五生酊外治配合WHO三阶梯镇痛方案治疗轻中度癌性疼痛的效果

摘要

Objective To observe the clinical effect of traditional Chinese medicine Wusheng Tincture combined with WHO "three stage" analgesic regimen in the treatment of mild and moderate cancer pain.Methods One hundred and twenty-six patients with cancer pain treated in Department of Oncology,the Second Affiliated Hospital of Guangzhou University of Chinese Medicine from September 2015 to February 2017 were selected as research objects,and they were randomly divided into the treatment group (65 cases) and control group (61 cases).According to numerical rating scale,in the treatment group,mild pain patients accounted for 50.8％ (33/65),moderate pain patients accounted for 49.2％(32/65),while in the control group,mild pain patients accounted for 50.8％ (31/61),moderate pain patients accounted for 49.2％ (30/61).The control group was taken WHO "three stage" analgesic regimen and the pain site was treated with placebo tincture;the treatment group was treated with Wusheng Tincture on the pain site on basis of control group.The two groups were treated for 7 days as one course.NRS was used to assess the pain level of the patients,the brief pain inventory (BPI) was used to evaluate the quality of life,the clinical effects and adverse reactions between the two groups were observed.The data was analyzed and processed by SPSS 18.0.Results A total of 120 patients completed the study (6 patients were excluded for the external use of cold stimulation).After treatment,the NRS scores in the two groups were all lower than those before treatment (P ＜ 0.01),and the NRS score of the treatment group was significantly lower than that of the control group,the difference was highly statistically significant (P ＜ 0.01).After treatment,the scores of BPI in the two groups were all significantly lower than those before treatment (P ＜ 0.05),and the BPI score of the treatment group was significantly lower than that of the control group,the difference was highly statistically significant (P ＜ 0.01).The BPI score of patients with mild pain in the treatment group after treatment was significantly lower than that of control group (P ＜ 0.05),while there was no significant difference of the BPI score between the patients with moderate pain in treatment group and control group (P ＞ 0.05).There was no statistically significant difference of total effective rate between the two groups (P ＞ 0.05).The incidence of constipation with Ⅳ degree in the treatment group was significantly lower than that in the control group (P ＜ 0.01),and the overall incidence of adverse reactions in the treatment group was significantly lower than that in the control group (P ＜ 0.05).Conclusion Compared with patients with moderate pain,external use of Wusheng Tincture has better effects for the analgesic efficacy and improvement of quality of life.%目的 观察中药五生酊外用配合WHO三阶梯镇痛方案治疗轻中度癌性疼痛的临床效果.方法 选取2015年9月～2017年2月于广州中医药大学第二附属医院肿瘤科就诊的126例癌痛患者作为研究对象,将其随机分为治疗组(65例)和对照组(61例).根据疼痛数字评分法(NRS),治疗组中,轻度疼痛占50.8％(33/65),中度疼痛占49.2％(32/65),对照组中,轻度疼痛占50.8％(31/61),中度疼痛占49.2％ (30/61).对照组采用WHO三阶梯止痛方案进行止痛,疼痛部位外涂安慰剂碘酊;治疗组在对照组的基础上给予疼痛部位外涂中药五生酊治疗.两组均以7d为1个疗程.NRS评价患者的疼痛程度,采用简明疼痛评估量表(BPI)评价患者生活质量,同时观察两组临床疗效和不良反应发生情况.本研究所得数据采用统计学软件SPSS 18.0进行分析处理.结果 共120例患者完成了本研究(6例因不受外用药物冷刺激而退出).治疗后,两组NRS评分均较治疗前显著下降(P＜0.01),且治疗组治疗后NRS评分显著低于对照组,差异有高度统计学意义(P＜0.01).治疗后,两组BPI评分均较治疗前明显降低(P＜0.05),且治疗组治疗后BPI评分显著低于对照组,差异有高度统计学意义(P＜0.01).轻度疼痛患者治疗组治疗后BPI评分显著低于对照组(P＜0.05),而中度疼痛患者两组BPI评分差异无统计学意义(P＞0.05).两组总有效率比较,差异无统计学意义(P＞0.05).治疗组便秘Ⅳ度发生率显著低于对照组(P＜0.01),且治疗组总的不良反应发生率显著低于对照组(P＜0.05).结论 与中度癌痛患者比较,中药五生酊外治对于轻度癌痛患者的止痛疗效和生存质量的改善效果更显著.