四逆散联合桃红四物汤加减治疗老年早期肺癌胸腔镜术后急性胸痛患者的临床疗效及对其生活质量的影响

Clinical Efficacy of Modified Sini San Combined with Taohong Siwu Decoction on A-cute Chest Pain and Its Effect on Quality of Life in Elderly Patients with Early Lung Cancer after Thoracoscopic Surgery

目的探讨四逆散联合桃红四物汤加减治疗老年早期肺癌胸腔镜术后急性胸痛患者的临床疗效及对其生活质量的影响。方法选取2019年1月-2020年6月期间在保定市第二中心医院接受治疗的86例非小细胞肺癌患者,采用随机数字表法分为对照组和观察组,每组各43例。对照组患者胸腔镜术后给予尼美舒利胶囊口服治疗,观察组患者胸腔镜术后给予四逆散合桃红四物汤加减方治疗。治疗2周后,观察比较两组患者临床疗效、不良反应情况,治疗前后疼痛状况评分[数字分级评分法评分(Numeric rating scale,NRS)、疼痛视觉模拟评分法评分(Visual analogue scale,VAS)]、咳嗽评分[咳嗽积分和咳嗽视觉模拟评分法(Visual analogue scale,VAS)]、EORTC QLQ-C30(version 3)生活质量量表评分。结果治疗后观察组总有效率93.02%(40/43)明显高于对照组74.42%(32/43),差异有统计学意义(P<0.05)。治疗后两组患者疼痛状况NRS、VAS评分均较治疗前明显降低,差异有统计学意义(P<0.01);且观察组疼痛状况NRS、VAS评分均明显低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者咳嗽状况咳嗽积分、咳嗽VAS评分均较治疗前明显降低,差异有统计学意义(P<0.01);且观察组咳嗽状况咳嗽积分、咳嗽VAS评分均明显低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者角色功能、躯体功能、认知功能、情绪功能、社会功能及总体健康状况评分均较治疗前升高,差异有统计学意义(P<0.01),两组患者恶心呕吐、疼痛评分均较治疗前降低,差异有统计学意义(P<0.01);且观察组角色功能、躯体功能、认知功能、情绪功能、社会功能及总体健康状况评分均明显高于对照组,观察组恶心呕吐、疼痛评分均明显低于对照组,差异有统计学意义(P<0.05)。治疗期间,两组患者肾功能、肝功能、血常规、心电图、尿常规、便常规等安全性指标均未出现明显异常,也未发生与药物使用相关的严重不良反应。结论四逆散合桃红四物汤加减方能够有效缓解早期肺癌患者胸腔镜术后急性疼痛程度和咳嗽程度,缩短疼痛治疗时间,减少西医止痛药物使用剂量,改善患者生活质量,安全且有效。

Objective To explore the clinical efficacy of modified Sini San combined with Taohong Siwu Decoction on acute chest pain and its effect on quality of life in elderly patients with early lung cancer after thoracoscopic surgery.Methods A total of 86 non-small cell lung cancer patients received treatment at the Second Central Hospital of Baoding City from January 2019 to June 2020 were randomly divided into the control group and the observation group using a random number table study method,with 43 cases in each group.The control group received oral treatment with Nimesuli Capsules after thoracoscopic surgery,while the observation group after thoracoscopic surgery received treatment with modified Sini San combined with Taohong Siwu Decoction for two weeks.The clinical efficacy,adverse reactions,pain status score[numerical rating scale(NRS)and pain visual analogue scale(VAS)],cough score[cough visual analogue scale(VAS)],and EORTC QLQ-C30(version 3)quality of life scale scores between two groups before and after treatment were observed and compared.Results After treatment,the total effective rate of the observation group was 93.02%(40/43),which was significantly higher than that of the control group at 74.42%(32/43),and the difference is statistically significant(P<0.05).After treatment,the NRS scores and VAS scores of the two groups were significantly reduced,and the difference is statistically significant(P<0.01).Moreover,the NRS scores and VAS scores in the observation group were significantly lower than those in the control group(P<0.05).After treatment,the cough scores and cough VAS scores of the two groups were significantly lower(P<0.01),and the cough scores and cough VAS scores in the observation group were significantly lower than those in the control group(P<0.05).After treatment,the scores of role function,physical function,cognitive function,emotional function,social function,and overall health status of the two groups of patients were significantly higher(P<0.01).The scores of nausea,vomiting,and pain were significantly lower(P<0.01).In addition,the role function,physical function,cognitive function,emotional function,social function,and overall health status scores of the observation group were higher than those of the control group,while the scores of nausea,vomiting,and pain were lower than those of the control group(P<0.05).During the treatment period,there were no significant abnormalities in safety indicators such as renal function,liver function,blood routine,electrocardiogram,urine routine,and stool routine in both groups of patients,and no serious adverse reactions related to drug use occurred.Conclusion The modified Sini San combined with Taohong Siwu Decoction can effectively alleviate the acute pain and cough degree of patients with early lung cancer after thoracoscopic surgery,shorten the pain treatment time,and reduce the dosage of Western medicine painkillers,so as to improve the quality of life of patients safely and effectively.