五生酊外治配合WHO三阶梯镇痛方案治疗轻中度癌性疼痛的效果

摘要
图/表
参考文献(20)
相关文章 (0)

全文: PDF (706 KB) HTML (1 KB)
输出: BibTeX | EndNote (RIS)

摘要目的观察中药五生酊外用配合WHO三阶梯镇痛方案治疗轻中度癌性疼痛的临床效果。方法选取2015年9月～2017年2月于广州中医药大学第二附属医院肿瘤科就诊的126例癌痛患者作为研究对象，将其随机分为治疗组（65例）和对照组（61例）。根据疼痛数字评分法（NRS），治疗组中，轻度疼痛占50.8%（33/65），中度疼痛占49.2%（32/65），对照组中，轻度疼痛占50.8%（31/61），中度疼痛占49.2%（30/61）。对照组采用WHO三阶梯止痛方案进行止痛，疼痛部位外涂安慰剂碘酊；治疗组在对照组的基础上给予疼痛部位外涂中药五生酊治疗。两组均以7 d为1个疗程。NRS评价患者的疼痛程度，采用简明疼痛评估量表（BPI）评价患者生活质量，同时观察两组临床疗效和不良反应发生情况。本研究所得数据采用统计学软件SPSS 18.0进行分析处理。结果共120例患者完成了本研究（6例因不受外用药物冷刺激而退出）。治疗后，两组NRS评分均较治疗前显著下降（P ＜ 0.01），且治疗组治疗后NRS评分显著低于对照组，差异有高度统计学意义（P ＜ 0.01）。治疗后，两组BPI评分均较治疗前明显降低（P ＜ 0.05），且治疗组治疗后BPI评分显著低于对照组，差异有高度统计学意义（P ＜ 0.01）。轻度疼痛患者治疗组治疗后BPI评分显著低于对照组（P ＜ 0.05），而中度疼痛患者两组BPI评分差异无统计学意义（P ＞ 0.05）。两组总有效率比较，差异无统计学意义（P ＞ 0.05）。治疗组便秘Ⅳ度发生率显著低于对照组（P ＜ 0.01），且治疗组总的不良反应发生率显著低于对照组（P ＜ 0.05）。结论与中度癌痛患者比较，中药五生酊外治对于轻度癌痛患者的止痛疗效和生存质量的改善效果更显著。

	服务

	把本文推荐给朋友
	加入我的书架
	加入引用管理器
	E-mail Alert
	RSS
	作者相关文章
	河文峰1 杨小兵1 许蕾2 张丽玲3 李秋萍1 毕嘉仪1 李秋霞4 邓宏1

关键词 ：癌性疼痛, 五生酊, 外用, 三阶梯镇痛方案

Abstract：Objective To observe the clinical effect of traditional Chinese medicine Wusheng Tincture combined with WHO "three stage" analgesic regimen in the treatment of mild and moderate cancer pain. Methods One hundred and twenty-six patients with cancer pain treated in Department of Oncology, the Second Affiliated Hospital of Guangzhou University of Chinese Medicine from September 2015 to February 2017 were selected as research objects, and they were randomly divided into the treatment group (65 cases) and control group (61 cases). According to numerical rating scale, in the treatment group, mild pain patients accounted for 50.8% (33/65), moderate pain patients accounted for 49.2% (32/65), while in the control group, mild pain patients accounted for 50.8% (31/61), moderate pain patients accounted for 49.2% (30/61). The control group was taken WHO "three stage" analgesic regimen and the pain site was treated with placebo tincture; the treatment group was treated with Wusheng Tincture on the pain site on basis of control group. The two groups were treated for 7 days as one course. NRS was used to assess the pain level of the patients, the brief pain inventory (BPI) was used to evaluate the quality of life, the clinical effects and adverse reactions between the two groups were observed. The data was analyzed and processed by SPSS 18.0. Results A total of 120 patients completed the study (6 patients were excluded for the external use of cold stimulation). After treatment, the NRS scores in the two groups were all lower than those before treatment (P ＜ 0.01), and the NRS score of the treatment group was significantly lower than that of the control group, the difference was highly statistically significant (P ＜ 0.01). After treatment, the scores of BPI in the two groups were all significantly lower than those before treatment (P ＜ 0.05), and the BPI score of the treatment group was significantly lower than that of the control group, the difference was highly statistically significant (P ＜ 0.01). The BPI score of patients with mild pain in the treatment group after treatment was significantly lower than that of control group (P ＜ 0.05), while there was no significant difference of the BPI score between the patients with moderate pain in treatment group and control group (P ＞ 0.05). There was no statistically significant difference of total effective rate between the two groups (P ＞ 0.05). The incidence of constipation with Ⅳ degree in the treatment group was significantly lower than that in the control group (P ＜ 0.01), and the overall incidence of adverse reactions in the treatment group was significantly lower than that in the control group (P ＜ 0.05). Conclusion Compared with patients with moderate pain, external use of Wusheng Tincture has better effects for the analgesic efficacy and improvement of quality of life.

