定痛方联合三阶梯止痛治疗肺癌疼痛临床研究

Clinical Study on Dingtong Decoction Combined with Three-step Analgesic Method in Treatment of Lung Cancer Pain

目的:观察定痛方联合三阶梯止痛治疗肺癌患者癌性疼痛的临床疗效及对生存质量和凝血功能的影响。方法:将80例肺癌患者随机分为对照组和治疗组,每组40例。对照组予以三阶梯止痛治疗,治疗组予以定痛方治疗,每日1剂,西药治疗同对照组。两组均以4周为1个治疗周期,观察治疗后两组患者疼痛控制情况、生存质量及凝血指标。结果:治疗后两组患者疼痛数字评价量表(numerical rating scale,NRS)评分均呈现进行性的下降,与治疗前比较,差异有统计学意义(P<0.05);治疗组NRS评分下降较对照组更明显,差异有统计学意义(P<0.05)。治疗后对照组疼痛缓解有效率为82.5%,治疗组为95.0%,两组比较,差异有统计学意义(P<0.05)。两组开始治疗之后,疼痛强度差均随着时间逐渐增大,与治疗前比较,差异有统计学意义(P<0.05)。治疗组患者生存质量改善情况优于对照组,差异有统计学意义(P<0.05)。治疗后,治疗组凝血酶原时间、活化部分凝血活酶时间、血浆纤维蛋白原、血小板及D-二聚体水平明显低于对照组,差异有统计学意义(P<0.05),两组凝血酶时间比较,差异无统计学意义(P>0.05)。结论:定痛方联合三阶梯止痛治疗血瘀痰结型肺癌患者癌性疼痛疗效满意,且能改善肺癌患者凝血功能紊乱,改善生存质量。

Objective： To observe the effect on the quality of life and coagulation function of patients with lung cancer treated by Dingtong Decoction and three-step analgesia. Methods： A total of 80 patients with lung cancer were randomly divided into two groups. Forty patients in the control group were treated with three steps analgesia. The treatment group（ 40 cases） was treated with Dingtong Decoction,once day in addition. After 4 weeks treatment,observe pain control,quality of life and coagulation index of both groups. Results： After the treatment,the scores of the pain numerical rating scales of both groups showed a progressive decrease,and the difference was statistically significant（ P〈0. 05）. The NRS score of the treatment group decreased more compared with that of the control group（ P〈0. 05）. The effective rate of pain relief was 82. 5% in the control group and 95. 0% in the treatment group（ P〈0. 05）. The pain intensity difference gradually increased with time,compared with before treatment,the difference was statistically significant（ P〈0. 05）. The improvement of the quality of life of the treatment group was better than that of the control group（ P〈0. 05）. After treatment,the levels of prothrombin time,activated partial thromboplastin time,plasma fibrinogen,platelet and D-dimer in the treatment group were significantly lower than those in the control group（ P〈0. 05） There was no significant difference in enzyme time（ P〈0. 05）. Conclusion： Dingtong Decoction combined with three-step analgesic treatment is satisfactory for the treatment of cancer pain in patients with lung cancer of blood stasis and phlegm obstruction syndrome,and can improve coagulation dysfunction and improve patients＇ quality of life.