癌理通膏外敷配合强阿片类止痛药对癌性骨痛的临床疗效观察

Clinical efficacy and safety of Ailitong ointment combined with strong opioid analgesics for cancerous bone pain

目的 探讨癌理通膏外敷配合强阿片类止痛药对癌性骨痛的临床疗效及安全性。方法 选取2019年4月至2020年4月间上海市瑞金康复医院收治的78例癌性骨痛患者,采用随机数字表法分为联合组和常规组,每组39例。常规组患者采用盐酸羟考酮缓释片和硫酸吗啡控释片,联合组在此基础上采用癌理通膏外敷,比较两组患者的疼痛程度、疼痛缓解情况、药物起效时间、疗效持续时间、爆发疼痛次数、KPS评分及不良反应发生情况。结果 联合组患者疼痛缓解有效率为84.6%,高于常规组的61.5%,差异有统计学意义(P<0.05)。治疗前,两组患者疼痛程度比较,差异无统计学意义(P>0.05);治疗后,两组患者疼痛评分均降低,且联合组重度疼痛低于常规组,差异均有统计学意义(均P<0.05)。两组患者中度疼痛比较,差异无统计学意义(P>0.05)。联合组患者爆发痛次数低于对照组,疗效持续时间和睡眠增加时间均优于常规组,差异均有统计学意义(均P<0.05);两组患者药物起效时间比较,差异无统计学意义(P>0.05)。治疗前,两组患者KPS评分比较,差异无统计学意义(P>0.05)。治疗后,两组患者KPS评分均升高,且联合组高于常规组,差异均有统计学意义(均P<0.05)。联合组患者不良反应发生率为20.5%,常规组为12.8%,两组比较,差异无统计学意义(P>0.05)。结论 癌理通膏外敷配合强阿片类止痛药对癌性骨痛的临床疗效较好,能够缓解疼痛症状,改善生活质量,且安全性高。

Objective To observe the clinical efficacy and safety of Ailitong ointment combined with strong opioid analgesics for cancerous bone pain. Methods A total of 78 patients with cancerous bone pain admitted to Shanghai Ruijin Rehabilitation Hospital were selected from April 2019 to April 2020. They were divided into a combination therapy group and a conventional therapy group with 39 patients in each group using the random number table method. Patients in the combination therapy group received Ailitong ointment combined with oxycodone sustained-release tablets and morphine sulfate controlled-release tablets and the conventional therapy group received oxycodone sustained-release tablets and morphine sulfate controlled-release tablets. The severity of pain, pain relief, drug onset time, duration of efficacy, and number of outbreaks of pain, Karnofsky performance status(KPS) score and the occurrence of adverse reactions were compared between the two groups. Results The efficacy rate of pain relief was 84.6% in the combination therapy group which was higher than 61.5% of the conventional therapy group(P<0.05). Before the treatment, there was no significant difference in severity of pain between the two groups(P>0.05). After the treatment, the numerical rating scale(NRS) scores decreased in both groups and the reduction in the severity of pain was lower in the combination therapy group than in the control group(P<0.05). The number of burst pain was lower and the duration of efficacy and sleep increase time were better in the combination therapy group than in the conventional therapy group(P<0.05). There was no significant difference in the onset time between the two groups of drugs(P>0.05). After the treatment, the KPS scores increased in the two groups and the scores were higher in the combination therapy group than in the conventional group(P<0.05). The incidence of adverse reactions was 20.5% in the combination therapy group compared with 12.8% in the conventional therapy group(P>0.05). Conclusion The external application of Ailitong ointment combined with strong opioid analgesics shows a significant clinical efficacy for cancerous bone pain. It can relieve pain symptoms, improve quality of life, and with high safety.