魏莲贴穴位贴敷治疗癌痛的临床观察
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摘要
目的:观察魏莲贴外敷神阙穴、阿是穴治疗癌性疼痛的疗效及其对生活质量的影响。方法:选取74例癌痛患者,随机分为治疗组和对照组。治疗组采用魏莲贴外敷神阙穴和阿是穴治疗癌性疼痛,每日一次,魏莲贴24小时换一次;对照组采用芬太尼透皮贴剂,外贴左或右锁骨下区皮肤治疗以止痛,72小时换帖一次;两组均以六天为一个观察周期,试验期间禁止使用与镇痛有关的其它中西药物。治疗期间观察治疗组和对照组的总有效率、显著缓解率、起效时间、KPS评分、生活质量积分情况、不良反应发生情况,收集数据、整理数据,分析其统计学意义。结果:两组治疗癌性疼痛均有较好疗效,魏莲贴外敷神阙穴和阿是穴治疗癌性疼痛总有效率(CR+PR+MR)为82.86%,显著缓解率(CR+PR)为65.71%,芬太尼透皮贴组治疗癌性疼痛总有效率为94.28%,显著缓解率为80.00%,两组在总有效率上及显著缓解率上差异无统计学意义(P>0.05)。两组对不同分级疼痛的治疗方面,治疗组对轻度、中度疼痛有较好疗效,其总有效率分别是100%、92.86%,对重度疼痛疗效较逊,总有效率是64.29%,对照组对轻、中、重度疼痛均有较好疗效,其总有效率分别是100%、92.31%、93.33%;两组相比较,治疗组较适用于轻中度癌痛,对照组较适用于中重度癌痛。疼痛部位上,治疗组对内脏痛、软组织痛疗效较好,两组间比较无统计学意义(P>0.05);起效时间上治疗组平均为(5.49+0.90)时,对照组平均为(5.86+1.41)时,两组相比,起效时间相当,差异无统计学意义(P>0.05);两组治疗后生活质量积分及卡氏评分均有提高,但治疗组优于对照组,有统计学意义(P<0.05);在不良反应发生情况方面,治疗组明显少于对照组,有统计学意义(P<0.05)。结论: (1)治疗组与对照组对治疗癌性疼痛都具有较好疗效;特别对内脏痛、软组织痛疗效好;其中,治疗组较适用于轻中度癌痛,对照组较适用于中重度癌痛;两组起效时间相当;2)与对照组相比,治疗组不良反应发生少,能较好地提高生活质量,从而使病人更能积极地配合治疗原发病。此方法尤其适用于因胃肠道反应而不耐受口服止痛的患者,使其对治疗的依从性更好,满意度也高,值得临床进一步探索应用。
Objective: To observe the effect of Wei-lian-plaster applied to the Shen-que and A-shi for patients of cancer pain on the rate of releasing cancer pain and the grade quality of life. Methods: 74 patients with different grades of cancer pain were randomly divided into the treatment group and the control group. The treatment group was treated by Wei-lian-plaster applied to the Shen-que and A-shi. Wei-lian-plaster is applied for each day;The control group was treated by Transdermal Fentanyl which is applied to the skin of the right or left clavicle which is applied for every third day; The observation period lasted six days and other druges were forbidden to control the cancer pain. During the period, We observed the site and degree of pain, KPS-mark, the patients quality of life before and after treatment, the time of drugs starting act and adverse effect. Then the data were clollected and trimmed, the statistical significance was analyzed. Results: Both the treatment group and the control group have good effects on releasing cancer pain. The total effective rate (CR+PR+MR) was 82.86% in the treatment group and 94.28% in the control group, the obvious remission rate (CR+PR) was 65.71% and 80.00%. The result showed that there wasn't statistical significant difference in total effective rate and obvious remission rate (P>0.05). The treatment group had a good effect on slight to moderate cancer pain. The total effective rate (CR+PR+MR) was 100%, 92.86% respectively. The treatment group had less effort on severe cancer pain and the total effective rate was 64.29%. The control group had a good effect on slight, moderate and severe cancer pain. The total effective rate was 100%, 92.23% and 93.33% respectively. In conclusion, the treatment group was suitable for slight and moderate cancer pain and the control group was suitable for moderate to severe cancer pain.The effect of two groups relieving pain in different position was different, the treatment group was best for the pain on internal organs and muscle and the control group was best for the pain on internal organs, muscle and nerve. However, the result showed no statistical significance (P>0.05). In the onset time of relieving cancer pain, the treatment group was (5.49±0.90) hours, the control group was (5.86±1.41) hours, the treatment group was better than the control group. However, the result showed no statistical significance (P> 0.05). The treatment group showed better effect on the improvement of QOL and satisfactory rate and KPS-mark, there was significant difference statistically between the two groups (P<0.05). The adverse effect of the treatment group was less than the control group. The result showed statistical significance. (P<0.05).Conclusion: 1) The two groups have good effects on releasing cancer pain. The result showed that Wei-lian-plaster was suitable for the treatment of slight and moderate cancer pain. The effect of treatment group relieving pain in different position was different:best for the pain on internal organs and muscle; 2) In the onset time of relieving cancer pain, the treatment group was better than the control group, the result showed no statistical significance; 3) the adverse effect of the treatment group was less than the control group. The treatment group showed better effects on the improvement of QOL and KPS-mark. In conclusion, Wei-lian-plaster's effect in treating cancer pain was obvious, It showed that external treatment with Chinese medicine had superiority in the treatment of cancer pain, especially for the patients with advanced stage cancer.
