吗啡滴定联合中医方法治疗晚期癌因性疲乏

Study of Morphine Dosage Titration and Traditional Chinese Medical Methods Treating Cancer Related Fatigue of Patients with Advanced Cancer

目的:研究应用吗啡滴定联合中医方法治疗中重度疼痛晚期癌症患者的癌因性疲乏CRF的临床疗效。方法:从2011年1月—2013年3月,选择39例在本院住院部接受治疗的有中重度疼痛表现的晚期癌症患者,行吗啡滴定和中医方法治疗。治疗前和治疗3周后评价CRF程度、疼痛强度、睡眠质量及吗啡的不良反应等指标。结果:治疗3周后,CRF程度较治疗前显著减轻,疼痛强度显著减弱,睡眠质量显著提高(P<0.01)。吗啡的不良反应得到有效控制。治疗前,CRF程度等级和疼痛强度等级呈正相关(P<0.05),CRF程度分值和匹兹堡睡眠质量指数分值呈正相关(P<0.05)。结论:吗啡滴定联合中医方法能有效治疗中重度疼痛晚期癌症患者的CRF,而且安全性也较高。减弱疼痛强度、提高睡眠质量可能是吗啡滴定联合中医方法治疗CRF的部分作用机制。

Objective：To study the effect of morphine dosage titration and traditional Chinese medical methods treating the cancer related fatigue（CRF） of patients in advanced cancer stage with middle -severe cancer pain. Methods：From January 2011 to March 2013,39 patients with advanced cancer in our hospital were selected and treated by morphine dosage titration and tradi- tional Chinese medical methods. Before the treatments and after three - week treatments, CRF, pain, sleep and adverse effects of morphine were evaluated. Results ： After three - week treatment, the CRF and pain of the patients became lighter（ P 〈 0. 01 ） , and the sleep became better（P 〈0. 01 ）. All the adverse effects were controlled effectively. Before the treatment,the CRF degree was related with the pain and Pittsburgh Sleep Quality Index（ P 〈 O. 05 ）. Conclusion：Morphine dosage titration and traditional Chinese medical methods can treat the CRF of patients in advanced cancer stage with middle - severe cancer pain effectively and safely. Some of the mechanisms may be that these methods can reduce pain and improve sleeo.