中药外敷联合西药治疗原发性肝癌疼痛临床研究

Clinical Study on External Application of Chinese Herbal Medicine Combined with Western Medicine for Pain of Primary Liver Cancer

目的:观察中药外敷联合西药治疗原发性肝癌疼痛的临床疗效。方法:将90例血瘀阻络型原发性肝癌疼痛患者按随机数字表法分为观察组和对照组各45例。2组服用布洛芬缓释片,中度疼痛者加用盐酸羟考酮缓释片,重度疼痛者加用硫酸吗啡缓释片。观察组在肝区疼痛部位、肿块部位与肝俞、期门、日月、章门穴进行中药外敷。2组疗程均为10天。采用疼痛视觉模拟评分法(VAS)和面部表情疼痛评分法(FPS-R)评价疼痛程度,评定简明疼痛评估量表(BPI)评分。结果:治疗后,观察组疼痛缓解情况优于对照组,差异有统计学意义(P <0.01)。观察组VAS评分和FPS-R评分均低于对照组(P <0.01)。观察组疼痛最剧程度、疼痛最轻程度、平均疼痛程度和目前疼痛程度评分均低于对照组(P <0.01),疼痛缓解程度优于对照组(P <0.05),情绪、睡眠、活动能力、食欲、日常生活、行走能力、与他人交往评分均低于对照组(P <0.01)。结论:在三阶梯药物止痛法的基础上采用中药外敷,能进一步减轻肝癌疼痛,改善疼痛对生活质量的负面影响。

Objective:To observe the clinical effect of the external application of Chinese herbal medicine combined with western medicine for the pain of primary liver cancer.Methods:A total of 90 cases of patients suffering from the pain of primary liver cancer of blood stasis obstructing the collaterals type were divided into the observation group and the control group according to the r andom number table method,45 cases in each group.Both groups were treated with ibuprofen sustained-release tablets;the patients suffering from moderate pain were additionally treated with oxycodone hydrochloride extended-release tablets and the ones suffering from severe pain were additionally treated with morphine sulfate extended-release tablets.The observation group was given the external application of Chinese herbal medicine at painful parts around the liver area,the mass parts as well as the points such as Ganshu(BL18),Qimen(LR14),Riyue(GB24)and Zhangmen(LR13).Both groups were treated for ten days.The scores of the pain were evaluated by the Visual Analogue Scale(VAS)and the Faces Pain Scale-Revised(FPS-R),and the scores of the Brief Pain Inventory(BPI)were evaluated.Results:After treatment,the remission of pain in the observation group was better than that in the control group,the difference being significant(P<0.01).The scores of VAS and FPS-R in the observation group were lower than those in the control group(P<0.01).The scores of the most severe pain,the mildest pain,the average pain and the current pain in the observation group were lower than those in the control group(P<0.01);the degree of pain release in the observation group was higher than that in the control group(P<0.05);the scores of mood,sleep,general activity,appetite,normal work,walking ability and relations with others in the observation group were lower than those in the control group(P<0.01).Conclusion:The therapy of external application of Chinese herbal medicine based on the method of three-step analgesic ladder can further alleviate the pain of liver cancer and lessen the negative effect of pain on the quality of life.