Objective: To observe the effect of Wei-lian-plaster applied to the Shen-que and A-shi for patients of cancer pain on the rate of releasing cancer pain and the grade quality of life. Methods: 74 patients with different grades of cancer pain were randomly divided into the treatment group and the control group. The treatment group was treated by Wei-lian-plaster applied to the Shen-que and A-shi. Wei-lian-plaster is applied for each day;The control group was treated by Transdermal Fentanyl which is applied to the skin of the right or left clavicle which is applied for every third day; The observation period lasted six days and other druges were forbidden to control the cancer pain. During the period, We observed the site and degree of pain, KPS-mark, the patients quality of life before and after treatment, the time of drugs starting act and adverse effect. Then the data were clollected and trimmed, the statistical significance was analyzed. Results: Both the treatment group and the control group have good effects on releasing cancer pain. The total effective rate (CR+PR+MR) was 82.86% in the treatment group and 94.28% in the control group, the obvious remission rate (CR+PR) was 65.71% and 80.00%. The result showed that there wasn't statistical significant difference in total effective rate and obvious remission rate (P>0.05). The treatment group had a good effect on slight to moderate cancer pain. The total effective rate (CR+PR+MR) was 100%, 92.86% respectively. The treatment group had less effort on severe cancer pain and the total effective rate was 64.29%. The control group had a good effect on slight, moderate and severe cancer pain. The total effective rate was 100%, 92.23% and 93.33% respectively. In conclusion, the treatment group was suitable for slight and moderate cancer pain and the control group was suitable for moderate to severe cancer pain.The effect of two groups relieving pain in different position was different, the treatment group was best for the pain on internal organs and muscle and the control group was best for the pain on internal organs, muscle and nerve. However, the result showed no statistical significance (P>0.05). In the onset time of relieving cancer pain, the treatment group was (5.49±0.90) hours, the control group was (5.86±1.41) hours, the treatment group was better than the control group. However, the result showed no statistical significance (P> 0.05). The treatment group showed better effect on the improvement of QOL and satisfactory rate and KPS-mark, there was significant difference statistically between the two groups (P<0.05). The adverse effect of the treatment group was less than the control group. The result showed statistical significance. (P<0.05).Conclusion: 1) The two groups have good effects on releasing cancer pain. The result showed that Wei-lian-plaster was suitable for the treatment of slight and moderate cancer pain. The effect of treatment group relieving pain in different position was different:best for the pain on internal organs and muscle; 2) In the onset time of relieving cancer pain, the treatment group was better than the control group, the result showed no statistical significance; 3) the adverse effect of the treatment group was less than the control group. The treatment group showed better effects on the improvement of QOL and KPS-mark. In conclusion, Wei-lian-plaster's effect in treating cancer pain was obvious, It showed that external treatment with Chinese medicine had superiority in the treatment of cancer pain, especially for the patients with advanced stage cancer.
引文
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