中药止痛贴联合吗啡治疗中重度癌痛的多中心临床研究  

Multicenter study on traditional Chinese medicine analgesic plaster combined with morphine in treatment of moderate and severe cancer pain

作　　者：喻明[1,2] 王华伟[1] 王文萍[1] 李晓斌[1] 吴登斌[3] 郭占文[4] 张有民[5] 吕玉萍 战祥毅 张文学[2] 

机构地区：[1]辽宁中医药大学附属医院,辽宁沈阳110032 [2]辽宁中医药大学,辽宁沈阳110032 [3]鞍山曙光医院,辽宁鞍山114000 [4]沈阳军区总医院,辽宁沈阳110016 [5]大连市中医院,辽宁大连116013 [6]山东诸城中医院,山东诸城262200 [7]瓦房店市中心医院,辽宁大连116300

出　　处：《中国新药与临床杂志》2015年第8期617-621,共5页Chinese Journal of New Drugs and Clinical Remedies

基　　金：十一五国家科技支撑计划项目(2008BAI53B021);沈阳市科技局课题(F12-262-1-00)

摘　　要：目的评价中药止痛贴联合吗啡治疗中重度癌痛(肝癌、骨转移癌)的有效性和安全性。方法中重度癌痛(肝癌、骨转移癌)患者264例,其中肝癌和骨转移癌患者各132例,分为试验组和对照组(n=66),分别给予中药止痛贴或安慰剂外用贴敷疼痛部位,每日每个部位1贴,同时加服吗啡,给药7 d后比较止痛效果、中医证候疗效等。结果肝癌患者试验组主诉疼痛程度平均下降(1.1±0.8)分,爆发痛平均(0.9±2.2)次·例-1·周-1,治疗满意度均优于对照组(P<0.05);骨转移癌患者试验组睡眠时间平均增加(1.6±1.9)h,疼痛影响评估平均减少(16.1±9.1)分,爆发痛平均(0.4±0.7)次·例-1·周-1,治疗满意度均优于对照组(P<0.05)。两组不良事件主要是合并口服止痛药有关的恶心、呕吐、便秘,未见与中药止痛贴有关不良反应。结论中药止痛贴联合吗啡能缓解中重度癌痛(肝癌、骨转移癌),能减少疼痛影响及提高治疗满意度,安全性高。AIM To evaluate efficacy and safety of traditional Chinese medicine analgesic paste combined with morphine in severe cancer pain （hepatocellular carcinoma, metastatic carcinoma of bone） . METHODS Moderate severe cancer pain （hepatocellular carcinoma, metastatic carcinoma of bone in 264 patients, including hepatocellular carcinoma） and metastatic carcinoma of bone of the 132 patients, divided into experimental group and control group （n = 66）, Chinese medicine analgesic paste or placebo were applied for external use in each pain location 1 sticker daily, at the same time served plus morphine, administration after 7 d. The analgesic effect of traditional Chinese medicine syndrome and curative effect were compared. RESULTS Liver cancer patients in the test group complained of pain degree decreased an average of （ 1.1 ± 0.8） points, an average of （0.9 ± 2.2） times a week, the outbreak of the pain, the treatment satisfaction were superior to the control group （P 〈 0.05）, bone metastasis cancer patients of the test group sleep time increased by an average of （1.6± 1.9） h, pain impact assessment reduce an average of （16.1 ± 9.1） points, average outbreak was （0.4± 0.7） times a week, treatment satisfaction were superior to the control group （P 〈 0.05）. Two groups of adverse events mainly combined oral relief of nausea, vomiting, constipation, no adverse reactions associated with Chinese traditional medicine analgesic plaster. CONCLUSION Herbal analgesic plaster combined with morphine can relieve moderate to severe pain （hepatocellular carcinoma, metastatic bone cancer）, can reduce pain affects and improve the effect of treatment satisfaction and high security.

关 键 词：经皮贴片 吗啡 疼痛管理 肝肿瘤 骨肿瘤 外治法 

分 类 号：R965.1[医药卫生—药理学]