足底反射区按摩及音乐疗法对癌痛的影响

目的探讨足底反射区按摩及音乐疗法在癌痛干预中的作用及可能机制。方法将符合入选条件的90例患者按入院先后顺序随机分为常规治疗组、足反射区按摩组和足底反射区按摩组＋音乐疗法组，各30例。采用长海痛尺进行疼痛评分，ELISA法检测癌痛患者外周血中B．内啡肽、前列腺素E2和肾上腺素含量。结果干预后第3天开始患者疼痛评分有不同程度的降低，但组间无统计学差异（P〉0．05），干预后第6天三组患者疼痛评分分别为常规治疗组（4．21±0．67），按摩组（2．12±1．39），按摩＋音乐组（1．88±0．77），三组间比较差异有统计学意义（F=21．99，P〈0．05）；干预后第3天各组间β-内啡肽、前列腺素E2和肾上腺素含量无统计学差异（P〉0．05）；按摩组、按摩组＋音乐组干预后第3天和第6天的组内前列腺素E2和肾上腺素含量差异有统计学意义（P〈0．05），在干预后第3天和第6天足底反射区按摩组和足底反射区按摩组＋音乐疗法组间β-内啡肽、前列腺素E2和肾上腺素含量差异均无统计学意义（P〉0．05）。结论足底反射区按摩对癌痛具有一定的缓解作用，可能与其心理治疗作用、刺激经络调整作用以及调节疼痛相关细胞因子分泌有关。

Effect of foot reflexology and music therapy on cancer pain

Objective To observe the effect and the possible mechanism of foot reflexology and music therapy on cancer pain intervention.Methods 90 Patients were randomly divided into 3 groups:normal therapy,palma reflexology massage; palma reflexology massage plus music therapy,30 patients in each group.Evaluated pain score by changhai pain rating scale,and tested patients' peripheral plasma concentration of β-endorphin、prostaglandin E2 and epinephrine by ELISA.Results Patients' pain score reduced to varying degrees,but no statistical differences were found among three groups with regard to pain score and serum concentration of β-endorphin,prostaglandin E2 and epinephrine 3 days post intervention (P ＞ 0.05 ).the pain score was (4.21 ± 0.67 ),(2.12 ± 1.39 ) and ( 1.88 ± 0.77) respectively in normal therapy group,palma reflexology massage group and palma reflexology massage plus music therapy group ( F =21.99,P ＜ 0.05 ),Statistical differences were found between 3 days and 6 days post intervention among internal palma reflexology massage and palma reflexology massage plus music therapy separately with regard to serum concentration of prostaglandin E2 and epinephrine ( P ＜ 0.05 ),whereas no statistical differences were found be tween the two groups at the two time points (P ＞ 0.05 ).Conclusions Palma reflexology massage can alleviate cancer pain; its mechanism may be due to its psychological effects,stimulating the modulation effect of meridians and collaterals,modifying pain-related cytokines secretion.