Ann Intern Med:阿片类止痛剂长期应用后的效果和危害

2015-02-23 梁怀彬 译 MedSci原创

阿片类止痛药处方不断增加,剂量不断增大,阿片类药物的弊端(恶心、呕吐、便秘、木僵、昏迷和呼吸抑制等)以及不确定的风险也随之增加,长期使用后止痛效果也受到了拷问。为系统评估长期使用阿片类药物(>3 months)慢性疼痛的疗效和危害,有研究者收集现有资料撰写了一项系统评价近日发表在Ann Intern Med杂志上。 数据来源于MEDLINE,PsycINFO,CINAHL,Cochrane系

阿片类止痛药处方不断增加,剂量不断增大,阿片类药物的弊端(恶心、呕吐、便秘、木僵、昏迷和呼吸抑制等)以及不确定的风险也随之增加,长期使用后止痛效果也受到了拷问。为系统评估长期使用阿片类药物(>3 months)慢性疼痛的疗效和危害,有研究者收集现有资料撰写了一项系统评价近日发表在Ann Intern Med杂志上。 数据来源于MEDLINE,PsycINFO,CINAHL,Cochrane系统评价,Cochrane实验注册,ClinicalTrials.gov实验注册,收集2008年1月至2014年8月的相关研究及文献引文。 入选标准为研究对象为患有慢性疼痛的成年人随机对照实验或观察性研究,实验中他们长期使用阿片类药物止痛。这些研究比较了阿片类药物和安慰剂或非阿片类药物相比疗效情况、不同剂量下疗效情况、降低阿片类药物危害的有效方法等。 研究收录工作完成后,对比研究阿片类药物和非阿片类药物“长期使用”(>1 year)后对疼痛的抑制效果、肢体功能、生活质量影响、药物滥用成瘾等方面的研究,研究者发现目前尚无这样的研究报道。高质量的横断面观察性研究揭示使用阿片类止痛剂相比其他止痛

