癌痛与中医针灸治疗的分经论治临床应用举隅

Clinical Application of Treatment of Cancer Pain and TCM Acupuncture and Moxibustion Therapy

据统计,每年全球新增的癌症病人中,中国癌症病人的比例占1/5,其中大约有一半的病人每天都遭受着癌痛的折磨,30%-45%忍受着中到重度的疼痛。癌痛的原因主要有三点:一是癌症本身引起癌痛,这种最常见,由于肿瘤侵犯或压迫神经组织,侵犯骨骼,或侵及胃、肠等空腔脏器,或肝、肾等实体器官的管道造成梗阻,血管阻塞或受侵,黏膜受侵或溃疡,颅内压升高等。二是与肿瘤相关的疼痛,不是肿瘤直接引起,但是与肿瘤的发生与发展有着明显的相关性,如由于恶病质等因素造成活动障碍引起的疼痛、褥疮、肌痉挛、便秘等。三是与治疗有关的疼痛,由一些有创性诊断及治疗措施,如骨髓穿刺、病理活检、腰椎穿刺等操作引起的疼痛;手术所致的瘢痕痛、神经损伤、幻肢痛;化疗引起的神经病变、栓塞性静脉炎、口腔黏膜炎等。在癌痛的处理上,无非是药物治疗与非药物治疗。非药物治疗中我们首推针灸治疗,其具有简、便、廉、验等特点。

According to statistics,the proportion of new cancer patients in the world each year is 1/5.About half of them suffer from cancer pain every day,and 30%-45% suffer from moderate to severe pain.There are three main causes of cancer pain:first,cancer itself causes cancer pain,which is the most common,because the tumor invades or oppresses nerve tissue,invades bone,or invades the stomach,intestine and other empty organs,or the duets of liver,kidney and other solid organs,resulting in obstruction,vascular obstruction or invasion,mucosal invasion or ulcer,intracranial hypertension and so on.Secondly,pain related to tumors is not caused cdirectly by tumors,but has a clear correlation with the ocicurrence and development of tumors,such as pain,bedsore,muscle spasm,constipation caused by cachexia and other factors.Third,pain related to treatment is caused by some invasive diagnostic and therapeutic measures,such as pain caused by bone marrow puncture,pathological biopsy,lumbar puncture,scar pain caused by surgery,nerve injury,phantom limb pain,neuropathy caused by chemotherapy,embolic phlebitis,oral mucositis,etc.In the treatment of cancer pain,there are no more than drug treatment and non-drug treatment.Acupuncture and moxibustion therapy is the first choice in non-drug treatment,which is simple,convenient,inexpensive and experimental.