腕踝针配合阿片类药物治疗难治性癌痛:随机对照研究  

Wrist-ankle needle combined with opioid drugs on refractory cancer pain: a randomized controlled trial

作　　者：吴秋兰 曹雯[1] 王伟[1] 姜子瑜[1] 陈莉[1] 李丽丽[1] WU Qiu-lan;CAO Wen;WANG Wei;JIANG Zi-yu;CHEN Li;LI Li-li(Department of Oncology, Hospital of Integrated Traditional Chinese and Western Medicine Affiliated to Nanjing University of CM, Nanjing 210028, Jiangsu Province,China)

机构地区：[1]南京中医药大学附属中西医结合医院肿瘤科

出　　处：《中国针灸》2019年第10期1051-1054,共4页Chinese Acupuncture & Moxibustion

基　　金：国家中医药管理局2016年全国中医护理骨干人才培训项目:国中医药办人教发[2016]37号

摘　　要：目的:比较腕踝针配合阿片类药物与单纯阿片类药物治疗难治性癌痛的临床效果。方法:将60例患者随机分为观察组和对照组,每组30例。对照组按三阶梯镇痛原则以阿片类药物为主,配合其他辅助药物镇痛治疗;观察组在此基础上加用腕踝针治疗,根据患者疼痛的部位结合原发灶进行选穴,每日1次,连续治疗10d。治疗第2、4、6、8、10天和治疗结束第3、7天分别比较两组患者视觉模拟量表(VAS)评分,治疗第2、6、10天和治疗结束后第7天比较两组患者爆发痛次数的变化,治疗后比较两组的临床疗效和不良反应的发生率。结果:与对照组比较,观察组从腕踝针治疗第2天开始VAS评分显著降低并持续到腕踝针治疗结束第3天(P<0.05),但治疗结束第7天两组VAS评分比较差异无统计学意义(P>0.05);与对照组比较,观察组治疗第2天到第10天爆发痛次数均减少(均P<0.05);与对照组比较,观察组恶心、呕吐和便秘的发生率显著减少(P<0.05);观察组患者总有效率为86.7%(26/30),高于对照组的76.7%(23/30,P<0.05)。结论:腕踝针配合阿片类为主的药物治疗能提高难治性癌痛的疗效,并降低阿片类药物的不良反应。Objective To compare the clinical effect of wrist-ankle needle combined with opioid drugs and opioid drugs alone in treating refractory cancer pain. Methods Sixty patients were randomly divided into an observation group and a control group, 30 cases in each one. The opioid drugs in accordance with the three-step analgesic principle and other auxiliary drugs were treated in the control group. On the basis of the treatment in the control group, wrist-ankle needle was added in the observation group, and acupoints were selected according to the pain site and the primary focus, the treatment was given once a day for 10 days. The visual analogue scale(VAS) score, the times of pain outbreaks and the incidence of adverse reactions were compared at the 2 nd, 4 th, 6 th, 8 th and 10 th days of treatment and the 3 rd and 7 th days after treatment. The therapeutic effect in the two groups were compared after treatment. Results Compared with the control group, the VAS scores in the observation group were significantly reduced from the 2 nd day of wrist-ankle needle treatment,and continued to the 3 rd day after the end of the treatment(P<0.05), but there was no statistically significant difference between the two groups on the 7 th day after the end of the treatment(P>0.05);compared with the control group, the times of pain outbreaks in the observation group decreased from the 2 nd day to the 10 th day of treatment(all P<0.05);the incidence of nausea, vomiting and constipation in the observation group was significantly reduced compared with the control group(P<0.05);the total effective rate in the observation group was 86.7%(26/30), which was higher than 76.7%(23/30) in the control group(P<0.05). Conclusion Wrist-ankle needle combined with opioid drugs can increase the efficacy of the refractory cancer pain and reduce the adverse reactions of opioid drugs.

关 键 词：难治性癌痛 腕踝针 阿片类药物 镇痛 随机对照试验 

分 类 号：R246.1[医药卫生—针灸推拿学]