电针缓解癌痛患者阿片耐受的临床观察  

Clinical observation of electroacupuncture relieving opioid resistance in cancer pain patients

作　　者：李莎[1] 田伟千[1] 赵峰[1] 季淑娟[1] 姚凤珍[1] 汤洋[1] 朱明慧[1] LI Sha;TIAN Weiqian;ZHAO Feng;JI Shujuan;YAO Fengzhen;TANG Yang;ZHU Minghui(Affiliated Hospital of Nanjing University of Chinese Medicine,Nanjing 210029,China)

机构地区：[1]南京中医药大学附属医院,南京210029

出　　处：《上海针灸杂志》2023年第9期889-894,共6页Shanghai Journal of Acupuncture and Moxibustion

基　　金：江苏省卫生计生委医学科研课题(H2018107)。

摘　　要：目的观察电针缓解癌痛患者阿片耐受的临床疗效。方法将60例癌痛患者随机分为电针组和对照组,每组30例。两组均使用阿片类药物进行镇痛治疗,电针组取双侧内关和足三里穴进行电针治疗,对照组取双侧内关和足三里穴旁开15 mm处非穴位点进行电针治疗。观察两组阿片耐受指数、爆发痛的次数和疼痛缓解持续时间,比较两组治疗前后数字等级评定量表(numeric rating scale,NRS)和欧洲癌症研究与治疗组织生命质量核心量表(European Organization for Research and Treatment of Cancer quality of life questionnaire-C30,EORTC QLQ-C30)评分变化,并比较两组不良反应发生率。结果电针组阿片耐受指数低于对照组(P<0.05),爆发痛次数低于对照组(P<0.05),疼痛缓解持续时间长于对照组(P<0.05)。电针组治疗后情绪、躯体、认知和社会功能及总体健康评分高于治疗前和对照组(P<0.05);电针组治疗后疲倦、恶心呕吐、疼痛、气促、失眠、食欲丧失和便秘评分低于治疗前和对照组(P<0.05)。电针组恶心呕吐和便秘的发生率低于对照组(P<0.05)。结论电针可减少癌痛患者镇痛治疗期间阿片耐受的发生,减轻疼痛,提高生活质量。Objective To observe the clinical efficacy of electroacupuncture in relieving opioid resistance in patients suffering from cancer pain.Method Sixty patients with cancer pain were randomized into an electroacupuncture group and a control group,with 30 cases in each group.Both groups used opioids for analgesia.In addition,the electroacupuncture group received electroacupuncture at bilateral Neiguan(PC6)and Zusanli(ST36),and the control group received electroacupuncture at non-meridian spots 15 mm away from bilateral Neiguan and Zusanli.The opioid resistance index,number of pain attacks,and pain-released duration were observed;before and after the treatment,the numeric rating scale(NRS)and European Organization for Research and Treatment of Cancer quality of life questionnaire-C30(EORTC QLQ-C30)scores were compared,as well as the adverse reaction rate.Result The opioid resistance index was lower in the electroacupuncture group than in the control group(P<0.05),so was the number of pain attacks(P<0.05),and the pain-released duration was longer in the electroacupuncture group than in the control group(P<0.05).After the treatment,the affection,body,cognition,social function,and overall health scores were higher in the electroacupuncture group compared with the same group before the treatment and the control group(P<0.05);the scores of fatigue,nausea-vomiting,pain,shortness of breath,insomnia,loss of appetite,and constipation dropped in the electroacupuncture group after the treatment and were lower than those in the control group(P<0.05).The occurrence rates of nausea-vomiting and constipation were lower in the electroacupuncture group than in the control group(P<0.05).Conclusion Electroacupuncture can reduce opioid resistance,ease pain,and enhance the quality of life in cancer pain patients during analgesic treatments.

关 键 词：电针 针药并用 癌痛 药物耐受 穴 内关 穴 足三里 数字等级评定量表 欧洲癌症研究与治疗组织生命质量核心量表 

分 类 号：R246.5[医药卫生—针灸推拿学]