针刺联合复方苦参注射液治疗胃癌疼痛的临床研究  

Clinical Study on Acupuncture plus Compound Ku Shen Injection for Gastric Cancer Pain

作　　者：李德辉[1] 苏伊璠 范焕芳[1] 孙春霞[1] LI De-hui;SU Yi-fan;FAN Huan-fang;SUN Chun-xia(Hebei Hospital of Traditional Chinese Medicine,Shijiazhuang 050011,China)

机构地区：[1]河北省中医院,石家庄050011

出　　处：《上海针灸杂志》2021年第4期406-410,共5页Shanghai Journal of Acupuncture and Moxibustion

基　　金：国家自然科学基金项目(81603412);河北省重点研发计划项目(18277731D);河北省中医药管理局科研计划项目(2017163,2019008,2020014);河北中医学院科研能力提升一般项目(KTY2019009);河北省中西医结合肝肾病证研究重点实验室2019年度开放课题资助项目(A201902);河北省“三三三人才工程”资助项目(A202002008)。

摘　　要：目的在三级阶梯止痛治疗基础上,观察针刺联合复方苦参注射液静脉滴注治疗胃癌疼痛的临床疗效及安全性。方法将符合纳入标准的80例胃癌疼痛患者随机分为4组,对照组、复方苦参注射液组、针刺组和联合组,每组20例。对照组予三阶梯止痛治疗,复方苦参注射液组在对照组治疗基础上予以复方苦参注射液静脉滴注,针刺组在对照组治疗基础上予针刺双侧足三里、太冲和合谷,联合组在对照组治疗基础上予以针刺联合复方苦参注射液静脉滴注治疗(针刺治疗方法同针刺组,复方苦参注射液治疗方法同复方苦参注射液组)。采用WHO评定标准判断止痛疗效,采用肿瘤生活质量评分(QOL)与Karnofsky功能状态评分(KPS)对患者治疗前后的生活质量进行评价,采用抑郁自评量表(SDS)和焦虑自评量表(SAS)对患者治疗前后的抑郁和焦虑状态进行评估。比较4组胃肠道不良反应发生率。结果治疗后,联合组临床显效率明显高于对照组,差异有统计学意义(P<0.01)。4组治疗后生活质量评分和抑郁评分均较治疗前明显改善(P<0.01)。联合组治疗后生活质量评分改善程度优于其他3组,差异有统计学意义(P<0.05);联合组治疗后SDS和SAS评分改善程度优于复方苦参注射液组和对照组,差异有统计学意义(P<0.05)。针刺组和联合组胃肠道不良反应发生率均低于对照组,差异有统计学意义(P<0.05,P<0.01)。结论在三级阶梯止痛治疗基础上,针刺联合复方苦参注射液静脉滴注治疗胃癌疼痛可提高止痛疗效,进一步改善患者的生活质量和抑郁焦虑程度,减少胃肠道不良反应的发生。Objective To observe the clinical efficacy and safety of acupuncture plus intravenous drips of compound Ku Shen injection in treating gastric cancer pain on the basis of three-step analgesic treatment.Method Eighty patients with gastric cancer pain meeting the diagnostic criteria were randomized to four groups,a control,a compound Ku Shen injection,an acupuncture and a combination group,with 20 cases in each group.The control group received three-step analgesic treatment;the compound Ku Shen injection group received intravenous drips of compound Ku Shen injection in addition to three-step analgesic treatment;the acupuncture group received acupuncture at bilateral Zusanli(ST36),Taichong(LR3)and Hegu(LI4)in addition to three-step analgesic treatment;the combination group received acupuncture(the same method as the acupuncture group)plus intravenous drips of compound Ku Shen injection(the same method as the compound Kushen injection group)in addition to three-step analgesic treatment.The analgesic effect was assessed using the WHO evaluation criteria.The quality of life was assessed using the tumor quality of life(QOL)score and the Karnofsky performance status scale(KPS)in the patients before and after treatment.Depression severity was assessed using the self-rating depression scale(SDS).Anxiety severity was assessed using the self-rating anxiety scale(SAS).The incidences of adverse reactions were compared between the four groups of patients.Result The clinical marked efficacy rate was significantly higher in the combination group than in the control group with a statistically significant difference between the two groups(P<0.01).The quality of life score increased significantly and the depression score decreased significantly in the four groups after treatment compared with before(P<0.01).The quality of life score increased more in the combination group than in the other three groups after treatment with statistically significant differences(P<0.05).The SDS and SAS scores decreased more in the combination group tha

关 键 词：针刺疗法 胃肿瘤 癌性疼痛 镇痛 三阶梯止痛法 复方苦参注射液 针药并用 

分 类 号：R246.5[医药卫生—针灸推拿学]