基于“子母补泻”法探讨针刺五输穴联合阿片类药物治疗中重度胃癌痛的临床疗效研究  

Clinical Efficacy of Acupuncture at Five-Shu Points Combined with Opioids in the Treatment of Moderate to Severe Gastric Cancer Pain Based on“Zimu Buxie”Method

作　　者：易雨 林颖曈 江钢辉[2] 冯淑兰 张正 YI Yu;LIN Ying-tong;JIANG Gang-hui;FENG Shu-lan;ZHANG Zheng(Clinical Medical College of Acupuncture Moxibustion and Rehabilitation,Guangzhou University of Chinese Medicine,Guangzhou 510405 Guangdong,China;The First Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510405 Guangdong,China)

机构地区：[1]广州中医药大学针灸康复临床医学院,广东广州510405 [2]广州中医药大学第一附属医院,广东广州510405

出　　处：《中医肿瘤学杂志》2024年第3期54-61,共8页Journal of Oncology in Chinese Medicine

基　　金：广东省科技计划(粤港澳大湾区国际科技创新中心建设一粤港澳联合创新领域)(编号:2022A0505020019)。

摘　　要：目的本研究旨在观察针刺五输穴联合阿片类药物对中重度癌痛的临床疗效。方法将来源于广州中医药大学第一附属医院针灸推拿康复中心及肿瘤中心患者60例随机分成试验组和对照组,每组各30例。对照组仅予阿片类止痛药物,试验组在予阿片类止痛药物的基础上同时给予针刺治疗,7天为1个疗程,共1个疗程,疗程结束2周后进行随访。观察治疗前后及随访时患者的数字疼痛评分量表(Numerical rating scale,NRS)、简化McGill疼痛问卷(SF-MPQ)、肿瘤患者生活质量评分(QOL量表)及治疗期间患者使用阿片类止痛药物总剂量。结果治疗后及随访时两组NRS量表评分、SF-MPQ量表总分均较治疗前有所下降,试验组评分差值较对照组更大,且止痛效果更持久,两组间差异均具有统计学意义(P<0.05)。对于中度癌痛的治疗,试验组的总体疼痛缓解有效率优于对照组,但差异无统计学意义(P>0.05);而对于重度癌痛,试验组的总体疼痛缓解有效率明显优于对照组,且差异具有统计学意义(P<0.05)。治疗前后及随访时患者QOL量表评分结果显示,试验组和对照组评分结果均较治疗前上升,但两组之间分值结果比较差异不具有统计学意义(P>0.05)。治疗前后两组药物使用总剂量结果显示,试验组使用总剂量明显低于对照组,且组间结果比较差异具有统计学意义(P<0.05)。结论本研究提示基于“子母补泻”配穴法针刺五输穴联合阿片类药物的总体临床疗效优于单纯使用阿片类药物,且能一定程度上减少药物用量,具有临床应用价值。Objective The purpose of this study was to observe the clinical efficacy of acupuncture at five-shu points combined with Opioids in the treatment of moderate to severe gastric cancer pain.Methods 60 patients from the Acupuncture and Massage Rehabilitation Center and Tumor Center of the First Affiliated Hospital of Guangzhou University of Chinese Medicine were randomly divided into the experimental group and the control group,with 30 cases in each group.The control group only received Opioid analgesics,while the experimental group received acupuncture therapy in addition to opioid analgesics.Both groups were treated for 7 days as a treatment course and were followed up after 2 weeks of treatment.The numerical rating scale(NRS),SF-MPQ,QOL scale,and total dose of Opioid analgesics used during treatment were observed before and after treatment as well as follow-up.Results After treatment and during follow-up,the NRS scores and total scores of SF-MPQ scale decreased in both groups compared to before treatment.The score difference of the experimental group was larger than that of the control group,and the analgesic effect was more persistent.The difference between the two groups was statistically significant(P<0.05).As for moderate cancer pain,the overall response rate of pain relief in the experimental group was better than that of the control group,but there was no statistically significant difference between the two groups(P>0.05).However,as for severe cancer pain,the overall response rate of pain relief in the experimental group was significantly better than that of the control group,and the difference was statistically significant(P<0.05).The results of the QOL scale before and after treatment as well as during follow-up showed that the scores of both the experimental group and the control group were higher than those before treatment.However,there was no statistically significant difference between the two groups(P>0.05).The total dose of both groups before and after treatment revealed that the total dose of the

关 键 词：五输穴 针刺 胃癌 癌痛 

分 类 号：R273[医药卫生—中西医结合] R735.2[医药卫生—中医肿瘤科]