消积镇痛膏贴敷治疗重度癌性疼痛临床疗效观察

The clinical effect observation of the treatment for severe cancer pain by acupoint application of nodule-eliminating and pain-easing paste

目的观察消积镇痛膏贴敷治疗重度癌性疼痛的临床疗效。方法将纳入重度癌痛患者52例分为对照组和治疗组,每组26例,两组均予以最佳支持治疗为基础治疗,对照组予以癌痛规范化治疗,治疗组予以癌痛规范化治疗联合消积镇痛膏阿是穴贴敷治疗。贴敷位置选择以阿是穴(疼痛点)为中心,每日1贴,敷药时间为6h,观察期为7d。在治疗开始前及治疗结束后观察并记录两组患者疼痛程度分级、止痛起效时间和持续时间、生活质量评分(QOL)以及有无不良反应。结果对照组总有效率为73.1%,显效率为30.8%;治疗组总有效率为84.6%,显效率57.7%,两组总有效率比较差异无统计学意义(P>0.05),治疗组显效率高于对照组,差异有统计学意义(P<0.05)。对照组止痛起效时间为(66.15±9.09)min,治疗组止痛起效时间为(59.19±7.20)min,治疗组止痛起效时间较对照组略有优势(P<0.05);对照组止痛持续时间为(10.21±1.89)h,治疗组止痛持续时间为(12.19±2.05)h,治疗组持续时间较对照组持续时间延长(P<0.01)。两组治疗前QOL评分比较差异无统计学意义(P>0.05);治疗组治疗后QOL评分高于对照组,差异有统计学意义(P<0.05);治疗后两组QOL评分较治疗前均有明显提高(P<0.01)。在治疗过程中,对照组出现13例不良反应,其中恶心/呕吐4例,头晕3例,便秘6例,发生率为50.0%;治疗组出现6例不良反应,其中恶心/呕吐2例,头晕1例,便秘3例,发生率为23.1%,两组患者均未出现明显皮肤反应,如皮疹、水疱等现象。治疗组不良反应发生率低于对照组,差异有统计学意义(P<0.05)。结论在癌痛规范化治疗基础上,联合消积镇痛膏阿是穴贴敷治疗,不仅能够有效控制疼痛,而且能够提高患者QOL评分,改善肿瘤患者生活质量,可以作为癌痛综合治疗的一部分,值得在临床进一步推广。

Objective To observe the clinical effect of the paste which can eliminate nodules and ease pain to treat severe cancer pain by attach ashi acupuncture point.Methods 52 patients with severe cancer pain were divided equally into control group and treatment group.Both groups were given the best supportive care for foundation treatment.Patients in the control group were treated by the standardized treatment on cancer pain.Beyond that,patients in the treatment group were combined with attaching Ashi acupuncture point by using the paste which can eliminate nodules and ease pain.The choice of attach location was centered on the Ashi acupuncture point.The frequency was daily 1piece and the medication time was 6hours,the observation period was 7days.Before and after treatment,these indexes were observed and recorded,including the degree of pain,the taking-effect time and continuous control pain time,the quality of life score（QOL）,and the presence of adverse reactions.Results There was no significant difference in gender,age,tumor stage and pain in the treatment group and control group（P〉0.05）.After treatment,the total effective rate was 73.1% and the effective rate was 30.8%in the control group,the total effective rate was 84.6% and the effective rate was 57.7%in the treatment group,and the chi square test was not significantly different in the total effective rate（P〉0.05）,there were significant differences between the two groups in the effective rate（P〈0.05）.The taking-effect time of the control group and the treatment group were（66.15±9.09）min and（59.19±7.20）min,respectively.The taking-effect time of the treatment group was slightly superior to the control group（P〈0.05）.The continuous control pain time of the control group was（10.21±1.89）h,the treatment group was（12.19±2.05）h,there were significant differences between the two groups in the continuous control pain time（P〈0.01）.There was no significant difference in QOL score between the two groups before treatment（P 0.05）.After treatment,there were statistically significant differences in QOL score（P〉0.05）.After treatment,QOL score of the two groups were significantly improved compared with before treatment（P〈0.01）.There were 13 cases of adverse reactions in the control group,including nausea/vomiting in 4cases,dizziness in 3cases,constipation in 6cases,the incidence rate was 50%;there were 6cases of adverse reactions in the treatment group,including nausea/vomiting in 2cases,dizziness in 1cases,constipation in 3cases,the incidence rate was23.1%.The obvious skin reactions were not found in the two groups of patients,such as rash,blisters and other phenomena.The incidence of adverse reactions in the treatment group was lower than that in the control group（P 0.05）.Conclusion Through clinical observation of using Ashi acupuncture point paste to treat severe cancer pain,it′s been found out that based on regulation treatment.Ashi acupuncture point paste not only effectively repressed pain,but also increased QOL score and improve the quality of life of patients with tumor.It＇s an additional treatment of terminal cancer and can ease the suffering of patient to some extent.It can reduce the pain of patients in some extent.