中药止痛贴外用治疗及联合吗啡治疗84例癌症疼痛的临床研究

目的:研究中药止痛贴治疗及联合吗啡治疗癌症疼痛的镇痛效果及安全性。方法:选取骨转移癌痛、肝癌疼痛(瘀血阻络证)患者84例,采用分层区组随机的方法,记录用药前后NRS(静止、运动)评分及主诉疼痛的程度、有痛时间和睡眠时间的累积、即释吗啡的使用总量、爆发痛的发作次数、疼痛影响评估积分、中医证候、治疗满意度、镇痛满意度。结果:轻度癌痛用中药止痛贴7天后,试验组在NRS评分(静止、运动)、主诉疼痛的程度、睡眠时间、有痛时间,中医证候的积分、疼痛影响的评估积分、镇痛及治疗满意度方面,两组的前后差值组间比较有统计学差异(P<0.05),且试验组优于对照组。中重度癌痛用中药止痛贴7天后,除睡眠时间、爆发痛次数、即释吗啡用量、治疗满意度方面,两组的治疗前后差值组间比较有统计学意义(P<0.05),试验组优于对照组,其它指标组间比较均无统计学意义(P>0.05)。结论:中药止痛贴外用能缓解轻度癌痛,显著改善患者的睡眠质量及提高患者的镇痛和治疗满意度;对中重度癌痛的治疗由于并用吗啡同时治疗,因此NRS评分等疼痛各项指标试验组和对照组的临床疗效总体相似,但中药止痛贴在减少爆发痛次数、减少即释吗啡的用量、提高治疗满意度方面有明显优势。

Clinical Observation on Analgesic Ointment and Morphine in Treatment of Cancer Pain

Objective： To research analgesic effect and safety of traditional Chinese medicine analgesic ointment combined with morphine for cancer pain. Methods： 84 cases of liver cancer patients with blood stasis syndrome were involved in. Using hierarchical coding block randomization method,before and after medication,we recorded NRS score,pain severity,accumulation of pain time and sleep time,total dosage of immediate morphine and outbreak pain times to evaluate score of influence pain,analgesic satisfaction,satisfaction with treatment. Results： With mild pain analgesic ointment,sevens day after test,medicine group had statistical changes on NRS score（ motion）,chief complaint of pain,sleep time,pain time,TCM syndrome and score of influence pain,analgesic satisfaction and treatment satisfaction. The two groups had significant difference（ P 〈 0. 05） and the experimental group was better than the control group. In moderate severe analgesic ointment group,after seven-day treatment,in addition to sleep time,outbreak pain times,morphine dosage and treatment satisfaction,the two groups had significant difference（ P 〈 0. 05） and the experimental group was better than the control group. Other indicators between groups were not statistically significant（ P 〉0.05）. Conclusion： In the treatment of clinical controlled observation of analgesic ointment,it can quickly and effectively relieve mild pain,prolong pain relief time,significantly improve sleep quality and enhance the analgesic satisfaction and satisfaction with treatment. As for the treatment of moderate to severe pain,due to the simultaneous treatment with morphine,pain NRS score and other indicators in test group and the control group are similar but in the aspect of reducing outbreak pain times,morphine dosage and increasing treatment satisfaction,there are obvious advantages to be improved.