外用蟾龙镇痛膏对中度癌痛患者止痛作用的临床研究

A clinical study on the analgesic eff ect of Chanlong Zhentong Ointment on the patients with moderate cancer pain

目的观察蟾龙镇痛膏局部外敷联合盐酸曲马多缓释片对中度癌性疼痛的临床疗效及其作用机制。方法患者随机分为治疗组与对照组,各30例。2组患者均口服盐酸曲马多缓释片,治疗组局部外敷蟾龙镇痛膏,对照组外用空白膏药。2个疗程后,观察患者疼痛强度评分(NRS)、疼痛缓解率、口服药物起效时间、起效剂量及维持剂量、Karnofsky(KPS)评分及不良反应情况,测定血清中IL-1β、IL-6、TNF-α炎症因子水平。结果与对照组相比,治疗组NRS评分明显降低,疼痛缓解率升高,盐酸曲马多缓释片维持剂量明显降低,KPS评分显著提高,血清中IL-1β、IL-6、TNF-α水平均明显降低(均P<0.05),且未出现严重不良反应。结论外用蟾龙镇痛膏能够有效改善中度癌痛患者炎症因子水平,降低口服药物维持剂量,提高止痛效果,改善生活质量,且副作用较小,具有较高的临床应用价值。

Objective To observe the clinical effi cacy and mechanism of the local external application of Chanlong Zhentong Ointment combined with the tramadol hydrochloride sustained-release tablets in the treatment of moderate cancer pain.Methods The patients were randomly divided into treatment group and control group,with 30 cases in each group.Both groups took the tramadol hydrochloride sustained-release tablets orally,while the treatment group was applied locally with Chanlong Zhentong Ointment,and the control group with blank plaster.After two courses of treatment,the pain intensity score(NRS),pain relief rate,onset time,onset dose and maintenance dose of the oral drug,Karnofsky(KPS)score and adverse reactions were observed,and the levels of IL-1,IL-6 and TNF-αin serum were measured.Results Compared with the control group,the NRS score of the treatment group was signifi cantly reduced,the pain relief rate was increased,the maintenance dose of the tramadol hydrochloride sustained-release tablets was significantly reduced,the KPS score was significantly increased,and the serum levels of IL-1β,IL-6,and TNF-αwere signifi cantly reduced(all P<0.05),and no serious adverse reactions occurred.Conclusion The local external application of Chanlong Zhentong Ointment can effectively improve the level of inflammatory factors in patients with moderate cancer pain,reduce the maintenance dose of oral drugs,improve the analgesic eff ect,improve the quality of life,and has less side eff ects,which has high clinical application value.