目的 比较吗啡、甲强龙（甲泼尼龙）和氨茶碱治疗晚期肿瘤患者呼吸困难的疗效。方法 170例晚期肿瘤呼吸困难者随机分三组，分别给予5~10 mg吗啡皮下注射（吗啡组，n=60）、40 mg甲强龙静脉点滴（甲强龙组，n=55）和025 g氨茶碱静脉点滴（氨茶碱组，n=55）治疗，通过视觉模拟评分（VAS）比较三种药物在治疗晚期肿瘤患者呼吸困难中的优劣。结果 治疗前三组患者间VAS评分比较差异无统计学意义（P>0.05）；但治疗后三组的VAS评分均显著低于治疗前，差异有统计学意义（P<0.01）。治疗后，吗啡组、甲强龙组和氨茶碱组的VAS评分分别为（12.82±11.40）、（24.58±17.51）和（34.25±17.75）mm，吗啡组显著低于甲强龙组和氨茶碱组，差异有统计学意义（P<0.01）；吗啡组控制呼吸困难有效率明显高于甲强龙组和氨茶碱组，差异有统计学意义（86.67%、67.27%和50.91%，P<0.05或P<0.01）。结论 吗啡用于治疗晚期肿瘤患者呼吸困难的疗效优于甲强龙和氨茶碱，能提高预计生存期较短的晚期肿瘤患者的生存质量。

Objective To investigate the effects of morphine, methylprednisolone and aminophylline on the management of dyspnea in patients with advanced cancer. Methods One hundred and seventy patients with advanced cancer suffering from dyspnea were randomly managed with morphine (5 to 10 mg, subcutaneous injection; morphine group, n=60), methylprednisolone (40 mg, intravenous administration; methylprednisolone group, n=55) and aminophylline (0.25 g, intravenous administration; aminophylline group, n=55), and the visual analogue scale (VAS) was adopted to evaluate the therapeutic effects. Results There was no significant difference in VAS among three groups before treatment (P>0.05). VAS after treatment was significantly lower than that before treatment in each group (P<0.01). VAS after treatment in morphine group, methylprednisolone group and aminophylline group were (12.82±11.40) mm, (24.58±17.51) mm and (34.25±17.75) mm respectively, and VAS in morphine group was significantly lower than those in methylprednisolone group and aminophylline group (P<0.01). The effective rate in control of dyspnea in morphine group (86.67%) was significantly higher than those in methylprednisolone group (67.27%) and aminophylline group (50.91%)(P<0.05 or P<0.01). Conclusion Morphine is more effective than methylprednisolone and aminophylline for dyspnea management in advanced cancer, and can improve the quality of life in patients with advanced cancer.