玄乌止痛膏穴位贴敷联合益气养阴解毒汤治疗癌性疼痛临床疗效及对患者生活质量的影响  

Clinical effect of acupoint application of Xuanwu Zhitong Paste combined with Yiqi Yangyin Jiedu Decoction on patients with cancer pain and its influence on quality of life

作　　者：李鑫 李占林 张光 李艳孔 解晓芳 崔朦 LI Xin;LI Zhanlin;ZHANG Guang;LI Yankong;XIE Xiaofang;CUI Meng(Department of Oncology,Zhangjiakou Hospital of Traditional Chinese Medicine,Zhangjiakou,Hebei 075000)

机构地区：[1]河北省张家口市中医院肿瘤科,河北张家口075000

出　　处：《河北中医》2024年第6期928-931,共4页Hebei Journal of Traditional Chinese Medicine

基　　金：张家口市重点研发计划项目(编号:2121051D)。

摘　　要：目的观察玄乌止痛膏穴位贴敷联合益气养阴解毒汤治疗癌性疼痛的临床疗效及对患者生活质量的影响。方法将60例癌性疼痛患者按照随机数字表法分为2组,对照组30例予三阶梯止痛治疗,治疗组30例予玄乌止痛膏穴位贴敷联合益气养阴解毒汤治疗,2组均治疗4周。比较2组镇痛疗效;比较2组疼痛缓解时间、镇痛持续时间及爆发痛发作次数;比较2组治疗前后疼痛介质指标变化;比较2组治疗前后生活质量评分;观察2组不良反应。结果治疗组总有效率90.00%(27/30),对照组总有效率66.67%(20/30),治疗组镇痛疗效优于对照组(P<0.05)。治疗组疼痛缓解时间、爆发痛发作次数均低于对照组(P<0.05),镇痛持续时间多于对照组(P<0.05)。2组治疗后内皮素-1(ET-1)、神经肽Y(NPY)水平均较本组治疗前降低(P<0.05),β-内啡肽(β-EP)水平较本组治疗前升高(P<0.05);治疗后治疗组ET-1、NPY水平均低于对照组(P<0.05),β-EP水平高于对照组(P<0.05)。2组治疗后世界卫生组织生存质量测定量表(WHOQOL-BREF)各项评分均较本组治疗前升高(P<0.05),且治疗组升高更明显(P<0.05)。治疗组不良反应总发生率低于对照组(P<0.05)。结论玄乌止痛膏穴位贴敷联合益气养阴解毒汤治疗癌性疼痛,镇痛效果显著,可有效改善患者疼痛介质水平,快速持久发挥镇痛效果,减少爆发痛发作次数,提高生活质量,安全性高。Objective To analyze the clinical effect of acupoint application of Xuanwu Zhitong Paste combined with Yiqi Yangyin Jiedu Decoction on patients with cancer pain and its influence on quality of life.Methods Sixty patients with cancer pain were randomly assigned to receive either three-step analgesic ladder(the control group,n=30)or acupoint application of Xuanwu Zhitong Paste combined with Yiqi Yangyin Jiedu Decoction(the treatment group,n=30).A 4-week treatment was performed.The pain relief time,duration of analgesic,number of breakthrough pain(BTP),pain mediator indexes,quality of life score were included as comparators.The analgesic effect and adverse reactions were assessed.Results The overall effective rate in the treatment group was better than that in the control group(90.00%[27/30]vs 66.67%[20/30],P<0.05).The pain relief time and the BTP frequency in the treatment group were significantly lower than those of the control group(P<0.05),and the duration of analgesia was significantly longer than that in the control group(P<0.05).After treatment,endothelin-1(ET-1)and neuropeptide Y(NPY)in the two groups decreased significantly than those before treatment,butβ-endorphin(β-EP)increased significantly(all P<0.05),and the treatment group was superior to the control group for ET-1,NPY andβ-EP(all P<0.05).After treatment,the quality of life score in the both groups was significantly higher than that before treatment(P<0.05),the improvement was more pronounced in the treatment group relative to the control group(P<0.05).The total incidence of adverse reactions was significantly lower in the treatment group than in the control group(P<0.05).Conclusion The acupoint application of Xuanwu Zhitong Paste combined with Yiqi Yangyin Jiedu Decoction has a significant analgesic effect in patients with cancer pain.It can effectively improve the levels of pain mediators,quickly and lastingly exert analgesic effects,reduce BTP frequency,improve the quality of life,and with a high safety.

关 键 词：疼痛 肿瘤 并发症 穴位贴敷疗法 中药疗法 

分 类 号：R441.1[医药卫生—诊断学] R273[医药卫生—临床医学] R245.9R289.6