阿片耐受的癌痛患者HANS辅助镇痛的随机对照研究  

A RANDOMIZED CONTROLLED TRIAL ON THE ADJUVANT HANS THERAPY IN OPIOID TOLERANT CANCER PAIN PATIENTS

作　　者：李小梅 肖文华[2] 赵慧霞[2] 孙红[3] 李萍萍[3] 吴晓明[4] 

机构地区：[1]解放军总医院南楼肿瘤内科,北京100853 [2]解放军总医院第304临床部肿瘤内科,北京100048 [3]北京大学肿瘤医院中西医结合科,北京100142 [4]中国医学科学院肿瘤医院综合科,北京100021

出　　处：《中国疼痛医学杂志》2016年第5期364-369,共6页Chinese Journal of Pain Medicine

摘　　要：目的:观察并评价韩氏穴位神经刺激仪(Han's acupoint nerve stimulator,HANS)对阿片耐受癌痛患者的辅助镇痛效果。方法:将阿片耐受的癌痛患者随机分两组,分别予HANS和MockHANS(假韩氏)治疗。用患者自评问卷评估基线和第8、15日的疼痛、生活质量和焦虑抑郁,并比较两组治疗后的均值。结果:64例患者完成2周治疗和评估(HANS组33例,Mock-HANS组31例),两组基线资料无显著差异。与Mock-HANS组相比,HANS组第8、15日的"最轻"和"平均"疼痛强度均值、第8日的"最重"疼痛强度均值都显著降低;第8及第15日的"日常生活"及"睡眠"的受干扰程度也明显改善。HANS组第8、15日时的"便秘"、"乏力"、"失眠"以及抑郁的得分均值、第15日的焦虑得分均值都显著低于对照组。结论:HANS可有效缓解阿片耐受患者的癌痛,减轻便秘、乏力和失眠等症状,并能显著缓解焦虑抑郁,是一种简便安全的非药物镇痛方法,值得进一步研究和应用。Objectives： To observe and evaluate adjuvant analgesic efficacy of Han＇s Accupoint Nerve Stimulator（HANS） in opioid tolerant cancer pain patients. Methods： Opioid tolerant cancer pain patients were randomly assigned into two groups either treated with HANS or Mock-HANS（fake-HANS）, respectively. Patient-reported questionnaires were used to assess baseline, the 8th and 15 th day＇s pain, Quality of life（QOL）, and anxiety and depression. Mean scores of the two groups of these measurements were compared accordingly. Results： 64 patients（33 in HANS group and 31 in Mock-HANS group） completed 2 weeks treatment and assessment. There was no significant difference at baseline between two groups. Compared with Mock-HANS group, HANS group reported significantly lower mean scores of the ＂least＂ and ＂average＂ pain intensity on Day 8 and 15, lower ＂worst＂ pain intensity on day 8, and less interfered ＂daily life＂ and ＂sleep＂ on day 8 and 15. Mean scores of constipation, fatigue, insomnia of HANS group were also significantly lower on both Day 8 and 15, compared with Mock-HANS group. The mean score of SDS（Self-Rating Depression Scale） on day 8 and day 15 and that of SAS（Self-Rating Anxiety Scale） on day 15 were significantly lower in HANS group, compared with Mock-HANS group. Conclusion： For cancer patients with opioid tolerance, HANS could effectively relieve pain and decrease the severity of constipation, fatigue and insomnia. Besides, HANS treatment could also alleviate anxiety and depression. These results suggested that HANS is a simple and safe non-drug analgesia treatment and deserves further study and application.

关 键 词：癌痛 阿片耐受 韩氏穴位神经刺激仪 

分 类 号：R730.5[医药卫生—肿瘤]