解毒定痛方对骨转移瘤放疗爆发痛热毒蕴结证的防治作用研究

Study on Prevention and Treatment of Jiedu Dingtong Recipe for Radiotherapy Pain Outbreak of Bone Metastasis

目的:应用解毒定痛方中药制剂,观察对骨转移瘤患者热毒蕴结证放疗爆发痛防治的临床疗效。方法:纳入病例102例,按照骨转移瘤患者放疗爆发痛方式的不同采用随机、双盲、对照的方法,将其分为观察组及对照组,对照组采用癌痛常规治疗,观察组在癌痛常规治疗基础上联合解毒定痛方中药制剂口服。观察两组治疗前后的NRS疼痛评分、KPS功能状态评分、爆发痛频率、生活质量评分、并发症发生率、镇痛效果的临床疗效评价及血清β-EP、PGE2、5-HT、NPY水平的差异。结果:总体有效率治疗组94.12%,对照组80.39%,两组间相比较,差异有统计学意义(P<0.05);观察组NRS疼痛评分、爆发痛频率、并发症发生率及PGE2、5-HT、NPY水平均明显低于对照组(P<0.05),观察组KPS功能状态评分、生活质量评分及血清β-EP水平明显高于对照组(P<0.05)。结论:采用解毒定痛方治疗骨转移瘤放疗爆发痛热毒蕴结证患者,可显著减少爆发痛频率,降低并发症发生率,降低血清疼痛介质水平,改善患者生活质量。

Objective:To apply the traditional Chinese medicine preparation of Jiedu Dingtong Recipe to observe the clinical efficacy of radiotherapy pain outbreak for patients with bone metastases.Methods:102 cases were enrolled.According to the different ways of radiation burst pain of patients with bone metastases,they were divided into an observation group and a controlled group by randomized,double-blind,and controlled methods.The controlled group received conventional cancer pain treatment,and the observation group was in cancer.On the basis of conventional treatment of pain,combined with traditional Chinese medicine preparations of Jiedu Dingtong Recipe orally.Observed the NRS pain score,KPS functional status score,burst pain frequency,quality of life score,complication rate,analgesic effect,and the clinical efficacy evaluation of the serumβ-EP,PGE2,5-HT,and NPY levels before and after treatment in the two groups.Results:The overall effective rate was 94.12%in the treatment group and 80.39%in the controlled group.The difference between the two groups was statistically significant(P<0.05);the observation group’s NRS pain score,burst pain frequency,complication rate and PGE2,5-HT and NPY levels were significantly lower than those of the controlled group(P<0.05).The KPS function status score,quality of life score and serumβ-EP level of the observation group were significantly higher than those of the controlled group(P<0.05).Conclusion:The use of Jiedu Dingtong Recipe in the treatment of patients with bone metastases with radioactive pain,fever and toxin accumulation syndrome can significantly reduce the frequency of outbreak pain,reduce the incidence of complications,reduce the level of serum pain mediators,and improve the quality of life of patients.