Yu Shi-ying, Sun Yan, Wu Yi-long, Qin Shu-kui, Xie Guang-ru, Liu Shu-jun, Sui Guang-jie, Zhang Hai-chun
Cancer Center of Tongji Hospital, Tongji Medical College, Huazhong University of Science and Techenology, Wuhan 430030, China.
Zhonghua Zhong Liu Za Zhi. 2005 Jun;27(6):369-72.
To evaluate the efficacy and adverse effects of transdermal fentanyl in management of patients with cancer pain.
A total of 4492 patients (aged 3-90) with cancer pain were enrolled in this multicenter study. The mean age was 58.5 (3 approximately 90) years old. All patients received transdermal fentanyl. The patients were asked to record the attacks of pain, quality of life, and any side effects of the treatment.
Baseline mean pain intensity was 7.37. On days 1, 3, 6, 9, 15, and 30, the mean scores of pain were decreased to 4.04, 2.98, 2.52, 2.19, 1.85 and 1.61, respectively (P < 0.01). The effective rate was 96.8%. The mean doses of fentanyl were 32.37 microg/h (25-200 microg/h) on the initial day, 42.57 microg/h and 49.57 microg/h (25-225 microg/h) on days 15 and 30. The quality of life was significantly improved after treatment (P < 0.01). The common side effects were constipation (9.8%), nausea (13.6%), dizziness (6.5%), vomiting (3.9%), sedation (2.0%) and respiratory depression (0.2%). The incidence of constipation was related to age, and the incidence of vomiting and difficulty of urination was related to gender. The majority (84.5%) of patients preferred continuation of the treatment with transdermal fentanyl.
Transdermal fentanyl for the patients with cancer pain is effective, safe, convenient and can improve the quality of life. Transdermal fentanyl can be recommended as one of first-line drugs for the treatment of patients with moderate to severe cancer pain.
评估透皮芬太尼治疗癌痛患者的疗效及不良反应。
本多中心研究共纳入4492例年龄在3至90岁的癌痛患者。平均年龄为58.5（3至90）岁。所有患者均接受透皮芬太尼治疗。要求患者记录疼痛发作情况、生活质量及治疗的任何副作用。
基线时平均疼痛强度为7.37。在第1、3、6、9、15和30天，疼痛平均评分分别降至4.04、2.98、2.52、2.19、1.85和1.61（P<0.01）。有效率为96.8%。芬太尼初始日平均剂量为32.37微克/小时（25至200微克/小时），第15天和第30天分别为42.57微克/小时和49.57微克/小时（25至225微克/小时）。治疗后生活质量显著改善（P<0.01）。常见副作用为便秘（9.8%）、恶心（13.6%）、头晕（6.5%）、呕吐（3.9%）、镇静（2.0%）和呼吸抑制（0.2%）。便秘发生率与年龄有关，呕吐和排尿困难发生率与性别有关。大多数（84.5%）患者倾向于继续使用透皮芬太尼治疗。
透皮芬太尼治疗癌痛患者有效、安全、方便，且可改善生活质量。透皮芬太尼可推荐作为中重度癌痛患者治疗的一线药物之一。
