针刺足三里、太冲、合谷穴配合三阶梯止痛治疗胃癌痛临床观察

Clinical Study on Acupuncture at Zusanli,Taichong and Hegu Points Combined with Three-step Analgesic Ladder for Treatment of Gastric Cancer Pain

【目的】观察针刺足三里、太冲、合谷穴配合世界卫生组织(WHO)三阶梯止痛法治疗胃癌癌性疼痛(简称胃癌痛)的疗效及安全性,为临床上治疗胃癌痛提供一种安全有效的治疗方案。【方法】将60例中重度胃癌痛患者随机分为治疗组和对照组各30例。治疗组采用针刺足三里、太冲、合谷穴配合WHO三阶梯止痛法治疗,对照组仅釆用WHO三阶梯止痛法治疗,2组均以7 d为1个疗程。1个疗程后釆用癌痛数字分级法(NRS)、生活质量量表[QOL-BREF(WHO)]、抑郁自评量表(SDS)来评价2组患者疗效,并比较2组患者的不良反应发生率。【结果】(1)治疗后,治疗组的止痛显效率明显高于对照组,差异有统计学意义(P<0.05)。(2)治疗后,2组患者的生活质量均较治疗前明显改善(P<0.05),且治疗组的改善作用优于对照组,差异有统计学意义(P<0.05)。(3)治疗后,2组患者的抑郁评分均较治疗前明显改善(P<0.05);但治疗后2组比较,差异无统计学意义(P>0.05)。(4)治疗组的药物不良反应发生率较对照组低,差异有统计学意义(P<0.05)。【结论】针刺足三里、太冲、合谷穴配合三阶梯止痛法治疗胃癌痛的效果明显优于单用三阶梯止痛法。

Objective To investigate the clinical effectiveness and safety of acupuncture at Zusanli （ST36）, Taichong（ LR3 ） and Hegu（LI4） points combined with three-step analgesic ladder for the treatment of gastric cancer pain. Methods Sixty patients with moderate and severe pain induced by gastric cancer were randomly divided into study group and control group, 30 cases in each group. The study group was treated with acupuncture at Zusanli, Taichong and Hegu points combined with three-step analgesic ladder for gastric cancer pain management, and the control group was treated with three-step analgesic ladder only. After treatment for 7 days, the clinical effectiveness was evaluated with the average pain scores of Numerical Rating Scale（NRS）, Quality of Life Scale （QOL-BREF by WHO）, Self-rating Depression Scale（ SDS ）. And the incidence of adverse reaction was also observed. Results （ 1 ） After treatment, the markedly-effective analgesic rate of the study group was higher than that of the control group （P 〈 0.05）. （2） After treatment, QOL scores of both groups were nmch improved as compared with those before treatment（P 〈 0.05） , and the improvement of the study group was superior to that of the control group（P 〈 0.05）. （3） The depression scores of both groups were much improved after treatment （P 〈 0.05 compared with those before treatment）, but the difference between the two groups was insignificant （P 〉 0.05）. （4） The incidence of adverse reaction of the study group was lower than that of the control group（P 〈 0.05） . Conclusion The effect of acupuncture at Zusanli, Taichong and Hegu points combined with three-step analgesic ladder is better than three-step analgesic ladder alone for the treatment of gastric cancer pain.