益肾骨康方联合奥施康定治疗中重度癌性躯体痛的有效性及安全性的临床观察

Effect and Safety of Yishen Gukang Decoction Combined with Oxycontin in Treating Cancer Somatic Pain

目的：观察益肾骨康方联合奥施康定（盐酸羟考酮缓释片）治疗癌性躯体痛患者的临床疗效及安全性。方法：本临床观察采用随机、对照、双盲的研究方法,将2015年1月至2017年5月就诊于望京医院肿瘤科符合纳入标准的100例中重度癌性躯体痛患者,随机分为治疗组和对照组,各50例,两组患者第1周给予奥施康定,第2周治疗组给予奥施康定加益肾骨康方汤剂,对照组给予奥施康定加安慰剂,每日1剂,分2次口服,连续治疗7 d,通过观察两组疗效、治疗前后体力状况（KPS）评分、奥施康定用量及不良反应发生情况,评价益肾骨康方治疗癌性躯体痛的临床疗效及安全性。结果：治疗后,益肾骨康方治疗组总有效率为94%,显效率为70%,对照组总有效率为88%,显效率为40%,治疗组疗效优于对照组（P〈0.01）,且治疗组在缓解中度疼痛疗效方面优于对照组（P〈0.01）;治疗后两组KPS评分较本组治疗前均提高,且治疗组高于对照组（P〈0.05）,治疗期间在奥施康定用量方面,治疗组少于对照组（P〈0.05）,治疗组不良反应发生情况低于对照组（P〈0.05）。结论：益肾骨康方可降低中重度癌性躯体痛患者疼痛,提高患者体力状况评分,提高生活质量,减少奥施康定用量,且在一定程度上改善因大量使用阿片类药物的引起的不良反应。益肾骨康方治疗癌性躯体痛疗效确切,不良反应少,值得进一步临床推广及研究。

Objective： To observe the efficacy and safety of Yishen Gukang decoction combined with oxycontin in treating cancer patients with somatic pain. Method： A total of 100 patients with cancer somatic pain treated in Wangjing Hospital from January 2015 to May 2017 were randomly divided into treatment group and control group,with 50 cases in each group. In the first week,both groups were given oxycontin. In the second week,treatment group was additionally given Yishen Gukang decoction,while control group was given placebo.The therapeutic course lasted for 7 days. karnofsky（KPS） score,Karnofsky score,oxycontin dosage and the adverse reactions of the two groups were observed before and after treatment. Result： The total effective rate of treatment group was 94%,with an efficiency rate of 70%; and the total effective rate of control group was 88%,with an efficiency rate of 40%. The curative effect of treatment group was significantly better than that of control group（P〈0. 01）. Moreover, treatment group was better than control group in relieving moderate pain（P〈0. 01）. In Karnofsky score,oxycontin dosage and adverse reactions,treatment group was better than control group（P〈0. 05）. Conclusion： Yishen Gukang decoction can effectively reduce the scores of cancer somatic pain and the oxycontin dosage,and improved the quality of patients＇ life. It is worth of further clinical promotion and study.