中西医结合在治疗晚期结肠癌患者癌痛的应用研究

Application of integrated traditional Chinese and western medicine in the treatment of cancer pain in patients with advanced colon cancer

目的探讨中西医结合在治疗晚期结肠癌患者癌痛的应用研究。方法选择2009年12月至2017年12月,接受诊治的晚期结肠癌患者61例,根据入院时间分为两组2013年12月之前入院治疗的30例为对照组,2013年12月之后入院的31例为治疗组,对照组给予吗啡缓释片,治疗组在对照组的基础上给予中药汤剂。比较两组镇痛效果,疼痛评分,心理状态,生活质量。结果治疗组镇痛有效率为96.77%显著高于对照组(P<0.05)。与治疗前相比,两组在治疗后NRS评分及吗啡缓释片使用剂量明显下降(P<0.05);且治疗组显著低于对照组(P<0.05)。两组在治疗后1、3个月HRSD评分明显降低(P<0.05),同时治疗组治疗后1、3个月HRSD评分均明显低于对照组(P<0.05)。两组治疗后1、3个月KPS评分明显升高(P<0.05),而且治疗组在治疗后1、3个月的KPS评分显著高于对照组(P<0.05)。两组治疗后均出现恶心呕吐、头晕、便秘等不良反应,但对照组还出现嗜睡、乏力、厌食等不良反应。对照组不良反应总发生率为46.67%(14/30),治疗组不良反应总发生率为16.12%(5/31),两组比较差异具有统计学意义(χ2=6.629,P<0.05)。结论中西医联合可有效缓解患者晚期结肠癌患者的癌性疼痛,改善患者抑郁情绪,提高生存质量,减少不良反应的发生。

Objective To investigate the Application of integrated traditional Chinese and western medicine in the treatment of cancer pain in patients with advanced colon cancer. Methods From December 2009 to December 2017, 61 patients with advanced colon cancer treated in our hospital. According to the time of admission, 30 patients were treated before December 2013,considered as control group and 31 patients were admitted after December 2013 as treatment group. The control group was given morphine sustained-release tablets according to the principle of cancer pain three-step administration, while the treatment group was given traditional Chinese medicine decoction on the basis of the control group. The analgesic effect, pain score, psychological state, quality of life and hemoglobin content were compared between the two groups. Results The effective rate of analgesia in the treatment group was 96.77 % significantly higher than that in the control group （ P 〈0.05）. Compared with before treatment, the NRS scores and dosage of morphine sustained-release tablets of the two groups were significantly lower than those of the control group （ P 〈0.05）, and that of the treatment group were significantly lower than that of the control group （ P 〈0.05）. The HRSD scores of the two groups were significantly lower than those of the control group at 1 month and 3 months after treatment, while the HRSD scores in the treatment group were significantly lower than those in the control group at 1 month and 3 months after treatment （ P 〈0.05）. The KPS score of the two groups was significantly higher than that of the control group at 1 month and 3 months after treatment, and the KPS score in the treatment group was significantly higher than that in the control group at 1 month and 3 months after treatment （ P 〈0.05）. Adverse reactions such as nausea, vomiting, dizziness, constipation were found in both groups, but in the control group, somnolence, fatigue and anorexia were also found. The total incidence of adverse reactions in the control group was 46.67 % （14/30）, and that in the treatment group was 16.12 % （5/31）. The difference between the two groups was statistically significant （ χ 2 =6.629, P 〈0.05 ） . Conclusion The combination of traditional Chinese and western medicine can effectively treat the cancer pain of patients with advanced colon cancer, improve their depression, improve their quality of life and reduce the occurrence of adverse reactions.