“加减身痛逐瘀汤”经神阙穴贴敷联合三阶梯止痛药疗法治疗癌性疼痛的临床效果观察

Clinical efficacy of acupoint Shenque application with"Modified Shentong Zhuyu Decoction"combined with three-step analgesic ladder in the treatment of cancer pain

目的 探究“加减身痛逐瘀汤”经神阙穴贴敷联合三阶梯止痛药疗法治疗癌性疼痛的临床效果观察。方法前瞻性选取2020年1月至2021年6月安徽中医药大学第一附属医院收治的恶性肿瘤伴有癌性疼痛患者60例为研究对象。采用随机数字表法分为观察组与对照组,每组各30例。对照组采用三阶梯止痛药疗法,观察组在此基础上联合使用“加减身痛逐瘀汤”贴敷神阙穴治疗。观察两组患者治疗后药物起效时间、止痛持续时间、24 h疼痛爆发次数。采用SF-36生活质量量表进行生活质量评分,采用数字量表评分法(NRS)评价疼痛情况。观察两组患者止痛疗效与不良反应发生率。结果 治疗后,观察组起效时间、24 h疼痛复发次数为(0.76±0.15) h、(1.27±0.51)次,均显著低于对照组[(0.89±0.31) h、(2.31±0.48)次],且止痛持续时间为(11.97±1.24) h,显著长于对照组[(11.01±1.28)h],差异均有统计学意义(P <0.05)。治疗前,两组患者生活质量评分比较,差异均无统计学意义(P> 0.05);治疗后,观察组生活质量评分显著高于对照组,差异均有统计学意义(P <0.05)。治疗后,观察组止痛疗效为93.24%,显著高于对照组(73.26%),差异有统计学意义(P <0.05)。治疗后,观察组不良反应发生率为9.99%,略低于对照组(13.32%),但两组患者总不良反应发生率差异无统计学意义(P>0.05)。结论 “加减身痛逐瘀汤”经神阙穴贴敷联合三阶梯止痛药疗法能有效延长止痛时间,提高患者生活质量,降低不良反应发生率,提升止痛疗效。

Objective To investigate the clinical efficacy of acupoint Shenque application with"Modified Shentong Zhuyu Decoction"combined with three-step analgesic ladder in the treatment of cancer pain.Methods Sixty patients with cancer pain due to malignant tumors in the First Affiliated Hospital of Anhui University of Traditional Chinese Medicine from January 2020 to June 2021 were prospectively selected,and divided into control group and observation group by random number table method,each with 30 cases.The control group received three-step analgesic ladder therapy,based on this,the observation group received acupoint Shenque application with"Modified Shentong Zhuyu Decoction".The onset time of the drug,the duration of pain relief and the number of breakthrough cancer pain within 24 h were observed in both groups,and the levels of pain mediators were detected,meantime,the SF-36 quality of life scale was used to evaluate the quality of life,and the numerical rating scale(NRS)was used to evaluate the pain.Thereafter,the analgesic efficacy and incidence of adverse effects were compared between two groups.Results After treatment,the onset time and 24-hour pain recurrence in the observation group were(0.76±0.15)h,(1.27±0.51)times,which were significantly lower than those in the control group[(0.89±0.31)h,(2.31±0.48)times],and the duration of analgesia was(11.97±1.24)h,which was significantly longer than that of the control group[(11.01±1.28)h],and the differences were statistically significant(P<0.05).Before treatment,there was no significant difference in the scores of quality of life between the two groups(P>0.05);after treatment,the scores of quality of life in the observation group were significantly higher than those in the control group,with statistical significance(P<0.05).The analgesic efficacy was 93.24%in observation group,which was significantly higher than that in control group(73.26%),and the difference was statistically significant(P<0.05).The adverse reaction rate was 9.99%in observation group,which was slightly lower than that in control group(13.32%),but there was no significant difference(P>0.05).Conclusion Acupoint Shenque application with"Modified Shentong Zhuyu Decoction"combined with three-step analgesic ladder in the treatment of cancer pain can effectively prolong the analgesic time,improve the quality of life,reduce the incidence of adverse reactions,and improve the efficacy of analgesic.