加味芍药甘草汤联合阿片类止痛药物治疗中重度癌性疼痛临床研究

Clinical Study on Modified Shaoyao Gancao Tang Combined with Opioid Analgesics for Moderate-to-Severe Cancer Pain

目的:观察加味芍药甘草汤联合阿片类止痛药物治疗中重度癌性疼痛的镇痛效果及对患者生活质量的影响。方法:选取68例中重度癌性疼痛患者,以随机数字表法分为对照组与试验组各34例。对照组给予羟考酮缓释片治疗,试验组在对照组基础上给予加味芍药甘草汤治疗。比较2组疼痛缓解情况、疼痛程度、爆发痛发作次数、盐酸吗啡片解救爆发痛剂量、生活质量、不良反应及疼痛控制满意率。结果:试验组疼痛缓解率85.29%,高于对照组61.76%(P<0.05)。与同组治疗第1天比较,2组治疗第3天、7天、10天、14天疼痛数字评分法(NRS)评分均降低(P<0.05);与对照组治疗第3天、7天、10天、14天比较,试验组同期NRS评分均较低(P<0.05)。与同组治疗第1周比较,2组治疗第2周爆发痛发作次数、盐酸吗啡片解救爆发痛剂量减少(P<0.05);与对照组治疗第2周比较,试验组治疗第2周爆发痛发作次数、盐酸吗啡片解救爆发痛剂量均较少(P<0.05)。与同组治疗前比较,2组治疗后晚期癌症患者生活质量量表EORTC QLQ-C15-PAL评分均降低(P<0.05);与对照组治疗后比较,试验组治疗后EORTC QLQ-C15-PAL评分均较低(P<0.05)。试验组治疗期间药物不良反应发生率17.65%,低于对照组41.18%(P<0.05)。试验组疼痛控制满意率94.12%,高于对照组73.53%(P<0.05)。结论:加味芍药甘草汤联合阿片类止痛药物治疗中重度癌性疼痛可提高疼痛缓解率,有效减轻疼痛程度,减少爆发痛发作次数及盐酸吗啡片解救爆发痛剂量,降低不良反应,从而提升患者的生活质量及对疼痛控制满意率。

Objective:To observe the analgesic effect of the therapy of modified Shaoyao Gancao tang combined with opioid analgesics on moderate-to-severe cancer pain and its effect on the quality of life of patients.Methods:A total of 68 cases of patients with moderate-to-severe cancer pain were divided into the control group and the experiment group according to the random number table method,with 34 cases in each group.The control group was treated with oxycodone sustained-release tablets,and the experiment group was additionally treated with modified Shaoyao Gancao tang based on the treatment of the control group.The pain relief,degree of pain,frequency of pain flares,dose of morphine hydrochloride tablets for pain flares,quality of life,adverse reactions and the satisfaction rate of pain control in the two groups were compared.Results:The pain relief rate was 85.29%in the experiment group,higher than that of 61.76%in the control group(P<0.05).After treatment,the numeric rating scale(NRS)scores in the two groups were decreased on the 3rd,7th,10th and 14th days of treatment when compared with those on the first day of treatment(P<0.05);the NRS scores on the 3rd,7th,10th and 14th days of treatment in the experiment group were lower than those in the control group at the same time(P<0.05).Compared with the first week of treatment,the frequency of pain flares and dose of morphine hydrochloride tablets for pain flares in the second week of treatment in the two groups was reduced(P<0.05);the above indexes in the experiment group in the second week of treatment were lower than those in the control group(P<0.05).After treatment,the EORTC QLQC15-PAL scores of patients with advanced cancer in both groups were decreased when compared with those before treatment(P<0.05);after treatment,the above score in the experiment group was lower than that in the control group after treatment(P<0.05).The incidence of adverse reactions during treatment was 17.65%in the experiment group,lower than that of 41.18%in the control group(P<0.05).The satisfaction rate of pain control was 94.12%in the experiment group,higher than that of 73.53%in the control group(P<0.05).Conclusion:The therapy of modified Shaoyao Gancao tang combined with opioid analgesics for moderate-and-severe cancer pain can improve the rate of pain relief and effectively reduce the degree of pain,frequency of pain flares of pain,dose of morphine hydrochloride tablets for pain flares and adverse reactions,so as to improve the quality of life of patients and satisfaction rate of pain control.