自拟芪黄蠲痛汤结合硫酸吗啡缓释片治疗癌性疼痛  

Clinical observation of Qihuang-Juantong decoction combined with morphine sulfate sustained-release tabletsin treatment for cancer pain

作　　者：衣学新[1] 邓军吉 Yi Xuexin;Deng Junji(Department of Hematologic Oncology,Linqu Country People＇s Hospital of Shandong,Linqu 262600,Chin;Radiotherapy Center,Weifang Central Hospital of Shandong,Weifang 261041,China)

机构地区：[1]山东省临朐县人民医院血液肿瘤科,262600 [2]山东省潍坊市中心医院放疗中心,261041

出　　处：《国际中医中药杂志》2018年第10期926-929,共4页International Journal of Traditional Chinese Medicine

摘　　要：目的评价自拟芪黄蠲痛汤结合硫酸吗啡缓释片对癌性疼痛的止痛效果。方法将符合入选标准的107例中重度癌性疼痛患者采用随机数字表法分为对照组53例、治疗组54例。对照组口服硫酸吗啡缓释片，治疗组在对照组基础上加服自拟芪黄蠲痛汤。2组均连续治疗14d。采用荧光标记单克隆抗体CD4^9、CD8^＋及CD4^＋／CD8^＋细胞比值，采用卡氏量表（Kamofsky Performance Status，KPS）评价患者生活质量，记录硫酸吗啡缓释片初始剂量及治疗2周后的服用剂量，评价临床疗效。结果治疗组总有效率为92．6％（50／54）、对照组为71．7％（38／53），2组比较差异有统计学意义（χ^2=7．996，P〈0．05）。治疗后，治疗组CD4^＋[（45．58±6．17）％比（31．06±4．87）％，t=13．496]、CD4^＋／CD8^＋[（1．26±0．15）比（0．69±0．10），t=23．083]高于对照组（P〈0．01）；CD8^＋[（36．18±3．36）％比（44．96±5．04）％，t=10．621]低于对照组（P〈0．01）；治疗组KPS评分[（70-3±6．4）分比（63-4±6．0）分，t=5．711]高于对照组（P〈0．01）；硫酸吗啡缓释片服用剂量[（42．20±5．31）mg比（47．08±6．23）mg，t=4．364]低于对照组（P〈0．01）。结论自拟芪黄蠲痛汤结合硫酸吗啡缓释片可缓解癌性疼痛患者的疼痛程度，提高患者免疫力和生活质量，减少阿片类药物的使用量。Objective To study the clinical efficacy of Qihuang-Juantong decoction combined with morphine sulfate sustained-release tablets in treatment of cancer pain. Methods A total of 107 patients with cancer pain were divided into the control group （n=53） and the treatment group （n=54） randomly. The control group were treated with morphine sulfate sustained-release tablets, and the treatment group were treated with Qihuang-Juantong decoction combined with morphine sulfate sustained-release tablets. The two groups were treated for 14 days. The clinical efficacy of the two groups after treatment was compared. The kamofsky performance status （KPS） score of the two groups before and after treatment were compared. The initial dose and dose after two periods of treatment of morphine sulfate sustained-release tablets of the two groups were compared. The CD4＋, CD8＋ and CD4~/CD8＋ofthe two groups before and after treatment were compared. The adverse reactions rates of the two groups during the treatment were compared. Results Total effective rate of treatment group was 92.59% （50/54）, which was significantly higher than the control group 71.70% （38/53）, and the difference was statistically significant χ^2=7.996, P〈0.05）. After treatment, the KPS score （70.3± 6.4 vs. 63.4 ±6.0, t=5.711） in the treatment group were significantly higher than that in the control group （P〈0.05）, the dose after two periods of treatment of morphine sulfate sustained-release tablets （42.20 ±5.31 mg vs. 47.08 ± 6.23 mg, t=4.364） in the treatment group were significantly lower than that in the control group （P〈0.01）. After treatment, the CD4^＋（45.58%±6.17% vs. 31.06% ± 4.87%, t=13.496）, CD4^＋/CD8^＋（1.26 ± 0.15 vs. 0.69 ± 0.10, t=23.083） in the treatment group were significantly higher than those in the control group （P〈0.05）, the CD8＋ （36.18% ± 3.36% vs. 44.96% ± 5.04%, t=10.621） in the treatment group were significantly lower than those in the control group （P〈0.01�

关 键 词：癌症疼痛 芪黄蠲痛汤 止痛剂(中药) 镇痛药 阿片类 

分 类 号：R730.5[医药卫生—肿瘤]