抑癌止痛散联合曲马多缓释片对原发性肝癌癌性疼痛疗效、肝癌标志物及T细胞亚群的影响

To explore the therapeutic effect of Yiai Zhitong powder combined with Tramadol hydrochloride sustained-release tablets on patients with mild to moderate cancer pain of primary liver cancer and the effects on serum liver cancer markers and T cell subsets

目的:探讨抑癌止痛散联合盐酸曲马多缓释片对原发性肝癌轻中度癌性疼痛患者的治疗效果及对血清肝癌标志物、T细胞亚群的影响。方法:选取我院2021年11月至2022年12月的原发性肝癌轻中度癌性疼痛住院患者60例,按完全随机数字法分为对照组和观察组各30例。两组患者均给予常规治疗,对照组在常规治疗基础上给予盐酸曲马多缓释片治疗,观察组在常规治疗基础上给予抑癌止痛散外敷联合盐酸曲马多缓释片治疗,共治疗10 d。观察两组患者治疗前后疼痛缓解情况(NRS)评分、生活质量(QOL-LC)评分、血清甲胎蛋白(AFP)、甲胎蛋白异质体(AFP-L3)、T淋巴细胞亚群(CD4^(+)、CD8^(+))水平及治疗结束时两组患者盐酸曲马多缓释片平均剂量,并判定临床疗效。结果:治疗10 d后观察组患者临床疼痛总缓解率96.67%,明显高于对照组的73.33%(P<0.05);治疗后两组患者QOL-LC评分均高于治疗前(P<0.05),且观察组优于对照组(P<0.05);治疗后两组患者血清AFP、AFP-L3水平较治疗前下降(P<0.05),且观察组下降幅度更大(P<0.05);治疗后两组患者血清中CD4^(+)含量均较治疗前上升(P<0.05),且观察组上升更显著(P<0.05);治疗后两组患者血清中CD8^(+)含量均较治疗前下降(P<0.05),且观察组下降更显著(P<0.05);观察组患者治疗结束时盐酸曲马多缓释片平均剂量较对照组明显减少,差异具有统计学意义(P<0.05)。结论:抑癌止痛散外敷联合盐酸曲马多缓释片对于原发性肝癌合并轻中度癌性疼痛患者,能改善临床症状,降低肿瘤标志物水平,改善患者免疫功能,减少止痛药物用量,减轻药物副作用,提高患者生活质量,具有较好的临床疗效,值得推广应用。

Objective:To explore the therapeutic effect of Yiai Zhitong powder combined with Tramadol hydrochloride sustained-release tablets on patients with mild to moderate cancer pain of primary liver cancer and the effects on serum liver cancer markers and T cell subsets.Methods:Sixty in patients with mild to moderate primary liver cancer pain in our hospital from November 2021 to December 2022 were selected and divided into a control group and observation group with 30 cases in each group according to a completely random number method.Both groups were given routine treatment,the control group was given tramadol hydrochloride sustained-release tablets on the basis of routine treatment,and the observation group was given Yiai Zitong powder combined with tramadol hydrochloride sustained-release tablets on the basis of routine treatment,for a total of 10 days.Pain relief(NRS)score,quality of life(QOL-LC)score,serum alpha-fetoprotein(AFP),alpha-fetoprotein anisoplast(AFP-L3),T lymphocyte subsets(CD4^(+),CD8^(+)),and average dose of Tramadol hydrochloride sustained release tablets at the end of treatment were observed before and after treatment,and clinical efficacy was determined.Results:After ten days of treatment,the total relief rate of clinical pain in the observation group was 96.67%higher than that in the control group(73.33%)(P<0.05).QOL-LC score after treatment was higher than that before treatment(P<0.05),and the observation group was better than the control group(P<0.05).After treatment,serum AFP and AFP-L3 levels in the two groups were decreased compared with those before treatment(P<0.05),and the decrease range was greater in observation group(P<0.05).After treatment,serum CD4^(+)content in the two groups was increased compared with that before treatment(P<0.05),and the increase was more significant in observation group(P<0.05).After treatment,serum CD8^(+)content in the two groups was decreased compared with before treatment(P<0.05),and the decrease was more significant in observation group(P<0.05).At the end of treatment,the average dose of Tramadol hydrochloride sustained release tablets in observation group was significantly reduced compared with control group,and the difference was statistically significant(P<0.05).Conclusion:For patients with primary liver cancer complicated with mild to moderate cancer pain,external application of Yiai Zhitong powder combined with Tramadol hydrochloride sustained release tablets can improve clinical symptoms,reduce the level of tumor markers,improve patients′immune function,reduce the amount of analgesic drugs,reduce drug side effects,and improve patients'quality of life.It has good clinical efficacy and is worthy of application.