芍药甘草汤联合加味四黄散外敷对肝癌癌痛的疗效、疼痛介质及炎症因子的影响  

Effect of Shaoyao Gancao decoction combined with modified Sihuang powder on liver cancer pain, pain mediators and inflammatory factors

作　　者：林仰璇 黄定鹏 张洁文 LIN Yangxuan;HUANG Dingpeng;ZHANG Jiewen(Affiliated Traditional Chinese Medicine Hospital of Guangzhou Medical University,Guangzhou Guangdong 510130,China;Department of Gastroenterology,Southern Theater Command General Hospital,Guangzhou Guangdong 510000,China)

机构地区：[1]广州医科大学附属中医医院,广东广州510130 [2]南部战区总医院消化内科,广东广州510000

出　　处：《四川中医》2024年第11期153-156,共4页Journal of Sichuan of Traditional Chinese Medicine

基　　金：广州市卫生健康科技项目(编号:20212A010004,子午流注纳支法联合加味四黄散治疗肝胆湿热型肝癌癌痛的临床研究)。

摘　　要：目的:分析芍药甘草汤联合加味四黄散外敷对肝癌癌痛的疗效、疼痛介质及炎症因子的影响。方法:回顾性选取2022年1月~2023年12月我院收治的68例肝癌癌痛患者为研究对象,以治疗方案不同分为观察组( n =36)和对照组( n =32)。对照组接受常规止痛治疗,观察组接受常规止痛治疗加芍药甘草汤联合加味四黄散外敷治疗,两组均治疗4周。比较两组的治疗效果、疼痛介质[β内啡肽(β-EP)、前列腺素E 2 (PGE 2 )、P物质(SP)]、炎症因子[白细胞介素(IL)-6、IL-1β、肿瘤坏死因子α(TNF-α)]、视觉模拟评分(VAS)、肝癌患者生活质量测定量表(QOL-LC)评分及不良反应事件。结果:观察组治疗效果优于对照组( P <0.05);治疗后,观察组β-EP水平高于对照组( P <0.05),PGE 2 、SP、IL-6、IL-1β、TNF-α水平均低于对照组( P <0.05);观察组的VAS、QOL-LC评分均优于对照组( P <0.05);两组不良反应发生率比较无统计学意义( P >0.05)。结论:芍药甘草汤联合加味四黄散外敷对改善肝癌癌痛具有良好的效果,有助于改善患者疼痛介质和炎症因子水平,从而减轻其疼痛程度,提升生活质量,安全性较好。Objective: To analyze the curative effect of Shaoyaogancao decoction combined with modified Sihuang powder on cancer pain of liver cancer, the influence of pain mediators and inflammatory factors. Methods: Sixty-eight patients with liver cancer pain admitted to our hospital from January 2022to December 2023were retrospectively selected as the study objects, and were divided into observation group( n =36) and control group( n =32) according to different treatment plans. The control group received conventional analgesic treatment, and the observation group received conventional analgesic treatment plus Shaoyao Gancao decoction combined with Jiawei Sihuang powder external treatment, both groups were treated for 4weeks. The therapeutic effects and pain mediators of the two groups were compared [βendorphin(β-EP), prostaglandin E 2 (PGE 2 ), Substance P(SP)], inflammatory factors [interleukin-6, IL-1β, tumor necrosis factor α(TNF-α)], visual analogue scale(VAS), QOL-LC score and adverse events. Results: The treatment effect of observation group was better than that of control group( P <0.05). After treatment, the β-EP level in observation group was higher than that in control group( P <0.05), and the levels of PGE 2 , SP, IL-6, IL-1β and TNF-α were lower than those in control group( P <0.05). VAS, QOL - LC score in observation group were better than the control group( P <0.05). There was no statistical significance in the incidence of adverse events between the two groups( P >0.05). Conclusion: Shaoyaogancao decoction combined with modified Sihuang powder has a good effect on improving the pain of liver cancer, which helps to improve the levels of pain mediators and inflammatory factors in patients, so as to reduce the degree of pain, improve the quality of life, and have good safety.

关 键 词：肝癌癌痛 芍药甘草汤 加味四黄散 疼痛介质 炎症因子 

分 类 号：R273[医药卫生—中西医结合]