综合疗法对阿片类药物治疗癌性疼痛患者的减毒增效作用  

Attenuated and synergistic effect of comprehensive therapy in patients receiving opioids for cancer pain

作　　者：张云芳[1] 万兴富 畅达[3] 

机构地区：[1]海南省中医院肿瘤科,海口571100 [2]琼海市中医院肿瘤科,琼海571400 [3]山西运城市中医医院门诊部,运城044000

出　　处：《中国肿瘤临床与康复》2017年第10期1158-1161,共4页Chinese Journal of Clinical Oncology and Rehabilitation

基　　金：海南省卫生厅资助项目(15036030A20003)

摘　　要：目的探讨综合疗法对阿片类药物治疗癌性疼痛患者的增效减毒作用。方法选取2016年5月至2017年6月间海南省中医院收治的100例癌性疼痛患者,采用随机数表法分为治疗组与对照组,每组50例。两组患者均给予阿片类药物止痛,治疗组患者给予止痛方联合通腑方治疗,对照组患者联合乳果糖口服溶液治疗。比较两组患者镇痛疗效、疼痛评分、体力状况评分(KPS)及不良反应情况。结果治疗组患者镇痛总有效率为92.0%,优于对照组患者的76.0%,差异有统计学意义(P<0.05)。治疗组患者疼痛评分及KPS评分优于对照组,差异均有统计学意义(均P<0.01)。治疗组患者便秘、恶心呕吐和尿潴留发生率均显著低于对照组患者,差异均有统计学意义(均P<0.05),两组患者皮肤瘙痒和头晕等不良反应比较,差异无统计学意义(P>0.05)。结论综合疗法运用于阿片类药物治疗癌性疼痛患者中,能够提高癌痛控制度,减轻阿片类药物的不良反应,改善患者生活质量。Objective To explore the efficacy of comprehensive therapy in patients receiving opioids for cancer pain. Methods One hundred patients with cancer pain were selected at Hainan Provincial Hospital of Traditional Chinese Medicine from May 2016 to June 2017. The patients were divided into a treatment group and a control group by a random number table with 50 patients in each group. Both groups were given opioid analgesics. The treatment group was given analgesic decoction combined with Tongfu decoction and the control group was treated with lactulose oral solution. The analgesic efficacy,pain score,physical condition score（ KPS） and adverse reactions were compared between the two groups. Results The overall efficacy rate was 92. 0 % for the treatment group,which was better than76. 0 % of the control group（ P〈0. 05）. The pain score and KPS score were better in the treatment group than in the control group（ all P〈0. 01）. There was no statistically significant difference in adverse reactions including skin itching and dizziness between the two groups（ P〉0. 05）. The incidence of constipation,nausea,vomiting and urinary retention was significantly lower in the treatment group than in the control group（ all P〈0. 05）. Conclusion Comprehensive therapy can improve the degree of cancer pain control,reduce the adverse effects of opioids and improve the quality of life in patients receiving opioids for cancer pain.

关 键 词：综合疗法 阿片类药物 癌性疼痛 增效减毒 

分 类 号：R730.5[医药卫生—肿瘤]