口服镇痛药联合星状神经节阻滞与直线偏振光照射治疗肺癌晚期疼痛的疗效

Efficacy of oral analgesics combined with stellate ganglion block and polarized light irradiation in the treatment of advanced lung cancer pain

目的观察口服镇痛药联合星状神经节阻滞与偏振光照射治疗肺癌晚期疼痛的疗效。方法肺癌晚期疼痛患者112例，随机分为药物组及阻滞组。药物组给予口服塞来昔布胶囊和盐酸羟考酮缓释片治疗，阻滞组在此用药基础上增加星状神经节阻滞与偏振光照射。两组均根据疼痛缓解情况调整盐酸羟考酮缓释片的剂量，直至将疼痛缓解至患者满意的程度。15d后比较两组患者镇痛效果、生活质量的变化及不良反应发生率。结果治疗后15d药物组镇痛总有效率（84．6％，44／52例）低于阻滞组（98．3％，59／60例）。阻滞组盐酸羟考酮缓释片的日平均用量（60±20）mg明显少于药物组（120±60）mg。阻滞组NRS0-3的例数（54例）明显高于药物组（34例）。阻滞组的不良反应发生率显著低于药物组。结论星状神经节阻滞与偏振光照射能增强羟考酮治疗肺癌晚期疼痛的镇痛效果、减少羟考酮用量、改善患者的生活质量，降低其不良反应发生率。

Objective To evaluate the effect of oral analgesics combined with stellate ganglion block and polarized light irradiation in the treatment of advanced lung cancer pain. Methods One hundred and twelve patients with advanced lung cancer pain were randomly divided into oral drug group and block group. Celecoxib capsules and oxycodone hydrochloride were given to the patients of oral drug group and addition of stellatc ganglion block and polarized light irradiation therapy to the patients of block group. The doses of oxycodone hydrochloride were adjusted according to the pain level, until all patients were satisfied. NRS, quality of life, dosage of oxycodone hydrochloride and adverse reactions were observed every day. Results The total effective rate （84.6%, 44/52 cases） in drug group was lower than that in block group （98.3%, 59/60） at 15 d after the treatment. The average daily dosage （60 ± 20） mg of oxycodone hydrochloride in block group was significantly less than that in the drug group （ 120 ± 60）mg. The NRS 0-3 cases （54 cases） in block group were significantly higher than that in drug group （34 cases）. The quality of life in the two groups was significantly improved after the treatment, and it was significantly better in block group than that in drug group. The incidence of adverse reactions in block group was significantly lower than in drug group. Conclusion Stellate ganglion block and polarized light irradiation can enhance the analgesic effect of oxycodone in the treatment of advanced lung cancer pain, reduce the dosage of oxycodone, improve the quality of life of patients, and reduce the incidence of adverse reactions.