盐酸羟考酮缓释片与硫酸吗啡缓释片的临床疗效安全性对比

doi:10.5246/jcps.2016.05.044

中国药学(英文版) ›› 2016, Vol. 25 ›› Issue (5): 387-394.DOI: 10.5246/jcps.2016.05.044

• 【研究论文】 • 上一篇

盐酸羟考酮缓释片与硫酸吗啡缓释片的临床疗效安全性对比

饶欣¹, 王长连^1*, 许雄伟¹, 黄品芳¹, 王航¹, 林璐²

1. 福建医科大学附属第一医院药学部, 福建福州 350005
2. 福建医科大学附属漳州市医院药学部, 福建漳州 363000

收稿日期:2016-01-13 修回日期:2016-02-22 出版日期:2016-05-30 发布日期:2016-03-07
通讯作者: Tel./Fax: +86-0591-87981331, E-mail: WCL@medmail.com.cn
基金资助:
Evaluation of Safe and Rational Medication and Study and Application of Interventional Technology (Grant No. 2013BAI06B04).

Meta-analysis of the clinical efficacy and safety of oxycodone and morphine in cancer pain treatment

Xin Rao¹, Changlian Wang^1*, Xiongwei Xu¹, Pinfang Huang¹, Hang Wang¹, Lu Lin²

1. Department of Pharmacy, The First Affiliated Hospital of Fujian Medical University, Fuzhou 350005, China
2. Department of Pharmacy, Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou 363000, China

Received:2016-01-13 Revised:2016-02-22 Online:2016-05-30 Published:2016-03-07
Contact: Tel./Fax: +86-0591-87981331, E-mail: WCL@medmail.com.cn
Supported by:
Evaluation of Safe and Rational Medication and Study and Application of Interventional Technology (Grant No. 2013BAI06B04).

摘要/Abstract

摘要：

本文通过Meta分析, 比较盐酸羟考酮缓释片与硫酸吗啡缓释片治疗癌痛的有效性及安全性, 为临床药物选择提供循证证据。文中检索了英文MEDLINE、EMBASE、PubMed、Cochrane library数据库, 中文中国期刊全文数据库(CNKI)、科技期刊全文数据库(维普)、万方数字化期刊全文库, 收集了国内外有关盐酸羟考酮缓释片与硫酸吗啡缓释片治疗癌痛的随机对照试验(RCT), 分析指标为治疗有效率和不良反应发生率。结果显示, 15个研究共1338例患者纳入分析, 根据评分方式的不同分成两个亚组, 盐酸羟考酮缓释片与硫酸吗啡缓释片以NRS评分疼痛缓解(RR: 1.04; 95%可信区间: 0.97–1.11); 以VAS评分疼痛缓解(RR: 1.03; 95%可信区间: 1.03–0.97)。在不良反应方面, 盐酸羟考酮缓释片较硫酸吗啡缓释片便秘的发生率低(RR: 0.70; 95%置信区间: 0.70–0.58), 其他不良反应无统计学差异。最终我们发现盐酸羟考酮缓释片与硫酸吗啡缓释片治疗癌痛的疗效相近, 但前者便秘的发生率相对较低。

关键词: 羟考酮缓释片, 吗啡缓释片, Meta分析, 癌痛

Abstract:

In the present study, the efficacy and safety of oxycodone and morphine in the treatment of cancer pain were compared in a meta-analysis with the goal of providing a reference for drug selection in clinical practice. Electronic literature databases were searched for articles published through February 2015, including PubMed, MEDLINE, the Cochrane library, and Embase; and the China National Knowledge Internet, VIP Databases and Wanfang Databases for studies published in Chinese. Only randomized controlled trials were selected. The primary outcome measures were efficacy and the incidence of adverse drug reactions (ADRs). Data were extracted from the studies by two independent reviewers. A total of 15 studies containing 1338 patients were included in the analysis. The studies were divided into two subgroups according to different scoring methods. The pain relief efficacies of oxycodone and morphine were rated by the numerical rating scale (NRS) (risk ratio [RR]: 1.04; 95% confidence interval [CI]: 0.97–1.11). Others were rated by the visual analog scale (VAS) (RR: 1.03; 95% CI: 0.97–1.10). Five studies showed that pain intensity scores did notsignificantly differ between oxycodone and morphine treatments (standard mean difference [SMD] = 0.16, 95% CI: –0.01~0.33, P = 0.06). Regarding ADRs, the incidence of constipation was lower in the oxycodone group (RR: 0.70; 95% CI: 0.58–0.85). No statistical difference was observed among other ADRs. The efficacies of oxycodone and morphine were similar in treating cancer pain. However, the incidence of constipation was lower in patients treated with oxycodone.

Key words: Oxycodone, Morphine, Meta-analysis, Cancer pain

中图分类号:

R977

Supporting:

饶欣, 王长连, 许雄伟, 黄品芳, 王航, 林璐. 盐酸羟考酮缓释片与硫酸吗啡缓释片的临床疗效安全性对比[J]. 中国药学(英文版), 2016, 25(5): 387-394.

Xin Rao, Changlian Wang, Xiongwei Xu, Pinfang Huang, Hang Wang, Lu Lin. Meta-analysis of the clinical efficacy and safety of oxycodone and morphine in cancer pain treatment[J]. Journal of Chinese Pharmaceutical Sciences, 2016, 25(5): 387-394.

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盐酸羟考酮缓释片与硫酸吗啡缓释片的临床疗效安全性对比

Meta-analysis of the clinical efficacy and safety of oxycodone and morphine in cancer pain treatment

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