中医定向透药治疗联合三阶梯止痛法对原发性胃癌患者化疗期间癌因性疲乏程度和癌性疼痛改善情况的影响  

Effects of Traditional Chinese Medicine Directional Penetration Combined with Three-Step Analgesic Ladder on Cancer-Related Fatigue Degree and Cancer Pain Improvement in Patients with Primary Gastric Cancer During Chemotherapy

作　　者：董明 雷静 王丽红 DONG Ming;LEI Jing;WANG Lihong(Dept.of Oncology,Qinhuangdao Hospital of Tianjin Cancer Hospital,Hebei Qinhuangdao 066000,China)

机构地区：[1]天津市肿瘤医院秦皇岛医院肿瘤科,河北秦皇岛066000

出　　处：《中国医院用药评价与分析》2025年第3期309-312,共4页Evaluation and Analysis of Drug-use in Hospitals of China

基　　金：2021年河北省医学科学研究课题计划(No.20211071)。

摘　　要：目的:探讨中医定向透药治疗联合三阶梯止痛法对原发性胃癌患者化疗期间癌因性疲乏程度和癌性疼痛改善情况的影响。方法:选取2022年6月至2024年6月该院收治的原发性胃癌疼痛患者106例,经随机数表法分为单纯止痛组和透入止痛组,各53例。单纯止痛组患者采用三阶梯止痛法,透入止痛组患者采用中医定向透药治疗联合三阶梯止痛法。比较两组患者的疼痛缓解效果、镇痛药剂量,治疗前和治疗第3、7日的癌性疼痛程度[数字疼痛分级法(NPIS)]、癌因性疲乏评分变化,对比治疗前后疼痛应激指标[β-内啡肽、降钙素基因相关肽(CGRP)和前列腺素E2(PEG2)]水平,记录不良反应发生情况。结果:透入止痛组患者的疼痛缓解率为96.23%(51/53),高于单纯止痛组的84.91%(45/53),差异有统计学意义(χ^(2)=3.975,P<0.05)。治疗第1日,两组患者镇痛药剂量比较,差异无统计学意义(t=1.092,P>0.05);治疗第3、7日,透入止痛组患者镇痛药剂量低于单纯止痛组,差异均有统计学意义(t分别为4.262、6.506,P<0.05)。治疗第3、7日,透入止痛组患者癌性疼痛NPIS评分、癌因性疲乏评分低于单纯止痛组,差异均有统计学意义(治疗第3日:t分别为5.137、10.981,P<0.05;治疗第7日:t分别为4.878、9.159,P<0.05)。治疗后,透入止痛组患者β-内啡肽水平高于单纯止痛组,CGRP和PEG2水平低于单纯止痛组,差异均有统计学意义(t分别为5.332、5.741、5.567,P<0.05)。透入止痛组患者镇痛药相关不良反应为9.43%(5/53),低于单纯止痛组的24.53%(13/53),差异有统计学意义(χ^(2)=4.283,P<0.05)。结论:中医定向透药治疗联合三阶梯止痛法能够有效改善原发性胃癌患者化疗期间的癌性疼痛和癌因性疲乏,减少镇痛药用量,缓解疼痛应激反应,且安全性好。OBJECTIVE:To probe into the effects of traditional Chinese medicine directional penetration combined with three-step analgesic ladder on cancer-related fatigue(CRF)degree and cancer pain improvements in patients with primary gastric cancer during chemotherapy.METHODS:A total of 106 patients with primary gastric cancer pain admitted into the hospital from Jun.2022 to Jun.2024 were selected to be divided into the simple analgesia group and penetration analgesia group via random number table method,with 53 cases in each group.The simple analgesia group was given three-step analgesic ladder,while the penetration analgesia group was given traditional Chinese medicine directional penetration combined with three-step analgesic ladder.The pain relief effect,analgesic dosage,changes of cancer pain degrees[Numeric Pain Intensity Scale(NPIS)]and CRF scores before treatment and at the 3rd day and 7th day of treatment were compared between two groups,the levels of pain stress indicators[β-endorphin,calcitonin gene-related peptide(CGRP)and prostaglandin E2(PEG2)]before and after treatment were compared,and the incidences of adverse drug reactions were recorded.RESULTS:The pain relief rate of the penetration analgesia group was 96.23%(51/53),higher than 84.91%(45/53)of the simple analgesia group,with statistically significant difference(χ^(2)=3.975,P<0.05).At the 1st day of treatment,there was no statistically significant difference in the comparison of analgesic dosages between groups(t=1.092,P>0.05),at the 3rd day and 7th day of treatment,the analgesic dosages of the penetration analgesia group were less than those of the simple analgesia group,with statistically significant differences(t were 4.262 and 6.506,respectively,P<0.05).At the 3rd day and 7th day of treatment,the scores of cancer pain NPIS and CRF of the penetration analgesia group were lower than those of the simple analgesia group,with statistically significant differences(at the 3rd day of treatment:t were 5.137 and 10.981,respectively,P<0.05;at the 7th day of

关 键 词：原发性胃癌 中医定向透药 三阶梯止痛法 癌因性疲乏 癌性疼痛 

分 类 号：R932[医药卫生—生药学] R971[医药卫生—药学]