丁丙诺啡透皮贴剂在癌痛治疗中的应用进展

The Application Progress of Buprenorphine Transdermal Patch in Cancer Pain Treatment

摘要:

随着癌症发病率的持续上升,慢性癌痛已成为疼痛管理领域关注的重点之一。阿片类药物作为中重度慢性癌痛治疗的主要药物,主要包括芬太尼透皮贴剂(Transdermal fentanyl, TDF)、硫酸吗啡缓释片、盐酸羟考酮缓释片等强效阿片类药物。丁丙诺啡透皮贴剂(Transdermal buprenorphine, TDB)作为阿片类药物透皮贴剂的一种,已被广泛应用于慢性非癌痛的治疗。鉴于TDB具备呼吸抑制的“天花板”效应、限制药物滥用和耐受性等独特优势,其在慢性癌痛治疗中的应用亦日益增多。然而,TDB与临床常规使用的其他强效阿片类药物在药理特性、临床应用等方面存在显著差异,因此本文旨在对TDB的药理特性及其在癌痛患者治疗中的应用剂量、转换方法和安全性等方面进行综合评述,以期为临床医生在使用TDB治疗癌痛患者时提供参考依据。

Abstract:

The escalating incidence of cancer has led to a heightened focus on chronic cancer pain within the domain of pain management. Opioid medications, serving as the principal treatment for moderate to severe chronic cancer pain, encompass potent opioids such as transdermal fentanyl (TDF), morphine sulfate extended-release tablets, and oxycodone hydrochloride extended-release tablets. Transdermal buprenorphine (TDB), a type of opioid transdermal patch, has gained widespread acceptance in the treatment of chronic non-cancer pain. Given TDB"s distinctive benefits, including a "ceiling" effect on respiratory depression, mitigation of drug abuse potential, and reduced tolerance development, its utilization in the management of chronic cancer pain is also on the rise. However, TDB exhibits significant differences from other potent opioids commonly employed in clinical settings, in terms of both pharmacological properties and clinical application. Consequently, this article seeks to provide a comprehensive review of TDB