基于整体观动态评价止痛搽剂治疗癌性疼痛的疗效  

Evaluation of Analgesic Liniment in Treating Cancer Pain Based on Dynamic Holistic View

作　　者：刘海涛 顾红军 金美 许雯 张璐 唐亚荣 LIU Haitao;GU Hongjun;JIN Mei;XU Wen;ZHANG Lu;TANG Yarong(Integrative Medicine Hospital of Jinshan District of Shanghai,Shanghai China 201501;Jinshan Branch of Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai China 201501)

机构地区：[1]上海市金山区中西医结合医院,上海201501 [2]上海中医药大学附属龙华医院金山分院,上海201501

出　　处：《中医学报》2023年第10期2214-2221,共8页Acta Chinese Medicine

基　　金：上海市金山区卫生健康委员会课题项目(JSKJ-KTZY-2020-02)。

摘　　要：目的:基于中医整体观引入生活质量量表联合疼痛量表动态评价止痛搽剂治疗癌性疼痛的临床疗效。方法:91例癌性疼痛患者采用完全随机、平行对照的方法分为对照组和治疗组。对照组以常规癌症镇痛三阶梯治疗为主,治疗组在对照组治疗基础上给予止痛搽剂(在疼痛部位涂搽两次,涂搽后应用经皮离子导入技术以促进药物吸收)。观察周期为6周,比较治疗前、治疗3周、治疗6周视觉模拟量表(visual analogue scale,VAS)评分、疼痛数字评估量表(numerical rating scales,NRS)评分、生活质量(quality of life,QOL)评分、McGill疼痛量表评分及临床疗效。结果:采用重复测量统计显示,与治疗前比较,两组患者疼痛均显著改善(P<0.01);t检验显示,入组时及治疗第3周两组患者疼痛比较,差异无统计学意义(P>0.05);治疗第6周,治疗组NRS、体力状况、QOL模块均显著优于对照组(P<0.01),其余模块之间比较,差异有统计学意义(P<0.05)。秩和检验显示,两组患者用药变化比较,差异无统计学意义(P>0.05)。Pearson相关分析显示,3个不同调查时间段各模块组之间均呈显著相关(P<0.01),其相关性并不随着时间的延长而改变。量表信度采用克朗巴哈α系数检测显示,各项系数均>0.8,信度非常好;量表效度采用探索性因子分析显示,KMO=0.799>0.5,适合因子分析。结论:中药止痛搽剂联合癌症镇痛三阶梯治疗明显优于单纯三阶梯治疗,特别是在改善患者生活质量及体力状况方面尤为显著。Objective:Based on the holistic view of traditional Chinese medicine,the quality of life scale and pain scale were introduced to dynamically evaluate the clinical efficacy of analgesic liniment in treating cancer pain.Methods:91 patients with cancer pain were randomly divided into control group and treatment group.The control group was mainly treated with conventional three-step cancer analgesia,while the treatment group was given analgesic liniment on the basis of the control group(applying transdermal iontophoresis to promote drug absorption after applying it twice to the painful part).The observation period was 6 weeks.The scores of visualanaloguescale(VAS),numericalratingscales(NRS),qualityoflife(QOL)and McGill Pain Scale were compared before treatment,after treatment for 3 weeks and after treatment for 6 weeks,and the clinical efficacy was counted.Results:The repeated measurement statistics showed that the pain of the two groups was significantly improved compared with that before treatment(P<0.01).T-test showed that there was no significant difference in pain between the two groups at the time of admission and the third week of treatment(P>0.05).At the 6th week of treatment,the NRS,physical condition and QOL module in the treatment group were significantly better than those in the control group(P<0.01),and the differences among other modules were statistically significant(P<0.05).Rank sum test showed that there was no significant difference in drug use between the two groups(P>0.05).Pearson correlation analysis showed that there was a significant correlation among all the modules in three different investigation periods(P<0.01),and the correlation did not change with time.The reliability of the scale was tested by Cronbach α coefficient,and all the coefficients were greater than 0.8,so the reliability was very good.Exploratory factor analysis showed that KMO=0.799>0.5,which was suitable for factor analysis.Conclusion:The analgesic liniment combined with cancer analgesic three-step therapy is obviously supe

关 键 词：癌性疼痛 止痛搽剂 生活质量 整体观 

分 类 号：R273.07[医药卫生—中西医结合]