特大肛周脓肿患者的健康教育与术后换药疼痛的心理护理

目的:提高患者对肛周脓肿相关知识的认识度,增强其术后换药疼痛的应对技巧与信心。方法:对患者实施健康教育及对术后换约疼痛采取心理护理干预措施。结果:患者对肛周脓肿疾病的相关的知识得到了提高,能正确理解术后每天换药的重要性,并能以良好的心态应对换药引起的疼痛,坚持每天换药。结论:健康教育及心理护理干预对特大肛周脓肿术后换药疼痛的患者是必要的,是肛肠疾病患者的重要护理内容之一。

2011—2012年厦门市第二医院癌性疼痛镇痛药应用分析

目的:了解癌性疼痛评估方法及癌性疼痛镇痛药在临床的用药趋势,并评价癌性疼痛镇痛药临床使用的合理性,为临床合理用药提供参考。方法:随机抽查我院2011年及2012年每年癌性疼痛治疗病历各60份,收集癌性疼痛镇痛药使用数据,并对其使用趋势进行分析。结果:2012年我院癌性疼痛镇痛药的总用量比2011年有所增长;吗啡制剂用量最大,居首位。结论:所抽查病历中癌性疼痛镇痛药用药结构趋于规范化,使用情况总体趋于合理化。

CYP2D6基因分型与羟考酮给药间期末疼痛的相关性研究

目的分析CYP2D6基因分型与羟考酮给药间期末疼痛(EDF)的相关性,以期为临床个体化镇痛提供依据。方法采集患者静脉血,提取血液基因组DNA,PCR检测CYP2D6基因分型,数字分级评分法对患者疼痛程度进行评估,比较不同基因分型患者的羟考酮镇痛效果和EDF的差异。结果共纳入服用羟考酮的癌痛患者64例,EDF发生率为4.69%,其中CYP2D6正常代谢型(NM)42例、慢代谢型(PM)22例,未检测到超快代谢型(UM)和中间代谢型(IM)。NM与PM组患者的羟考酮镇痛效果和EDF发生率均无显著差异(P>0.05)。结论CYP2D6正常代谢型和慢代谢型与羟考酮EDF无明显相关性,但超快代谢型和中间代谢型对患者EDF的影响及最终结论尚需扩大样本量进一步研究。

电针结合苗药康膝疼痛贴治疗膝关节骨性关节炎的临床疗效观察

目的研究电针结合苗药康膝疼痛贴治疗膝关节骨性关节炎的治疗效果。方法选取贵州省松桃苗族自治县民族中医院2017年3月至2019年3月收治的150例膝关节骨性关节炎患者作为研究对象,随机分为对照A组、对照B组和观察组各50例。对照A组的患者使用电针进行治疗,对照B组的患者使用苗药康膝疼痛贴进行治疗,观察组的患者使用电针结合苗药康膝疼痛贴进行治疗。对比3组患者的视觉模拟疼痛(VAS)评分与骨关节炎指数(WOMAC)评分。结果对照A组与对照B组患者的VAS评分均高于观察组患者,差异具有统计学意义(P<0.05);对照A组与对照B组患者的WOMAC的疼痛、僵硬以及功能障碍评分均高于观察组患者,差异具有统计学意义(P<0.05)。结论对患有膝关节骨性关节炎的患者使用电针结合苗药康膝疼痛贴治疗的效果更好,患者的VAS评分更高,僵硬缓解效果更好,关节功能恢复更好,值得在临床进一步推广。

护理干预在非甾体镇痛药治疗长者疼痛中的影响

目的探讨护理干预在非甾体镇痛药治疗长者疼痛中的影响。方法选择患有各种疼痛的长者120例,按入住奇偶次序随机分为两组,两组各60例,对照组按照医嘱服用NSAID药物,观察组在对照组的基础上增加护理干预,治疗一个月后观察比较两组用药效果和药物副作用的发生情况。结果观察组的用药有效率99.3%明显高于对照组,观察组用药副作用38.3%明显低于对照组,差异具有统计学意义(P<0.05)。结论护理干预在非甾体镇痛药治疗长者的疼痛中有积极影响,有利于提高长者本人及家属对镇痛药及各种疼痛的认知水平,有效增强镇痛效果,树立战胜疼痛的信心,从而提高长者的生活质量。

建立无痛人流术静脉给药通道血管选择探讨

目的探讨无痛人流术建立静脉给药通道,手背小静脉、头静脉、肘正中静脉穿刺对初期推注药液时引起疼痛感觉的比较,以便选择最佳穿刺部位。方法选择61例作手背表浅静脉穿刺(A组)123例作上肢头静脉或肘正中静脉穿刺(B组)并对两组病人穿刺的成功率和疼痛感进行比较。结果两组病人的统计学结果P>0.05。结论采用头静脉,肘正中静脉穿刺成功率高,初期推注药液时刺激小,痛感率低,值得借鉴。

