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[针刺联合阿片类药物治疗中重度癌痛:一项随机对照试验]

[Acupuncture combined with opioid drugs on moderate and severe cancer pain: a randomized controlled trial].

作者信息

Li Dan, Sun Rui-Rui, Li Qing-Ling, Ma Qiang, Zeng Yong-Lei, Jia Xue-Zhao, Wang Jing

机构信息

Guoyitang Department of Anhui University of CM, Hefei 230038, China.

Third Affiliated Hospital of Anhui University of CM.

出版信息

Zhongguo Zhen Jiu. 2020 Mar 12;40(3):257-61. doi: 10.13703/j.0255-2930.20190311-k0001.

Abstract

OBJECTIVE

To explore the clinical therapeutic effect of acupuncture combined with opioid drugs on moderate and severe cancer pain.

METHODS

A total of 60 patients with cancer were randomized into an observation group and a control group, 30 cases in each group. Oxycodonehydrochloride prolonged-release tablet was taken orally in the control group. On the basis of the control group, acupuncture was applied at Hegu (LI 4), Neiguan (PC 6), Zusanli (ST 36), Sanyinjiao (SP 6), etc. Corresponding back- points, -cleft points and points were selected additionally according to primary viscera and pain sites in the observation group. The treatment was given once a day for 2 weeks. Symptomatic and supportive treatment were implanted, and no other antalgic measures were given during the trial. The daily dosage of opioid drug and the adverse reactions were recorded in both groups. Karnofsky performance status (KPS) and quality of life (QOL) scale scores were compared before and after treatment. Numerical rating scale (NRS) score was calculated to evaluate the clinical therapeutic effect.

RESULTS

Compared before treatment, the daily dosage of opioid drugs after treatment was obviously reduced in the observation group (<0.01), and was obviously increased in the control group (<0.05). The dosage of opioid drugs after treatment in the observation group was much less than the control group (<0.01). After treatment, the KPS and QOL scores were increased in both groups (<0.01), and the scores in the observation group were superior to the control group (<0.01, <0.05). The analgesic effective rate was 90.0% (27/30) in the observation group, which was superior to 76.7% (23/30) in the control group (<0.05). The adverse reactions rate in the observation group was lower than the control group (<0.01).

CONCLUSION

Acupuncture combined with opioid drugs can effectively relieve the cancer pain, improve the performance status and quality of life in cancer patients, reduce the dosage of opioid drugs and adverse reactions rate.

摘要

目的

探讨针刺联合阿片类药物对中重度癌痛的临床治疗效果。

方法

将60例癌症患者随机分为观察组和对照组,每组30例。对照组口服盐酸羟考酮缓释片。观察组在对照组基础上,针刺合谷(LI 4)、内关(PC 6)、足三里(ST 36)、三阴交(SP 6)等,并根据原发脏腑及疼痛部位额外选取相应的背俞穴、郄穴等。每天治疗1次,共2周。进行对症及支持治疗,试验期间不给予其他镇痛措施。记录两组阿片类药物的每日用量及不良反应。比较治疗前后卡氏功能状态评分(KPS)和生活质量(QOL)量表评分。计算数字分级量表(NRS)评分以评估临床治疗效果。

结果

与治疗前比较,观察组治疗后阿片类药物每日用量明显减少(<0.01),对照组明显增加(<0.05)。观察组治疗后阿片类药物用量明显少于对照组(<0.01)。治疗后,两组KPS和QOL评分均升高(<0.01),且观察组评分优于对照组(<0.01,<0.05)。观察组镇痛有效率为90.0%(27/30),优于对照组的76.7%(23/30)(<0.05)。观察组不良反应发生率低于对照组(<0.01)。

结论

针刺联合阿片类药物可有效缓解癌痛,改善癌症患者的功能状态和生活质量,减少阿片类药物用量及不良反应发生率。

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