| 自拟癌痛止痛贴膏联合盐酸羟考酮治疗难治性癌性疼痛的效果观察 |
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| 引用本文： | 杜莉,许远,张炼,徐桂花,王桂芬,刘震杰. 自拟癌痛止痛贴膏联合盐酸羟考酮治疗难治性癌性疼痛的效果观察[J]. 中华全科医学, 2022, 20(7): 1094-1097. DOI: 10.16766/j.cnki.issn.1674-4152.002531 |
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| 作者姓名： | 杜莉 许远 张炼 徐桂花 王桂芬 刘震杰 |
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| 作者单位： | 1.衢州市中医医院肿瘤内科，浙江 衢州 324002 |
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| 基金项目： | 国家自然科学基金项目81970398 |
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| 摘 要： | 目的 观察自拟外敷癌痛止痛贴膏联合盐酸羟考酮治疗难治性癌性疼痛的效果。 方法 选择2019年1月—2020年6月衢州市中医医院收治的102例难治性癌性疼痛患者，按照随机数字表法分为对照组和观察组，各51例。对照组给予盐酸羟考酮缓释片，观察组在对照组基础上给予自拟外敷癌痛止痛贴膏治疗，对比疼痛治疗效果、数字疼痛评分(NRS)、羟考酮应用剂量、爆发痛次数、疼痛缓解平均起始时间、Karnofsky功能状态(KPS)评分、焦虑自评量表(SAS)评分、每日睡眠时间，监测血清中相关致痛介质、免疫调节因子水平。 结果 观察组的总有效率为93.62%(44/47)，显著高于对照组的77.78%(35/45，P＜0.05)；治疗1 d、治疗1周同一时间点比较，观察组的疼痛NRS评分显著低于对照组(均P＜0.05)；治疗后，与对照组相比，观察组患者的羟考酮应用剂量减少，爆发痛次数更少，疼痛缓解平均起始时间显著缩短(均P＜0.05)；观察组患者的生活质量KPS评分显著升高，焦虑SAS评分更低，睡眠时间显著增加，血清中致痛介质P物质(SP)、前列腺素E2(PGE2)明显降低，β内啡肽(β-EP)含量明显升高(均P＜0.05)；治疗1 d、治疗1周同一时间点比较，观察组的血清中IL-2含量明显高于对照组(均P＜0.05)；2组患者的不良反应发生率比较，差异无统计学意义(P＞0.05)。 结论 自拟外敷癌痛止痛贴膏联合盐酸羟考酮治疗难治性癌性疼痛安全有效，其机制可能与调节血清中SP、PGE2、β-EP、IL-2含量以镇痛、增强免疫功能有关。
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| 关 键 词： | 难治性癌性疼痛 自拟外敷癌痛止痛贴膏 盐酸羟考酮 |
| 收稿时间： | 2021-10-29 |
Effect of self-designed cancer pain analgesic plaster combined with oxycodone hydrochloride on refractory cancer pain |
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| Affiliation: | Internal Medicine-Oncology, Quzhou Hospital of Traditional Chinese Medicine, Quzhou, Zhejiang 324002, China |
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| Abstract: | Objective To observe the effect of self-designed external application of cancer pain analgesic plaster combined with oxycodone hydrochloride in the treatment of refractory cancer pain. Methods A total of 102 patients with refractory cancer pain admitted to Quzhou Hospital of Traditional Chinese Medicine from January 2019 to June 2020 were selected and divided into the control group and observation group, with 51 cases in each group. The control group was given oxycodone hydrochloride sustained-release tablets, and the observation group was treated with self-designed external application of cancer pain analgesic plaster on the basis of the control group. The clinical pain treatment effect, digital pain score (NRS), dosage of oxycodone, frequency of pain outbreak, average starting time of pain relief, Karnofsky functional status (KPS) score, self-rating anxiety scale (SAS) score and daily sleep time changes were compared. The serum levels of pain-causing mediators and immunoregulatory factors were monitored. Results The effective rate of observation group was 93.62%(44/47), which was significantly higher than that of the control group (77.78%, 35/45, P < 0.05). The NRS score of the observation group was significantly lower than that of the control group at 1 day and 1 week after treatment (all P < 0.05). After treatment, compared with the control group, the dose of oxycodone in the observation group was reduced, the number of pain bursts was less and the average time to start pain relief was significantly shortened (all P < 0.05). In the observation group, the KPS score of quality of life significantly increased, the anxiety SAS score was lower, sleep time was significantly increased, the serum pain transmitters SP and PGE2 were significantly decreased and β-EP content significantly increased (all P < 0.05). The IL-2 level in the observation group was significantly higher than that in the control group (all P < 0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P>0.05). Conclusion Self-designed external application of cancer pain analgesia plaster combined with oxycodone hydrochloride in the treatment of refractory cancer pain is safe and effective. Its mechanism may be related to the regulation of serum substance P(SP), prostaglandin E2(PGE2), β-EP and IL-2 levels to relieve pain and enhance immune function. |
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