疼痛护理干预在癌症中的应用

目的:研究疼痛护理干预在癌症患者疼痛治疗的效果。方法:选取癌症患者60例,随机分为对照组与实验组每组各30例,对照组进行常规护理,实验组除进行常规护理外同时进行疼痛护理干预。观察两组疼痛控制效果。结果:实验组通过疼痛护理干预后疼痛得到有效控制,控制总有效率达(28)93.33%,高于对照组(20)66.67%(P<0.05)。结论:疼痛护理干预可以有效的缓解病人疼痛,提高癌症患者的舒适度,有效地提高了病人的生活质量。

Translational pain research: Evaluating analgesic effect in experimental visceral pain models

Deep visceral pain is frequent and presents major challenges in pain management, since its pathophysiology is still poorly understood. One way to optimize treatment of visceral pain is to improve knowledge of the mechanisms behind the pain and the mode of action of analgesic substances. This can be achieved through stand-ardized experimental human pain models. Experimental pain models in healthy volunteers are advantageous for evaluation of analgesic action, as this is often diff icult to assess in the clinic because of confounding factors such as sedation, nausea and general malaise. These pain models facilitate minimizing the gap between knowledge gained in animal and human clinical studies. Combining experimental pain studies and pharmacokinetic stud- ies can improve understanding of the pharmacokinetic-pharmacodynamic relationship of analgesics and, thus, provide valuable insight into optimal clinical treatment of visceral pain. To improve treatment of visceral pain, it is important to study the underlying mechanisms of pain and the action of analgesics used for its treatment. An experimental pain model activates different modalities and can be used to investigate the mechanism of action of different analgesics in detail. In combination with pharmacokinetic studies and objective assessment such as electroencephalography, new information re-garding a given drug substance and its effects can be obtained. Results from experimental human visceral pain research can bridge the gap in knowledge between animal studies and clinical condition in patients suffering from visceral pain, and thus constitute the missing link in translational pain research.

Network pharmacology-based approach to investigate the mechanisms of Yiyi Fuzi Baijiang Powder in the treatment of malignant tumors

Objective:To systematically investigate the main active components,targets,target-related diseases and action mechanism of Yiyi Fuzi Baijiang powder(YFBP)of Zhang Zhongjing,a Chinese physician of Eastern Han Dynasty of China(3 century A.D.)using the method of network pharmacology.Methods:The active components of YFBP were identified from several databases(TCMSP,TCM Database@Taiwan and TCMID).The potential active compounds were screened based on oral bioavailability and drug-like index in the TCMSP database.DrugBank,TCMSP,and TCMID database searches were performed to predict target-related diseases.Biological functions and KEGG pathway outcomes of all potential targets were analyzed using the DAVID database.Results:A total of 24 active compounds of YFBP,133 related targets,and 305 potential related diseases were obtained.These results showed that YFBP may treat inflammation,pain,and cancer.The functional enrichment analysis indicated that YFBP probably exerts its therapeutic effects by regulating neuroactive ligand-receptor interactions,the TNF signaling pathway,and the PI3K-Akt signaling pathway.Conclusion:This study provides preliminary confirmation that YFBP has the great potentials to treat inflammation,pain,and tumors,which supports Zhang Zhongjing’s original intention to treat intestinal carbuncle with ancient prescription YFBP,but also provides a scientific basis for its treatment in the malignant tumors.

Listening to Turkish classical music decreases patients’anxiety,pain,dissatisfaction and the dose of sedative and analgesic drugs during colonoscopy:A prospective randomized controlled trial

AIM： To determine whether listening to music decreases the requirement for dosages of sedative drugs, patients＇ anxiety, pain and dissatisfaction feelings during colonoscopy and makes the procedure more comfortable and acceptable. METHODS： Patients undergoing elective colonoscopy between October 2005 and February 2006 were randomized into either listening to music （Group 1, n = 30） or not listening to music （Group 2, n = 30）. Anxiolytic and analgesic drugs （intravenous midazolam and meperidine） were given according to the patients＇ demand. Administered medications were monitored. We determined their levels of anxiety using the State-Trait Anxiety Inventory Test form. Patients＇ satisfaction, pain, and willingness to undergo a repeated procedure were self-assessed using a visual analog scale. RESULTS： The mean dose of sedative and analgesic drugs used in group 1 （midazolam： 2.1 ± 1.4, meperidine： 18.1 ± 11.7） was smaller than group 2 （midazolam： 2.4 ± 1.0, meperidine： 20.6 ± 11.5）, but without a significant difference （P 〉 0.05）. The mean anxiety level in group 1 was lower than group 2 （36.7 ± 2.2 vs 251.0 ± 1.9, P 〈 0.001）. The mean satisfaction score was higher in group 1 compared to group 2 （87.8 ± 3.1 vs 58.1 ± 3.4, P 〈 0.001）. The mean pain score in group i was lower than group 2 （74.1 ± 4.7 vs 39.0 ± 3.9, P 〈 0.001）. CONCLUSION： Listening to music during colonoscopy helps reduce the dose of sedative medications, as well as patients＇ anxiety, pain, dissatisfaction during the procedure. Therefore, we believe that listening to music can play an adjunctive role to sedation in colonoscopy. It is a simple, inexpensive way to improve patients＇ comfort during the procedure.

