临床研究表明,帕米膦酸二钠治疗骨转移引起的疼痛有肯定的疗效,提高使用剂量能否提高疗效尚未明确。本研究的目的是观察两组不同剂量的帕米膦酸二钠治疗骨转移引起疼痛的效果和毒副作用。方法:将90例实体瘤骨转移患者随机分为治疗组和对照组。治疗组45例,采用帕米膦酸二钠120mg分3天静滴(即60mg,d1;30mg,d2～3);对照组采用帕米膦酸二钠90mg分3天静滴(即30mg,d1～3)。二组均4周为一周期。结果:治疗组45例,显效20例,有效23例,无效2例,总有效率95.6%(43/45);用药一疗程取得疗效40例(88.9%),一周内取得疗效36例(80%);不良反应3例(6.7)%。对照组45例,显效16例,有效20例,无效9例,总有效率80.0%;用药一疗程取得疗效26例(57.8%),一周内取得疗效26例(57.8%);不良反应3例(6.7%)。经统计学分析,总有效率及一周内有效率两组比较有显著性差异(P<0.05),用药一疗程有效率两组间有非常显著性差异(P<0.01)。结论:帕米膦酸二钠对骨转移引起的疼痛有良好的止痛效果,一疗程采用120mg优于90mg,患者可以耐受。
【关键词】：骨转移癌;帕米膦酸二钠;止痛实体瘤骨转移引起的疼痛、功能障碍、甚至病理性骨折,严重影响患者生活质量。体内及动物实验证实,帕米膦酸二钠是破骨细胞增殖和活性的强有力抑制剂,对实体瘤骨转移引起的疼痛有较好的止痛效果,但提高使用剂量是否能提高疗效尚未明确。本研究观察帕米膦酸二钠对90例实体瘤骨转BACKGROUND &OBJECTIVE:Clinical studies showed that pamidronate h as curative effects on pain induced by bone metastasis. This study was to observe curative effects, and side effects of different dosages of pamidronate on pain i nduced by bone metastasis. METHODS: Ninety patients with metastatic bone tumor w ere divided into 2 groups randomly. In group A,120 mg pamidronate was given by i ntravenous infusion in 3 days (60mg day1, 30 mg day2-3) ;in group B, 90 mg pami dronate was given by intravenous infusion in 3 days (30 mg day1-3), repeated ev ery 4 weeks. RESULTS: The notable effect, effect, and no effect were observed in 20, 23, and 2 patients of group A, and 16, 20, and 9 patients of group B, respe ctively. Total effective rate in group A was 95.6%(43/45) , in group B was 80.0 %(36/45) (P< 0.05) . Curative rate within 1 course of treatment in group A was 88.9%(40/45) , in group B was 57.8%(26/45)(P< 0.01). Curative rate within 1 we ek in group A was 80%(36/45) , in group B was 57.8%(26/45)(P< 0.05). Side effe cts were observed in 3 patients (6.7%). CONCLUSIONS: Pamidronate has good curat ive effects in treating pain induced by bone metastasis. Efficacy of 120 mg pami dronate is better than 90 mg pamidronate.
【Keyword】：Bone metastasis;Pamidronate;Anodyne