Abstract:  Objective To investigate the efficacy and safety of active application morphine in the treatment of idiopathic pulmonary fibrosis (IPF) with dyspnea. Methods A total of 33 IPF patients with severe dyspnea were enrolled in this study. They were divided into the observation group (16 cases) and the control group (17 cases) according to the order of admission. The control group received respiratory support, glucocorticoids and other conventional treatment, in the whole course of hospitalization, the observation group was treated with low dose of morphine 1 mg subcutaneous injection three times a day on the basis of control group. The visual analogue scale (VAS) score was recorded at different time points after admission. The length of hospital stay, the number of acute dyspnea, cumulative glucocorticoid dose and adverse reactions were recorded and compared between the two groups. Results There was no significant difference in VAS score in patients on admission between two groups. The VAS scores were significantly lower four days after admission, 2 days before discharge and at discharge in observation group than those of control group (P < 0.05). There was no significant difference in the length of hospital stay between two groups (P＞0.05). The number of acute dyspnea and cumulative glucocorticoid dose were significantly decreased in observation group than those of control group (P < 0.05). No adverse reactions related to respiratory depression were found in two groups. There were more patients with constipation symptoms in the observation group than those of control group. The nausea ratio was smaller in the observation group than that in the control group (P＜0.05). Conclusion The active application of morphine therapy can help to relieve dyspnea symptoms in IPF patients, and it is safe and effective.

Key words: morphine, pulmonary fibrosis, dyspnea, clinical protocols