糖尿病神经病变

糖尿病神经病变是糖尿病的常见并发症。多见于中老年Ⅱ型糖尿病患者,男女发病几率相等,随病程的增长,发病率增高,病程25年者发病率达50％。另外,血糖控制差者易发病,也与遗传易感性有关。 糖尿病神经病变的发病机制尚不完全明了,目前认为与血管缺血缺氧、硫胺素和营养代谢障碍有关。出现神经轴索变性。

Statistic analysis of 6891 cancer-paining patients' information from Gansu Province Tumour Hospital,China

Objective： To analyze and gain the interlinking degree of the cancer pain with patients＇ cancer-species, sexuality and age etc. Methods： The information of narcotic drugs used for cancer pain patients in our hospital （Gansu Province Turnout Hospital, China） during 2002-2007 were typed in designed EXCEL form, then counted and analyzed. Results： The total number of cancer pain patients used narcotic drugs during 2002-2007 was 6891 （n = 6891 ）, among them, 4164 （60.44%） were males, and 2727 （39.56%） females. The top-range of cancer-species in those patients was as follows： lung cancer （20.39%）, gastric cancer （14.85%）, esophageal cancer （9.71%）, hysterocarcinoma （6.79%）, liver cancer （6.70%） and breast cancer （6.31%）. Conclusion： （a） The male number of cancer pain patients using narcotic drugs is higher than the female number （1.53：1）. （b） In the cases of lung cancer, gastric cancer, esophageal cancer, liver cancer and kidney cancer, the male numbers are twice more than the female numbers, and the difference between the two groups are significant. （c） Most of the cancer pain patients （over 87%） are over 40 years old.

External application of Chinese medicine formula combined with analgesic drugs to treat lung squamous cell carcinoma pain： A case study with mixed methods

Objective： To investigate the effectiveness of the external application of Chinese medicine combined with analgesicdrugs to treat lung squamous cell carcinoma pain. Methods： A 54-year-old patient with upper lobe of the left lungsquamous cell carcinoma was studied, who suffered from severe cancer pain with the initial numeric rating scale （NRS）7 point when admitted. Exterior-use formula was applied to pain spot to relieve the pain. Mixed methods approachcomprising NRS, Short-form of McGill Pain Questionnaire, quality of life scale, times of breakout pain, records ofadverse reactions and semi-structured interviews were utilized to evaluate the effect. Results： With the combination useof the formula and analgesic drugs, the patient’s NRS score dropped from 7 to 3 point. Quality of life scale scoreimproved from 33 to 42 point. Times of breakout pain reduced from twice to none. The amount of oxycodone decreasedfrom 30 mg Bid to 10 mg Bid. No adverse effect appeared. The patient’s felt more energetic with good sleep and appetite.Conclusion： This formula is effective and safe for pain relief when combined with analgesic drugs, and may be a goodoption in dealing with local cancer pain. Future randomized, controlled studies are needed to better evaluate the efficacy.

01032 CeNeS将完成M6G的开发

CeNeS制药公司正计划筹集大约1140万英镑，这些资金中大约有1050万英镑被公司用于投入到治疗术后疼痛的化合物M6G(morphine-6-glucuronide，吗啡-6-葡萄糖苷酸)第二个Ⅲ期临床试验和其他中枢神经系统项目的进一步研究。

首个在美上市的通用名Duragesic

美国FDA最终批准了Mylan公司的Duragesic[J＆J公司的经皮芬太尼(transdermal fentanyl)](I)通用名版本。这项决定刚好是在J＆J公司的儿科用独占权于1月23日期满后几天宣布的。该公司计划立即推出它的产品，但分析人员指出它将面临一种授权通用名药(作为一项涉及J&J公司的许可证贸易的一部分)竞争。Mylan公司这种用于慢性疼痛的产品将有4种规格，

