复方苦参注射液联合唑来膦酸治疗恶性肿瘤骨转移临床观察

Clinical Observation of Compound Kushen Injection Combined with Zoledronic Acid in Treatment of Malignant Bone Metastasis

目的观察复方苦参注射液(岩舒)联合唑来膦酸治疗恶性肿瘤骨转移的临床疗效。方法选择2018年3月—2019年3月辽阳市中心医院和辽阳市第三人民医院肿瘤内科收治的恶性肿瘤骨转移患者70例。随机分为观察组和对照组,两组均采用唑来膦酸,观察组患者加用复方苦参注射液。观察两个组的疼痛缓解率、镇痛效果、镇痛药量、疼痛强度(NRS评分)、生存质量卡氏评分(KPS评分)、5项生活质量、碱性磷酸酶、血钙治疗前后疗效对比。结果与对照组相比,观察组镇痛药量明显减少(P <0. 05),观察组治疗疼痛缓解率比对照组明显增高(P <0. 05),NRS较对照组明显提高(P <0. 05),两组治疗后KPS评分变化无显著差异(P> 0. 05)。治疗后患者睡眠、社交、正常工作、行走能力和情绪5项生活质量评分比较,差异具有统计学意义(P <0. 05)。治疗组治疗后碱性磷酸酶、血钙水平较治疗前降低(P <0. 05)。但血钙水平与对照组比较,差异无统计学意义(P> 0. 05)。结论临床使用复方苦参注射液联合唑来膦酸治疗骨转移痛是有效治疗方式,能有效提高止痛效果,减少止痛药用量,提高患者生活质量,对改善肿瘤骨破坏具有协同作用的趋势。

Objective To observe the clinical effect of the combination of Compound Kushen Injection and zoledronic acid in the treatment of malignant bone metastasis.Methods Seventy patients with bone metastases of malignant tumor were selected form the department of oncology in Center Hospital of Liaoyang andThe Third People's Hospital of Liaoyang from March 2018 to March 2019 and were randomly divided into the observation group and the control group.Two groups were both treated by zoledronic acid,and the observation group was also treated by Compound Kushen Injection.Changes of the analgesic effects,the analgesic medicinal amount,numeric rating scales(NRS)and life quality scores(KPS)five assessments of QOL,the alkaline phosphataseand blood calcium of two groups were observed before and after treatment.Results Compared with the control group,the analgesic medicinal amount of the observation group reduced significantly(P<0.05),the pain relief rate of patients in observation group was significantly higher than that in control in control group(P<0.05),and NRS improved significantly(P<0.05).After treatment,KPS of two groups had no significant changes(P>0.05).All five assessments of QOL,including sleeping,social activity,work,ambulation and emotion life in both groups were improved after treatment(P<0.05).After treatment,the alkaline phosphatase and blood calcium level of the treatment group decreased significantly compared with that before treatment(P<0.05).While compared with the blood calcium level of control group,the blood calcium difference was not significant(P>0.05).Conclusion The combination of Kushen Injection and zoledronic acid is an effective therapy for bone metastasis malignant tumors.Kushen Injection can effectively improve the analgesic effect,reduce the analgesic medicinal amount,improve the patients'life quality and has a tendency of synergy in improving the bone destruction caused by tumor.