摘要
目的观察郄穴电针联合温阳止痛贴外用治疗阴寒凝滞型癌症疼痛的疗效及对疼痛介质的影响。方法将60例阴寒凝滞型癌症疼痛患者按照随机数字表法分为2组,对照组30例根据患者病情使用1种或多种止痛药,治疗组30例在对照组治疗基础上加用郄穴电针联合温阳止痛贴外用治疗。2组均治疗14天。比较2组卡氏功能状态评分(KPS)疗效、中医证候疗效;比较2组治疗前后疼痛评分、爆发痛次数变化;比较2组吗啡首日、全程剂量;比较2组治疗前后血清内啡肽、前列腺素E_(2)(PGE_(2))水平变化。结果治疗组KPS总有效率70.00%(21/30),对照组KPS总有效率50.00%(15/30),治疗组KPS疗效优于对照组(P<0.05)。治疗组中医证候总有效率66.67%(20/30),对照组中医证候总有效率33.33%(10/30),治疗组中医证候疗效优于对照组(P<0.05)。2组治疗前后疼痛评分差值比较差异有统计学意义(P<0.05),治疗组优于对照组。2组治疗后爆发痛次数较本组治疗前降低(P<0.05),治疗后治疗组爆发痛次数均低于对照组(P<0.05)。治疗组吗啡全程剂量低于对照组(P<0.05)。2组治疗后血清内啡肽水平较本组治疗前升高(P<0.05),PGE_(2)水平较本组治疗前降低(P<0.05),治疗后治疗组血清内啡肽水平高于对照组(P<0.05),PGE_(2)水平低于对照组(P<0.05)。结论郄穴电针联合温阳止痛贴外用治疗阴寒凝滞型癌症疼痛,能缓解临床疼痛及中医证候,降低爆发痛次数,减少吗啡全程剂量,降低血清内啡肽、PGE_(2)水平。
Objective To observe the therapeutic effect of Wenyang Zhitong paste combined with acupuncture on Xi Points for cancer pain(Yin-cold stagnation-type)and its influence on pain mediators.Methods A total of 60 patients with cancer pain(Yin-cold stagnation-type)were randomly assigned into the treatment group(n=30)and the control group(n=30).Patients in the control group were given one or several types of pain killers,and those in the treatment group were additionally managed by cancer pain combined with Acupuncture on Xi Points for 14 days.The aim was to compare Karnofsky Performance Scale(KPS),traditional Chinese medicine(TCM)syndrome scores,pain scores,and the number of pain bursts,the 1st-day and total dosage of morphine and serum levels of beta-endorphin(β-EP)and prostaglandin E_(2)(PGE_(2)).Results The total effective rate of KPS in the treatment group was significantly higher than that of the control group(70.00%[21/30]vs 50.00%[15/30],[P<0.05],respectively).The total effective rate of TCM syndromes in the treatment group was significantly higher than that of the control group(66.70%[20/30]vs 33.30%[10/30],[P<0.05],respectively).The difference between the two groups before and after treatment was statistically significant(P<0.05),and the treatment group was better than the control group(P<0.05).The number of pain bursts in both groups was significantly reduced(P<0.05),which was significantly lower in the treatment group than in the control group(P<0.05).The total dosage of morphine in the treatment group was lower than the control group(P<0.05).Serumβ-EP and PGE_(2) in both groups were significantly reduced(P<0.05),which were significantly lower in the treatment group than in the control group(P<0.05).Conclusion For patients with with cancer pain(Yin-cold stagnation-type),Wenyang Zhitong paste combined with acupuncture can significantly alleviate clinical pain and TCM syndrome,and reduce the number of pain bursts,the total dosage of morphine and serum levels ofβ-EP and PGE_(2).
作者
庞燕
史福敏
左晓娜
吴春莹
PANG Yan;SHI Fumin;ZUO Xiaona;WU Chunying(Department of Oncology,Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine,Cangzhou,Hebei 061000;Department of Radiotherapy and Chemotherapy,East District,Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine,Cangzhou,Hebei 061000)
出处
《河北中医》
2023年第3期462-465,469,共5页
Hebei Journal of Traditional Chinese Medicine
基金
河北省中医药管理局2022年度中医药类科研计划课题(编号:2022247)
河北省中医药管理局2017年度中医药类科研计划课题(编号:2017145)。
关键词
疼痛
辨证
外用药
针刺疗法
Pain
Differential diagnosis
External application drugs
Acupuncture therapy
