加味活络效灵丹治疗晚期癌性疼痛的临床效果观察

Clinical effect observation of Jiawei Huoluoxiaolingdan in the treatment of advanced cancer pain

目的探讨加味活络效灵丹对晚期癌性疼痛患者疼痛情况及血清P物质(SP)、β-内啡肽(β-EP)、前列腺素E_(2)(PGE_(2))水平的影响。方法将2019年3月至2021年2月于阳江市中医医院收治的60例晚期癌性疼痛患者,按照随机数字表法分为对照组(30例,给予盐酸羟考酮缓释片,并视情况加用即释吗啡片治疗)和观察组(30例,在对照组的基础上联合加味活络效灵丹治疗),两组均给予2周治疗。比较两组患者治疗后的临床疗效,治疗前后血清疼痛因子水平、简明疼痛评估量表(BPI)及生活质量水平。结果治疗后,观察组患者的临床疼痛总缓解率为86.67%,高于对照组的63.33%;相比于治疗前,治疗后两组患者血清SP、PGE_(2)水平及BPI评分(疼痛最剧程度、疼痛最轻程度、平均疼痛程度、目前疼痛程度)均降低,且观察组低于对照组,而血清β-EP水平及生活质量评分(家庭的理解与配合、同事的理解与配合、精神状态、睡眠情况、日常生活、面部表情、疲乏程度、疼痛程度、自身对癌症的认识、饮食情况、对治疗的态度)均升高,且观察组高于对照组(均P<0.05)。结论加味活络效灵丹能够有效地缓解晚期癌性疼痛患者临床症状,抑制疼痛介质的分泌,减轻患者的疼痛,提高患者生活质量水平,提高临床疗效。

Objective To explore the effect of Jiawei Huoluoxiaolingdan on the pain and serum substance P(SP), β-endorphin(β-EP)and prostaglandin E_(2)(PGE_(2)) levels in patients with advanced cancer pain. Methods A total of 60 patients with advanced cancer pain who were admitted to Yangjiang Hospital of Traditional Chinese Medicine from March 2019 to February 2021 were divided into the control group(30 cases, given Oxycodone hydrochloride sustained-release tablets, and combined with Instant-release Morphine depending on the situation) and the observation group(30 cases, combined with Jiawei Huoluoxiaolingdan on the basis of the control group) according to the random number table, both groups were given 2 weeks of treatment. The clinical effects of patients in the two groups after treatment were compared, the serum pain mediator levels, the score of brief pain assessment scale(BPI) and the level of quality of life before and after treatment of patients in the two groups were compared. Results After treatment, the total clinical pain relief rate of patients in the observation group was 86.67%, which was higher than that 63.33% of patients in the control group;compared with before treatment, the serum SP, PGE_(2) levels and BPI scores(the most severe degree of pain, the least pain degree, the average pain degree, the current pain degree) of patients in the two groups after treatment reduced, and the observation group was lower than the control group, while the serum β-EP level and quality of life score(family understanding and cooperation, colleague’s understanding and cooperation, mental state, sleep status, daily life, facial expression, fatigue level, pain level, own understanding of cancer, dietary status, treatment attitudes) increased, and the observation group was higher than the control group(all P< 0.05). Conclusion Jiawei Huoluoxiaolingdan can effectively relieve the clinical symptoms of patients with advanced cancer pain, inhibit the secretion of pain mediators, reduce the pain of patients, improve the quality of life, and improve clinical efficacy.