients use The dosage is 2.5 ~ 10mg every 3 days.