离子导入祛毒镇痛贴中医外治联合盐酸羟考酮缓释片治疗胃癌晚期癌性疼痛的临床观察

Clinical observation of iontophoresis Qudu Analgesic Paste Chinese medicine combined with oxycodone hydrochloride sustained-release tablets in the treatment of advanced gastric cancer pain

目的探讨离子导入祛毒镇痛贴中医外治联合盐酸羟考酮缓释片(奥施康定)治疗胃癌晚期癌性疼痛的临床观察。方法选取2013年2月～2016年2月晚期胃癌中重度癌痛患者80例,将其随机分为治疗组和对照组各40例。治疗组给予离子导入祛毒镇痛贴,对照组给予安慰剂外用帖,两组均采用三阶梯止痛疗法,根据患者疼痛情况滴定盐酸羟考酮缓释片剂量,每日每个部位1帖,连续观察14d,采用χ对两组患者治疗前后疼痛疗效、盐酸羟考酮缓释片剂量的增减及生活质量评分进行分析。结果治疗组缓解率为82.50%,对照组缓解率为57.50%,两组差异有统计学意义(P=0.015);治疗组盐酸羟考酮缓释片用药剂量增加率为27.50%,对照组奥施康定用药剂量增加率为67.50%,两组差异有统计学意义(P=0.001);对照组KPS改善率为17.50%,治疗组KPS改善率为40.00%,两组KPS改善率比较,差异有统计学意义(P=0.047);治疗过程中两组患者均未出现严重不良反应。结论离子导入祛毒镇痛贴中医外治联合羟考酮缓释片治疗胃癌晚期癌性疼痛可明显增加癌痛控制效果,减轻羟考酮缓释片的使用剂量,显著提高癌痛患者的生活质量。

Objective To explore the clinical observation of iontophoresis Qudu Analgesic Paste combined with Oxycodone Hydrochloride Sustained Release Tablets (Oxycontin) in the treatment of advanced cancer pain of gastric cancer. Methods From February 2013 to February 2016,80 patients with moderate or severe cancer pain in advanced gastric cancer were enrolled and randomly divided into treatment group and control group with 40 cases in each group.The treatment group was treated with iontophoresis Qudu Analgesic Paste and the control group was treated with placebo external application Paste,both groups were treated with three-step analgesic therapy.According to the patient's pain,the amount of oxycodone hydrochloride sustained-release tablets was titrated,and one tablet per part of the day was observed for 14 consecutive days.The Chi-square test was used to analyze the pain efficacy,dosage increase and decrease of oxycodone hydrochloride sustained-release tablets and quality of life score of the two groups before and after treatment. Results The remission rate was 82.50% in the treatment group and 57.50% in the control group.The difference between the two groups was statistically significant (P=0.015);The dosage increase rate of oxycodone hydrochloride sustained-release tablets in treatment group was 27.50%,and that of Oxkandin in control group was 67.50%.There was significant difference between the two groups (P=0.001);The KPS improvement rate was 17.50% in the control group and 40.00% in the treatment group,and the KPS improvement rate was statistically significant (P=0.047);There were no adverse reactions occurred in either group during the treatmen. Conclusion Treatment of advanced cancer pain of gastric cancer with iontophoresis Qudu Analgesic Patch combined with Oxycodone Sustained Release Tablets can significantly increase the control effect of cancer pain,redue the dosage of oxycodone sustained-release tablets significantly improves the quality of life of patients with cancer pain,reduce dosage of oxycodone sustained-release tablets,and Improve the quality of life of cancer patients.