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目的:应用Meta分析的方法评估羟考酮缓释片联合吗啡片滴定方案治疗中、重度癌痛疗效。方法:2016年1月以前发表的有关羟考酮缓释片联合吗啡片滴定方案治疗中、重度癌痛疗效的国内外文献,采用Newcastle-Ottawa Scale(NOS)标准进行质量评估后,使用Q检验和I2统计量进行异质性检验,并进行数据合并,再以Rev Man 5.1和Stata 12.0软件对符合质量要求的文献进行Meta分析。结果:(1)根据检索词初检出5篇文献,然后进行筛选,最终共纳入符合标准的4篇病例对照研究文献,均为以中文发表的文献,共中、重度癌痛442例,其中羟考酮缓释片联合吗啡片滴定治疗组与对照组治疗227例,羟考酮缓释片或者吗啡片治疗治疗215例。(2)对羟考酮缓释片联合吗啡片恶心呕吐发生率的Meta分析,两组间有显著差异,尿潴留发生率的Meta分析两组间差异不明显。结论:对于中、重度癌痛患者,羟考酮缓释片联合吗啡片具有疗效好、恶心呕吐等不良反应发生率低,值得临床上推广应用。
OBJECTIVE: To evaluate the efficacy of oxycodone sustained-release tablets combined with morphine tablets titration in the treatment of moderate-severe cancer pain with Meta-analysis. METHODS: Domestic and foreign literatures published before January 2016 on the efficacy of oxycodone extended-release tablets in combination with morphine titration in the treatment of moderate-to-severe cancer pain were assessed by the Newcastle-Ottawa Scale (NOS) And I2 statistics were tested for heterogeneity and the data were merged. Meta-analysis was performed on the documents meeting the quality requirements using Rev Man 5.1 and Stata 12.0 software. Results: (1) According to the search term, five articles were initially detected and then screened. Finally, a total of four case-control studies were included, all of which were published in Chinese. There were 442 cases of moderate and severe cancer pain, among which Oxycodone sustained-release tablets combined with morphine tablets titration treatment group and control group, 227 cases of oxycodone sustained-release tablets or morphine tablets treatment of 215 cases. (2) Meta-analysis of oxycodone sustained release tablets combined with morphine tablets nausea and vomiting, there are significant differences between the two groups, the incidence of urinary retention Meta analysis was not significantly different between the two groups. CONCLUSION: Oxycodone extended-release tablets combined with morphine tablets have good efficacy and low incidence of adverse reactions such as nausea and vomiting in moderate and severe cancer patients. It is worth popularizing and applying clinically.