Key words： Cancer pain Wusheng Tincture External use "Three stage" analgesia regimen

基金资助:广东省中医药局建设中医药强省科研课题项目（20142077）。

作者简介: 河文峰（1978.9-），男，硕士研究生，主要从事肝癌、肺癌、肠癌的中西医结合临床研究。

引用本文:

河文峰1 杨小兵1 许蕾2 张丽玲3 李秋萍1 毕嘉仪1 李秋霞4 邓宏1. 五生酊外治配合WHO三阶梯镇痛方案治疗轻中度癌性疼痛的效果[J]. 中国医药导报, 2017, 14(30): 25-29.
HE Wenfeng1 YANG Xiaobing1 XU Lei2 ZHANG Liling3 LI Qiuping1 BI Jiayi1 LI Qiuxia4 DENG Hong1. Clinical effect of Wusheng Tincture combined with WHO "three stage" analgesic regimen in treating patients with mild and moderate cancer pain. 中国医药导报, 2017, 14(30): 25-29.

链接本文:

http://www.yiyaodaobao.com.cn/CN/ 或 http://www.yiyaodaobao.com.cn/CN/Y2017/V14/I30/25

[1] 刘玉梅，邵宗鸿，李薇，等.影响晚期癌症伴慢性中重度疼痛患者镇痛效果的因素分析[J].临床肿瘤学杂志，2016， 21（3）：251-256.
[2] 贾青.肝癌晚期患者的疼痛控制与临终关怀护理体会[J].医药卫生，2016，10（1）：98.
[3] 邓宏，许蕾，河文峰，等.中药五生酊外用治疗癌性疼痛临床疗效观察[J].广州中医药大学学报，2014，31（6）：885-890.
[4] 胡纯嘏，杨金凤.CYP3A基因多态性与阿片类药物治疗癌痛的研究进展[J].医学临床研究，2015，10（2）：388-392.
[5] Shufang MA，Zhou M，Wei Z. Clinical research of Cancer Pain Subsides Pasted in Treating Moderately and Severe Cancer Pain [J]. Clinical Journal of Traditional Chinese Medicine，2016，12（9）：1088-1089.
[6] 万德森.临床肿瘤学[M]. 4版.北京：科学出版社，2014：125.
[7] 王洪武.癌性疼痛的综合治疗[M].北京：科学普及出版社，2010：78.
[8] Dobosz ?覵，Stefaniak T，Dobrzycka M，et al. Invasive treatment of pain associated with pancreatic cancer on different levels of WHO analgesic ladder [J]. BMC Surg，2016，16：20.
[9] 李建，胥润，吴雪莲，等.心理社会治疗对胃癌患者焦虑、抑郁情绪及免疫功能的影响[J].肿瘤学杂志，2016，22（9）：722-726.
[10] Rust?覬en T，Valeberg BT，Kolstad E，et al. A randomized clinical trial of the efficacy of a self-care intervention to improve cancer pain management [J]. Cancer Nurs，2014， 37（1）：34-43.
[11] 孟祥荣，李连海.胃癌疼痛的治疗进展[J].世界最新医学信息文摘，2016，16（59）：1458-1461.
[12] 杨亚旭，黄小丽，陈琳，等.治疗风寒湿型类风湿关节炎的中药外治方剂的筛选归纳[J].风湿病与关节炎，2015， 9（5）：25-28.
[13] 郭志俊，段小花，陈翠玲，等.制黄草乌中滇乌碱及其转化产物8-去乙酰基滇乌头碱药效和毒性的初步研究[J].中国中医药信息杂志，2015，22（10）：60-63.
[14] 孙妍，商庆辉.乳香中三萜类化合物和药理活性的研究进展[J].环球中医药，2016，9（5）：616-620.
[15] 姜海波，王军，苏建华，等.延胡索乙素对小鼠坐骨神经CCI模型背根神经节Cav1.2表达的影响[J].中国药理学通报，2015，27（11）：1598-1603.
[16] 常芸，宋萍，黄天熠.多磺酸黏多糖乳膏外用联合冰片湿敷防治胺碘酮相关静脉炎效果观察[J].护理研究，2015， 10（29）：3670-3671.
[17] 李雪妮，姜春状.盐酸吗啡缓释片联合中药足浴治疗癌性疼痛的临床观察[J].健康之路，2016，15（7）：232-233.
[18] 马淑芳，周明雪，魏征.癌疼消外贴治疗中重度肿瘤疼痛临床研究[J].中医药临床杂志，2016，28（7）：987-988.
[19] 李昕.中药硬膏散结止痛方治疗癌症疼痛80例临床疗效观察[J].中医临床研究，2016，8（9）：132-133.
[20] 陈宗湖，苏坤，徐培培，等.癌痛酊治疗癌性疼痛的效果观察[J].当代医药论丛，2017，15（1）：112-113.