浮针联合穴位敷贴对中晚期肝癌癌性疼痛(气滞血瘀型)患者疼痛程度、疼痛应激介质的影响

Effect of Fu's Subcutaneous Needling Combined with Acupoint Application on Pain Degree and Pain Mediators in Patients with Cancer Pain of Intermediate and Advanced Liver Cancer (Qi Stagnation and Blood Stasis Pattern)

目的:探究浮针联合穴位敷贴对中晚期肝癌癌性疼痛(气滞血瘀型)患者疼痛程度、疼痛应激介质的影响。方法:将96例在本院接受治疗的中晚期肝癌癌性疼痛(气滞血瘀型)患者按照随机数字表法随机分为观察组和对照组,每组48例。对照组采用三阶梯镇痛法,观察组在对照组的基础上使用浮针联合中药穴位贴敷,每疗程7 d,治疗两个疗程共14 d。观察两组患者疼痛程度和疼痛相关血清学因子变化。结果:观察组总有效率为81.25%(39/48),较对照组62.50%(30/48)更高,差异有统计学意义(P<0.05);治疗后,观察组与对照组疼痛数字评分(NRS)和描述性疼痛程度分级(VRS)较治疗前均降低,且观察组NRS评分和VRS分级较对照组更低,差异有统计学意义(P<0.05);治疗后两组血清中5-羟色胺(5-HT)和前列腺素E2(PGE2)水平均降低,且观察组5HT和PGE2水平较对照组更低,差异有统计学意义(P<0.05);观察组治疗后血清缺氧诱导因子-1(HIF-1)和血管内皮生长因子(VEGF)水平较治疗前降低,差异有统计学意义(P<0.05),而对照组HIF-1和VEGF水平较治疗前差异无统计学意义(P>0.05);治疗后,两组KPS评分均高于治疗前,差异有统计学意义(P<0.05),且观察组较对照组KPS评分更高,差异有统计学意义(P<0.05);观察组不良反应总发生率为35.42%(17/48),较对照组68.75%(33/48)更低,差异有统计学意义(P<0.05)。结论:使用浮针联合穴位敷贴治疗中晚期肝癌气滞血瘀型癌性疼痛,可有效缓解患者疼痛程度,降低疼痛介质水平,提升患者生活质量,并减少不良反应的发生,具有较高的临床推广价值。

Objective:To investigate the effect of Fu's subcutaneous needling combined with acupoint application on pain degree and pain mediators in patients with cancer pain of intermediate and advanced liver cancer(Qi stagnation and blood stasis pattern).Methods:A total of 96 patients with cancer pain of intermediate and advanced liver cancer(Qi stagnation and blood stasis pattern) were randomly divided into the observation group and the control group,with 48 patients in each group.The control group was given three-step analgesia;on which basis,the observation group was also treated with Fu's subcutaneous needling and acupoint application of Chinese medicinal.7 d was taken as one course of treatment,and both groups were treated for two courses of 14 d.Pain degree and pain related serum indicators were observed in the two groups.Results:The total effective rate was 81.25%(39/48) in the observation group,which was higher than 62.50%(30/48) in the control group(P<0.05).The scores of Numerical Rating Scale(NRS) and Verbal Rating Scale(VRS) were decreased after the treatment in the two groups,and the decreases were more significant in the observation group than those in the control group(P<0.05).The serum levels of 5-hydroxytryptamine(5-HT) and prostaglandin E2(PGE2) were decreased after the treatment in the two groups,and the levels of 5-HT and PGE2 were lower in the observation group than those in the control group after the treatment(P<0.05).The serum levels of hypoxia-inducible factor 1(HIF-1) and vascular endothelial growth factor(VEGF) were decreased in the observation group after the treatment(P<0.05);whereas the control group showed no significant differences in serum levels of HIF-1 and VEGF between before and after the treatment(P>0.05).The KPS score was higher after the treatment than that before the treatment in the two groups(P<0.05),and the KPS score was higher in the observation group than that in the control group after the treatment(P<0.05).The total incidence of adverse reactions was 35.42%(17/48) in the observation group,which was lower than 68.75%(33/48) in the control group(P<0.05).Conclusion:Fu's subcutaneous needling combined with acupoint application can effectively alleviate pain,lower levels of pain mediators,improve life quality and reduce adverse reactions in treatment of cancer pain of intermediate and advanced liver caner(Qi stagnation and blood stasis pattern).The therapy has a higher value of clinical promotion.