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    2015-12-26 hixiaoluo

    值得看,谢谢分享,值得收藏、转发

    0

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    2015-05-16 ljjj1053

    很不错学习了

    0

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    2015-04-12 x35042875

    患OS这个疾病的高风险人群提供干预措施以避免不良预后和机械治疗措施

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=48005, encodeId=c3f04800583, content=值得看,谢谢分享,值得收藏、转发, beContent=null, objectType=article, channel=null, level=null, likeNumber=89, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bc301610909, createdName=hixiaoluo, createdTime=Sat Dec 26 14:23:00 CST 2015, time=2015-12-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=23706, encodeId=334923e0679, content=很不错学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=ac181616815, createdName=ljjj1053, createdTime=Sat May 16 19:31:00 CST 2015, time=2015-05-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=20891, encodeId=44d12089122, content=患OS这个疾病的高风险人群提供干预措施以避免不良预后和机械治疗措施, beContent=null, objectType=article, channel=null, level=null, likeNumber=96, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20150920/IMG55FDE671A89482379.jpg, createdBy=cef3108336, createdName=x35042875, createdTime=Sun Apr 12 07:40:00 CST 2015, time=2015-04-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1980772, encodeId=7e2c1980e72b5, content=<a href='/topic/show?id=2f2a631644f' target=_blank style='color:#2F92EE;'>#止痛剂#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=63164, encryptionId=2f2a631644f, topicName=止痛剂)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=cbcc223, createdName=cooco, createdTime=Thu May 07 23:19:00 CST 2015, time=2015-05-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1308999, encodeId=895213089999d, content=<a href='/topic/show?id=a0179e879ac' target=_blank style='color:#2F92EE;'>#阿片类#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=97879, encryptionId=a0179e879ac, topicName=阿片类)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7e12358, createdName=lhlxtx, createdTime=Wed Feb 25 06:19:00 CST 2015, time=2015-02-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1405490, encodeId=9d151405490b8, content=<a href='/topic/show?id=597b631634d' target=_blank style='color:#2F92EE;'>#止痛#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=63163, encryptionId=597b631634d, topicName=止痛)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8da42553722, createdName=zhangxingru, createdTime=Wed Feb 25 06:19:00 CST 2015, time=2015-02-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1606414, encodeId=18191606414a6, content=<a href='/topic/show?id=eb6b1145939' target=_blank style='color:#2F92EE;'>#Med#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11459, encryptionId=eb6b1145939, topicName=Med)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=552a19396740, createdName=ms3994565386320060, createdTime=Wed Feb 25 06:19:00 CST 2015, time=2015-02-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=16922, encodeId=1c9c169226d, content=希望能有更深入的研究, beContent=null, objectType=article, channel=null, level=null, likeNumber=121, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3yz0JbjHQ7nicJU7lHMOu0Itf3Zv3VBzEvK3k4AFPBXhiaxIRNGVI33GicoRXQEjkaasjdlWKwZuwcyhDP9Jibqt5ct/0, createdBy=f1281613275, createdName=zhouanxiu, createdTime=Tue Feb 24 15:20:00 CST 2015, time=2015-02-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=16856, encodeId=d8261685684, content=不错的文章,学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f2fb1607679, createdName=orthoW, createdTime=Tue Feb 24 11:13:00 CST 2015, time=2015-02-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=16837, encodeId=22101683eac, content=o,不错,学习了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=99, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b5a81612548, createdName=xjtumd07, createdTime=Tue Feb 24 10:56:00 CST 2015, time=2015-02-24, status=1, ipAttribution=)]
    2015-05-07 cooco
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    2015-02-25 lhlxtx
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  7. [GetPortalCommentsPageByObjectIdResponse(id=48005, encodeId=c3f04800583, content=值得看,谢谢分享,值得收藏、转发, beContent=null, objectType=article, channel=null, level=null, likeNumber=89, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bc301610909, createdName=hixiaoluo, createdTime=Sat Dec 26 14:23:00 CST 2015, time=2015-12-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=23706, encodeId=334923e0679, content=很不错学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=ac181616815, createdName=ljjj1053, createdTime=Sat May 16 19:31:00 CST 2015, time=2015-05-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=20891, encodeId=44d12089122, content=患OS这个疾病的高风险人群提供干预措施以避免不良预后和机械治疗措施, beContent=null, objectType=article, channel=null, level=null, likeNumber=96, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20150920/IMG55FDE671A89482379.jpg, createdBy=cef3108336, createdName=x35042875, createdTime=Sun Apr 12 07:40:00 CST 2015, time=2015-04-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1980772, encodeId=7e2c1980e72b5, content=<a href='/topic/show?id=2f2a631644f' target=_blank style='color:#2F92EE;'>#止痛剂#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=63164, encryptionId=2f2a631644f, topicName=止痛剂)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=cbcc223, createdName=cooco, createdTime=Thu May 07 23:19:00 CST 2015, time=2015-05-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1308999, encodeId=895213089999d, content=<a href='/topic/show?id=a0179e879ac' target=_blank style='color:#2F92EE;'>#阿片类#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=97879, encryptionId=a0179e879ac, topicName=阿片类)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7e12358, createdName=lhlxtx, createdTime=Wed Feb 25 06:19:00 CST 2015, time=2015-02-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1405490, encodeId=9d151405490b8, content=<a href='/topic/show?id=597b631634d' target=_blank style='color:#2F92EE;'>#止痛#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=63163, encryptionId=597b631634d, topicName=止痛)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8da42553722, createdName=zhangxingru, createdTime=Wed Feb 25 06:19:00 CST 2015, time=2015-02-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1606414, encodeId=18191606414a6, content=<a href='/topic/show?id=eb6b1145939' target=_blank style='color:#2F92EE;'>#Med#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11459, encryptionId=eb6b1145939, topicName=Med)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=552a19396740, createdName=ms3994565386320060, createdTime=Wed Feb 25 06:19:00 CST 2015, time=2015-02-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=16922, encodeId=1c9c169226d, content=希望能有更深入的研究, beContent=null, objectType=article, channel=null, level=null, likeNumber=121, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3yz0JbjHQ7nicJU7lHMOu0Itf3Zv3VBzEvK3k4AFPBXhiaxIRNGVI33GicoRXQEjkaasjdlWKwZuwcyhDP9Jibqt5ct/0, createdBy=f1281613275, createdName=zhouanxiu, createdTime=Tue Feb 24 15:20:00 CST 2015, time=2015-02-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=16856, encodeId=d8261685684, content=不错的文章,学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f2fb1607679, createdName=orthoW, createdTime=Tue Feb 24 11:13:00 CST 2015, time=2015-02-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=16837, encodeId=22101683eac, content=o,不错,学习了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=99, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b5a81612548, createdName=xjtumd07, createdTime=Tue Feb 24 10:56:00 CST 2015, time=2015-02-24, status=1, ipAttribution=)]
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    2015-02-24 zhouanxiu

