160例恶性肿瘤患者疼痛负担及其影响因素研究  

Pain Burden and Its Influencing Factors for 160 Malignant Tumor Patients

作　　者：黎雪 金嘉悦 韩宝瑾 刘杰[1] 林洪生[1] LI Xue;JIN Jiayue;HAN Baojin;LIU Jie;LIN Hongsheng(Guang′anmen Hospital,China Academy of Chinese Medical Sciences,Beijing 100053,China;Beijing University of Chinese Medicine,Beijing 100029,China)

机构地区：[1]中国中医科学院广安门医院,北京100053 [2]北京中医药大学,北京100029

出　　处：《世界中医药》2023年第8期1136-1141,共6页World Chinese Medicine

基　　金：国家中医药管理局中医药国际合作专项(GZYYGJ2017008);首都临床特色应用研究项目(Z181100001718175);中国中医科学院科技创新工程重大攻关项目-中西医结合优势病症整合证据生态链构建研究(CI2021A05502)。

摘　　要：目的:探索中医药治疗恶性肿瘤患者的疼痛负担及其影响因素。方法:选取2019年9月至2021年12月中国中医科学院广安门医院等10家中医药三甲医院初次就诊的恶性肿瘤患者临床数据,运用简明疼痛调查量表(BPI)进行疼痛评估,采用多因素回归分析方法探讨疼痛负担的影响因素。结果:160例近期未进行抗肿瘤治疗的恶性肿瘤患者中,62.5%为男性患者,65岁以上的患者为55.6%,75.6%临床分期为Ⅳ期,80.6%患者正在使用阿片类药物;癌症患者在过去24 h疼痛平均程度为4分,疼痛最剧烈程度为6分;在疼痛对功能的干扰方面,总体干扰平均得分为4.94分,活动干扰及情感干扰得分分别为5.11分、4.69分;多因素分析中,正在服用阿片类药物的患者具有更高的疼痛最剧烈程度(β=0.239,95%CI为0.267~1.285,P=0.003)。结论:寻求中医药治疗的恶性肿瘤患者疼痛负担总体处于轻至中度水平,疼痛对患者总体功能、活动、情感干扰产生中度影响;正在服用阿片类药物的患者出现爆发痛时疼痛程度更高。Objective:This study aims to explore the pain burden and its influencing factors for malignant tumor patients treated by traditional Chinese medicine(TCM).Methods:The clinical data of malignant tumor patients who first visited the 10 top three hospitals of TCM,such as Guang′anmen Hospital,China Academy of Chinese Medical Sciences from September 2019 to December 2021 were selected.The pain assessment was carried out by using the brief pain inventory(BPI),and the influencing factors of pain burden were explored by multivariate regression analysis.Results:Among 160 malignant tumor patients who had not received antitumor therapy recently,62.5%were male;55.6%were over 65 years;75.6%underwent stageⅣ;80.6%were taking opioids.Those patients experienced an average pain level of 4 and a worst pain level of 6 during the past 24 hours.In terms of the interference of pain on function,the average total interference was 4.94.The activity-related interference and mood-related interference were 5.11 and 4.69,respectively.In the multivariate analysis,the patients taking opioids had more severe pain(β=0.239,95%CI 0.267 to 1.285,P=0.003).Conclusion:The overall pain burden of malignant tumor patients pursuing TCM treatment was at a mild to moderate level,and the pain had a moderate impact on the overall function,activity,and emotional-related interference of patients.Patients taking opioids experienced higher levels of pain when they underwent bursts of pain.

关 键 词：患者报告的临床结局 恶性肿瘤 癌痛 症状负担 简明疼痛调查量表 生命质量 中医药 辨证论治 

分 类 号：R273[医药卫生—中西医结合] R255.9[医药卫生—中医肿瘤科]