Development of New Guideline for the Theatment of Bone Cancer Pain.

非类固醇抗炎药(NSAIDs)是临床上用于治疗骨癌疼痛的药物，但NSAIDs对骨癌疼痛患者产生镇痛作用的机制尚不完全清楚。为了探讨非甾体抗炎药对骨癌疼痛产生镇痛作用的机制，作者观察了口服COX-1选择性抑制剂(SC560)、COX-2选择性抑制剂(塞来昔布)和非选择性4 COX抑制剂(消炎痛)对小鼠骨癌疼痛的影响，并将这些作用与口服吗啡的作用进行了比较。最近，第三个COX，COX-3，已有报道。据报道，对乙酰氨基酚是一种选择性的COX-3抑制剂。我们还检查了扑热息痛对骨癌疼痛的影响。扑热息痛和消炎痛对骨癌疼痛有止痛作用，而SC560和塞来昔布则没有。亚止痛剂量的吗啡与对乙酰氨基酚联合给药可增强对乙酰氨基酚的止痛效果。我们的数据表明，口服对乙酰氨基酚，而不是COX-1和COX-2选择性抑制剂，对骨癌疼痛有止痛作用。扑热息痛与阿片类药物联合给药在骨癌疼痛的治疗中提供了有益的效果。

Non-steroidal anti-inflammatory drugs (NSAIDs) are clinically used for the treatment of bone cancer pain but the mechanisms NSAIDs use to produce an analgesic effect in patients with bone cancer pain are not fully understood. To explore the mechanisms NSAIDs use to produce an analgesic effect on bone cancer pain, the authors examined the effects of oral administration of a COX-1 selective inhibitor (SC560), a COX-2 selective inhibitor (celecoxib) and a non-selective 4 COX inhibitor (indomethacin) in a mouse bone cancer pain model and compared these effects to the effect of orally administered morphine. Recently, the third COX, COX-3, has been reported. Acetaminophen has been reported to be a selective COX-3 inhibitor. We also examined the effect of acetaminophen on bone cancer pain. Acetaminophen and indomethacin, but not of SC560 and celecoxib, produced an analgesic effect on bone cancer pain. Co-administration of sub-analgesic doses of morphine with acetaminophen enhanced an analgesic effect of acetaminophen. Our data suggested that the oral administration of acetaminophen, but not a COX-1 selective inhibitor and a COX-2 selective inhibitor, produces an analgesic effect on bone cancer pain. The co-administration of acetaminophen with an opioid provides a beneficial effect in the treatment of bone cancer pain.