    希望能有更深入的研究

    0

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    2015-02-24 orthoW

    不错的文章,学习了

    0

  10. [GetPortalCommentsPageByObjectIdResponse(id=48005, encodeId=c3f04800583, content=值得看,谢谢分享,值得收藏、转发, beContent=null, objectType=article, channel=null, level=null, likeNumber=89, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bc301610909, createdName=hixiaoluo, createdTime=Sat Dec 26 14:23:00 CST 2015, time=2015-12-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=23706, encodeId=334923e0679, content=很不错学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=ac181616815, createdName=ljjj1053, createdTime=Sat May 16 19:31:00 CST 2015, time=2015-05-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=20891, encodeId=44d12089122, content=患OS这个疾病的高风险人群提供干预措施以避免不良预后和机械治疗措施, beContent=null, objectType=article, channel=null, level=null, likeNumber=96, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20150920/IMG55FDE671A89482379.jpg, createdBy=cef3108336, createdName=x35042875, createdTime=Sun Apr 12 07:40:00 CST 2015, time=2015-04-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1980772, encodeId=7e2c1980e72b5, content=<a href='/topic/show?id=2f2a631644f' target=_blank style='color:#2F92EE;'>#止痛剂#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=63164, encryptionId=2f2a631644f, topicName=止痛剂)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=cbcc223, createdName=cooco, createdTime=Thu May 07 23:19:00 CST 2015, time=2015-05-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1308999, encodeId=895213089999d, content=<a href='/topic/show?id=a0179e879ac' target=_blank style='color:#2F92EE;'>#阿片类#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=97879, encryptionId=a0179e879ac, topicName=阿片类)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7e12358, createdName=lhlxtx, createdTime=Wed Feb 25 06:19:00 CST 2015, time=2015-02-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1405490, encodeId=9d151405490b8, content=<a href='/topic/show?id=597b631634d' target=_blank style='color:#2F92EE;'>#止痛#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=63163, encryptionId=597b631634d, topicName=止痛)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8da42553722, createdName=zhangxingru, createdTime=Wed Feb 25 06:19:00 CST 2015, time=2015-02-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1606414, encodeId=18191606414a6, content=<a href='/topic/show?id=eb6b1145939' target=_blank style='color:#2F92EE;'>#Med#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11459, encryptionId=eb6b1145939, topicName=Med)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=552a19396740, createdName=ms3994565386320060, createdTime=Wed Feb 25 06:19:00 CST 2015, time=2015-02-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=16922, encodeId=1c9c169226d, content=希望能有更深入的研究, beContent=null, objectType=article, channel=null, level=null, likeNumber=121, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3yz0JbjHQ7nicJU7lHMOu0Itf3Zv3VBzEvK3k4AFPBXhiaxIRNGVI33GicoRXQEjkaasjdlWKwZuwcyhDP9Jibqt5ct/0, createdBy=f1281613275, createdName=zhouanxiu, createdTime=Tue Feb 24 15:20:00 CST 2015, time=2015-02-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=16856, encodeId=d8261685684, content=不错的文章,学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f2fb1607679, createdName=orthoW, createdTime=Tue Feb 24 11:13:00 CST 2015, time=2015-02-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=16837, encodeId=22101683eac, content=o,不错,学习了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=99, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b5a81612548, createdName=xjtumd07, createdTime=Tue Feb 24 10:56:00 CST 2015, time=2015-02-24, status=1, ipAttribution=)]
    2015-02-24 xjtumd07

    o,不错,学习了!

    0

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