身痛逐瘀汤联合针刺四关穴对中重度癌痛的疗效及β内啡肽的影响

Study on Effect of Shentong Zhuyu Decoction Combined with Acupuncture at Siguan Points in Treatment of moderateand Severe Cancer Pain and Its Influence on Serum β Endorphin

目的:探讨身痛逐瘀汤联合针刺四关穴对中重度癌痛患者的疗效及β内啡肽的影响。方法:将中重度癌痛患者124例,随机分两组,各62例,对照组采用三级止痛治疗,在此基础上,观察组采用身痛逐瘀汤联合针刺四关穴治疗,治疗1周为1个疗程。比较两组患者临床疗效、视觉模拟评分法(Visual analogue scale,VAS)、卡氏评分(Karnofsky,KPS)、Barthel指数(the Barthelindex of ADL,BI)及血β内啡肽(β-endorphin,β-EP)、P物质(Substance P,SP)水平,记录不良反应。结果:对照组有效率79.03%低于观察组91.94%,差异具有统计学意义(P<0.05)。治疗后对照组和观察组VAS评分为(1.24±0.61)、(0.71±0.52),KPS评分为(79.32±10.01)、(86.37±8.65),BI指数为(56.17±10.58)、(64.35±9.30),血β-EP为(50.12±8.42)ng/L、(57.74±9.10)ng/L,血SP为(57.61±18.65)ng/L、(45.82±17.32)ng/L,对照组和观察组上述指标比较,差异具有统计学意义(P<0.05)。两组患者不良反应率比较,差异无统计学意义(P>0.05)。结论:身痛逐瘀汤联合针刺四关穴对中重度癌痛患者的疗效显著,有助于改善疼痛和生存质量,改善血β内啡肽、P物质水平,且患者可以耐受。

Objective: To investigate the effect of Shentong Zhuyu Decoction combined with acupuncture at Siguan points in the treatment of patients with moderate and severe cancer pain on the serum β endorphin. Methods:A total of 124 patients with moderate and severe cancer pain were randomly divided into two groups, 62 cases in each. The control group received three-stage analgesia and the observation group additionally received Shentong Zhuyu Decoction combined with acupuncture at Siguan points, and two groups were treated for one week. The clinical efficacy, visual analogue scale(VAS), Karnofsky score(KPS), the Barthelindex of ADL(BI), blood beta-endorphin(β-EP) and substance P(SP) levels were compared between two groupsand adverse reactions were recorded. Results: The effective rate of the control group(79.03%) was lower than the observation group's(91.94%) and the difference was statistically significant(P<0.05). After treatment, the VAS scores of control group and observation group were 1.24±0.61 and 0.71±0.52, KPS scores were 79.32±10.01 and 86.37±8.65, BI indexes were 56.17±10.58 and 64.35±9.30, blood β-EP were(50.12±8.42)ng/L and(57.74±9.10)ng/L, and blood SP were(57.61±18.65)ng/L and(45.82±17.32)ng/L and the difference between the control group and the observation group were statistically significant(P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05). Conclusion: Shentong Zhuyu Decoction combined with acupuncture at Siguan points in the treatment of patients with moderate and severe cancer pain was significant effective, which is helpful to improve pain and quality of life, blood β-endorphin and substance P levels, and can be tolerated by patients.