A survey of advanced medical students’ knowledge towards cancer pain management

Objective: The aim of the study was to investigate advanced medical students' knowledge towards cancer pain management, and understand the effect of specialisms and duration of oncology rotation on the advanced medical students' cognitive level towards cancer pain management. Methods: Randomly selected the respondents from a medical school in Wuhan, China. The educational background of the respondents should belong to one of these conditions: (1) clinical master degree candidate; (2) clinical doctor degree candidate; (3) the sixth or seventh year of clinical medicine for seven years. The respondents should also spend more than one year on internship. The self-developed questionnaire papers were distributed to respondents in the unit of dorms selected randomly and recovered them immediately after they're finished. The categori- cal data were expressed at the form of frequency (rate or constituent ratio). Chi-square test was required only as needed. Results: The survey was anonymous. We distributed 300 papers, recovered 300 papers and weeded out 8 invalid papers. Finally there were 292 valid papers, and the valid recovery rate was 97.3%. The 96.7% of oncological medical students and 47.6% non-oncological medical students relied on patients' description for cancer pain assessments; 90.0% of oncological medical students and 53.0% of non-oncological medical students prescribed strong opioid drugs firstly for patients suffering severe cancer pain; only 24.1% of non-oncological medical students recognized that pethidine was not safe and effective to treat cancer pain, which was much lower than oncological medical students (90.0%); 73.3% of oncological medical students and 28.9% of non-oncological medical students had the correct impression of drug addiction; 85.5% of non-oncological medi- cal students worried about the drug addiction, while 60.0% of oncological medical students worried about the strict control over opioid. In respect of the details of cancer pain management, only 66.7% of oncological medical students recognized that there was no upper limit of opioid prescribed clinically, and 16.3% of oncological medical students recognized that there was no psychological dependence if patients took opioid orally. The 69.8% of the students from no-less-than-two-week group relied on patients' description for cancer pain assessments, 76.7% prescribed strong opioid drugs firstly for patients suffer- ing severe cancer pain, 69.8% recognized that pethidine was not safe and effective to treat cancer pain, and 55.8% had the correct impression of drug addiction. All of the data were higher than that in no-rotation group and that in less-than-two-week group. The 51.2% of the students from no-less-than-two-week worried about drug addiction, which was the lowest of all. Conclusion: The cognitive level of advanced medical students towards cancer pain management is so low that it could not satisfy the clinical requirement, especially for the non-oncological medical students and the students spending little time on oncology rotation. Though the oncological medical students know something about cancer pain treatment, they know little about the details.

Effect of Gan Fu Le on24 Cases of Primary Hepatocarcinoma

Since 1994 we have treated 24 cases of primary hepatocarcinoma with a novel preparation Gan Fu Le (肝复乐). The effect was definite as reported in the following.Subjects and methodA total of 24 cases of primary hepatocarcinoma (21 males and 3 females) aged 42-73 (mean 57) years old were enrolled in the treatment group and treated only with Gan Fu Le, 10 tablets, t.i.d. for 2 months as one therapeutic course.

多学科的配合是规范化治疗中度疼痛的重点

日前，20多位来自不同学科的中外医学专家在“中度疼痛的规范化用药”的研讨会上指出，应早日制定出各专业学科关于中度疼痛的治疗规范。

Efficacy study on pestle needle combined with Chinese herbal fumigation for cervical spondylosis

Objective：To observe the clinical effect of pestle needle combined with Chinese herbal fumigation on cervical spondylosis and provide a safe effective therapy for this condition.Methods：A total of 54 cases were randomly allocated into two groups（27 cases in each group） according to their sequence of consultation.Patients in both groups were treated with the same Chinese herbal fumigation.Patients in the treatment group were additionally treated with pestle needle therapy on a unique set of Ba Zhen points around Dazhui（GV 14）,Fengfu（GV 16） and the distance between Naohu（GV 17） and Dazhui（GV 14） along the He Che pathway,whereas patients in the control group were additionally treated with routine acupuncture therapy.Then the short-term and long-term efficacies were observed and compared after treatment using the visual analog scale（VAS） and pain rating index（PRI）.Results：At the end of treatment,VAS scores were significantly decreased in both groups,and the VAS score in the treatment group was lower than that in the control group（P〈0.05）.The intra-group differences were statistically significant in VAS scores 1 month,3 and 6 months after treatment（all P〈0.05）.At the end of treatment,the sensory and total PRI scores in the treatment group were significantly lower than those in the control group,showing statistically significant differences（both P〈0.01）;and there was no significant between-group difference（P〈0.05） in the affective PRI score.At the end of treatment,the total effective rate was 85.2% in the treatment group,versus 65.4% in the control group,showing a statistical significance（P〈0.05）.The follow-up six months later showed that the total effective rate was 92.6% in the treatment group,versus 76.9% in the control group,showing a statistical significance（P〈0.05）.Conclusion：Pestle needle therapy is a stable and positive therapy for cervical spondylosis.