加味芍药甘草汤缓解中晚期结肠癌患者癌性疼痛的效果  

Effect of Jiawei Shaoyao Gancao Decoction(加味芍药甘草汤)on Relieving Cancer Pain in Patients with Advanced Colon Cancer

作　　者：王文雯 孙颖 李哲[2] 王爱丽 赛佳洋 董莹 WANG Wenwen;SUN Ying;LI Zhe;WANG Aili;SAI Jiayang;DONG Ying(The Third Affiliated Hospital of Beijing University of Chinese Medicine,Beijing 100029,China;Oriental College,Beijing University of Chinese Medicine,Langfang 065011,Hebei,China;Beijing Kangyide Pulmonary Hospital of Integrated Chinese and Western Medicine,Beijing 101400,China)

机构地区：[1]北京中医药大学第三附属医院,北京100029 [2]北京中医药大学东方学院,河北廊坊065011 [3]北京康益德中西医结合肺科医院,北京101400

出　　处：《辽宁中医杂志》2025年第4期122-126,共5页Liaoning Journal of Traditional Chinese Medicine

摘　　要：目的评价加味芍药甘草汤缓解中晚期结肠癌患者癌性疼痛的效果。方法选取2021年5月—2023年5月北京中医药大学第三附属医院肿瘤血液科收治的中晚期结肠癌癌性疼痛患者79例,分为A组(39例)与B组(40例),方法为随机数字表法。所有患者均进行基础治疗,A组于此基础上使用硫酸吗啡缓释片,B组则在A组治疗方案上加用加味芍药甘草汤,两组患者均持续治疗4周。比较两组治疗4周后临床疗效,治疗期间镇痛剂应用情况,不同时间NRS得分,治疗前及治疗4周后炎性因子、疼痛因子,治疗期间不良反应发生情况。结果治疗4周后,B组总有效率高于A组;B组镇痛剂每日平均剂量低于A组;平均起效时间短于A组;平均持续时间长于A组;与治疗前比,两组数字分级法(NRS)得分均呈逐渐降低趋势,且B组同期NRS得分低于A组;与治疗前比较,治疗4周后,两组血清肿瘤坏死因子(TNF)-α、白细胞介素(IL)-1β、S100钙结合蛋白A8(S100A8)、S100A9、前列腺素E2(PGE2)、神经肽Y(NPY)、内皮素1(ET-1)水平降低,且B组更低;血清β-内啡肽(β-EP)水平升高,且B组更高,差异具有统计学意义(P<0.05)。结论中晚期结肠癌患者加用加味芍药甘草汤相较于单一西药治疗疗效更佳,可有效改善镇痛剂使用情况,降低炎性因子水平,阻断负向循环,改善疼痛因子,并缓解癌性疼痛,且安全性良好。Objective To evaluate the effect of Jiawei Shaoyao Gancao Decoction(加味芍药甘草汤)on relieving cancer pain in patients with advanced colon cancer.Methods From May 2021 to May 2023,79 patients with cancer pain of advanced colon cancer admitted to the department of Oncology and Hematology,the Third Affiliated Hospital of Beijing University of Chinese Medicine were selected and divided into the group A(39 cases)and the group B(40 cases).The method was random number table.All patients were given basic treatment,and the group A was given morphine sulfate sustained-release tablets on this basis,while the group B was given Jiawei Shaoyao Gancao Decoction on the treatment plan of the group A.Both groups continued to be treated for 4 weeks.The clinical efficacy after 4 weeks of treatment,analgesic application,numerical rating scale(NRS)scores at different times,inflammatory factors,pain factors and adverse reactions before and after 4 weeks of treatment were compared between the two groups.Results After 4 weeks of treatment,the total effective rate of the group B was higher than that of the group A.The average daily dose of analgesic of the group B was lower than that of the group A.The average onset time was shorter than that of the group A.The average duration was longer than that of the group A.Compared with those before treatment,the NRS scores of the two groups showed a decreasing trend,and the NRS scores of the group B were lower than those of the group A in the same period.Compared with those before treatment,after 4 weeks of treatment,the serum levels of tumor necrosis factor(TNF)-α,interleukin(IL)-1β,S100 Calcium Binding Protein A8(S100A8),S100A9,prostaglandin-2(PGE2),neuropeptide Y(NPY)and endothelin-1(ET-1)of the two groups decreased,and the levels of the group B were lower.Serumβ-endorphin(β-EP)level increased,the level of the group B was higher,and the differences were statistically significant(P<0.05).Conclusion Compared with single western medicine,Jiawei Shaoyao Gancao Decoction is more effecti

关 键 词：中晚期结肠癌 癌性疼痛 硫酸吗啡缓释片 加味芍药甘草汤 炎性因子 疼痛因子 安全性 

分 类 号：R273.5[医药卫生—中西医结合]