穴位贴敷联合中药口服治疗癌性疼痛临床研究

Clinical Study on Treatment of Cancer Pain by Acupoint Application Combined with Oral Administration of Traditional Chinese Medicine

目的 探讨玄乌止痛膏穴位贴敷联合中药口服治疗癌性疼痛的临床疗效。方法 选取2020年2月—2021年6月张家口市中医院收治的120例癌性疼痛患者,根据随机数字法分为对照组和观察组各60例,对照组给予三阶梯止痛治疗,观察组给予玄乌止痛膏穴位贴敷联合口服加味芍药甘草汤治疗,疗程4周。比较两组临床疗效、疼痛数字评分法(NRS)、卡氏功能状态(KPS)评分、疼痛介质[前列腺素E2(PGE2)、P物质(SP)、5-羟色胺(5-HT)]、生活质量(QOL)评分及不良反应发生率。结果 观察组总缓解率高于对照组[91.67%(55/60)vs 70.00%(42/60)](P<0.05)。治疗后两组NRS评分和血清PGE2、SP、5-HT水平均降低,KPS、QOL评分均升高(P<0.05);且观察组NRS评分和血清PGE2、SP、5-HT水平低于对照组,KPS、QOL评分高于对照组(P<0.05)。观察组便秘、恶心、呕吐发生率低于对照组(P<0.05)。结论 玄乌止痛膏穴位贴敷联合中药口服治疗癌性疼痛疗效显著,可改善机体疼痛介质,提高生活质量,降低不良反应,值得临床推广。

Objective To explore the clinical curative effect of Xuanwu Zhitong Plaster(玄乌止痛膏)for acupoint application combined with oral administration of traditional Chinese medicine(TCM)on cancer pain.Methods A total of 120 patients with cancer pain admitted to the hospital were enrolled as the research objects between February 2020 and June 2021.According to random number table method,they were divided into control group and observation group,60 cases in each group.The control group was given three-step analgesic treatment,and the observation group was given Xuanwu Zhitong Ointment for acupoint application combined with oral administration of Shaoyao Gancao Decoction(芍药甘草汤)for 4 weeks.The clinical curative effect,scores of numerical rating scales(NRS)and Karnofsky performance status(KPS),pain mediators[prostaglandin E2(PGE2),substance P(SP),5-hydroxytryptamine(5-HT)],score of quality of Life(QOL)and incidence of adverse reactions were compared between the two groups.Results The total remission rate in the observation group was higher than that in the control group[91.67%(55/60)vs 70.00%(42/60)](P<0.05).After treatment,NRS score and levels of serum PGE2,SP and 5-HT were decreased,while KPS and QOL scores were increased in both groups(P<0.05).After treatment,NRS score and levels of serum PGE2,SP and 5-HT in the observation group were lower than those in the control group,while KPS and QOL scores were higher than those in the control group(P<0.05).The incidence of constipation,nausea and vomiting in the observation group was lower than that in the control group(P<0.05).Conclusion The curative effect of Xuanwu Zhitong Plaster for acupoint application combined with oral administration of TCM decoction is significant on cancer pain,which can improve tje levels of pain mediators and quality of life,and reduce the incidence of adverse reactions.