中药外敷痛点及腧穴配合针刺对晚期肺癌患者癌痛程度、睡眠质量的影响

目的:观察中药外敷痛点及腧穴配合针刺用于晚期肺癌疼痛控制效果及对患者负性情绪、睡眠质量的影响。方法:106例晚期肺癌患者采用随机数字表法分成观察组、对照组各53例,两组均有规范三阶梯止痛方案,对照组采取中药外敷痛点及腧穴治疗,观察组在对照组之上配合针刺治疗,以两周为观察周期,比较两组疼痛NRS评分及疗效,记录患者治疗期间每日阿片类药物剂量、爆发痛发作次数,观察治疗前后血清疼痛介质水平5羟色胺(5-HT)、神经肽Y(NPY)、P物质(SP)、β内啡肽(β-EP)]、焦虑抑郁情绪医院焦虑抑郁量表(HADs)]及睡眠质量匹兹堡睡眠质量指数(PSQI)]。结果:两组治疗后NRS评分均显著低于治疗前(P<0.05),且观察组显著低于对照组(P<0.05),观察组疼痛缓解率94.34%,显著高于对照组81.13%(P<0.05); 观察组每日阿片类药物剂量、爆发痛发作次数均显著低于对照组(P<0.05); 两组治疗后血清5-HT、NPY、SP水平均显著低于治疗前、β-EP水平显著高于治疗前(P<0.05),HADs量表中焦虑、抑郁评分均显著低于治疗前(P<0.05),PSQI得分均显著低于治疗前(P<0.05),且观察组血清5-HT、NPY、SP水平、HAD评分中焦虑、抑郁评分以及PSQI得分均显著低于对照组、血清β-EP水平显著高于对照组(P<0.05)。结论:中药外敷痛点及腧穴配合针刺用于晚期肺癌中,可显著缓解患者疼痛、减少阿片类药物剂量、降低血清疼痛介质水平,有利于改善患者焦虑抑郁情绪、提高睡眠质量。

Effect of external application of Chinese medicine at pain points and acupoints combined with acupuncture on reducing cancer pain level and sleep quality of patients with advanced lung cancer

Objective:To observe the pain control effects of external application of Chinese medicine at pain points and acupoints combined with acupuncture on patients with advanced lung cancer and the effects on negative emotions and sleep quality.Methods:106 patients with advanced lung cancer were divided into observation group and control group according to the random number table method,with 53 cases in each group.The two groups were given standardized three-ladder acesodyne regimen.In addition,control group was given external application of Chinese medicine at pain points and acupoints while observation group was combined with acupuncture on the basis of control group,and 2 weeks were taken as the observation cycle.The pain NRS score and efficacy were compared between the two groups,and the daily dose of opioids and frequency of breakthrough pain attack were recorded during treatment,and the serum pain media(5-HT,NPY,SP,β-EP,HADs,PSQI)were observed before and after treatment.Results:The NRS scores in the two groups after treatment were significantly lower than those before treatment(P<0.05),and the score in observation group was significantly lower than that in control group(P<0.05).The pain relief rate in observation group was significantly higher than that in control group( 94.34% vs 81.13%)(P<0.05).The daily dose of opioids and frequency of breakthrough pain attack in observation group were significantly lower than those in control group(P<0.05).The levels of serum 5-HT,NPY and SP in the two groups after treatment were significantly lower than those before treatment while the β-EP level was significantly higher than that before treatment(P<0.05).The scores of anxiety and depression of HADs were significantly lower than those before treatment(P<0.05)while the PSQI score was significantly lower than that before treatment(P<0.05).The levels of serum 5-HT,NPY and SP and scores of anxiety and depression of HAD scale and score of PSQI in observation group were significantly lower than those in control group while the serum β-EP level was significantly higher than that in control group(P<0.05).Conclusion:External application of Chinese medicine at pain points and acupoints combined with acupuncture for advanced lung cancer can significantly alleviate pain,reduce the dose of opioids and lower the levels of serum pain media,and it is beneficial to improve anxiety and depression and enhance sleep quality.