中药止痛贴与吗啡联合应用于癌症疼痛的镇痛效果及安全性

目的:探讨中药止痛贴与吗啡联合应用于癌症疼痛治疗中的镇痛效果及安全性。方法:选取2016年5月至2017年5月我院收治的100例中重度癌症疼痛患者为研究对象,根据随机数字表方法将入选的患者分为对照组和研究组,每组50例。对照组患者给予吗啡治疗,研究组患者在此基础上联合应用中药止痛贴治疗,连续给药14天。比较两组患者的临床疗效、数字评分法(digital scoring method,NRS)、爆发痛次数、吗啡使用量、中医证候评分。结果:研究组患者治疗总有效率为96.0%,显著高于对照组患者(86.0%,P0.05)。研究组盐酸吗啡缓释片使用剂量(83.23±23.14)mg/d]低于对照组(110.13±25.23)mg/d](P0.05)。治疗前,两组患者各中医证候评分比较差异均无统计学意义(P0.05);治疗后,两组患者各中医证候评分均较治疗前明显降低,且研究组显著低于对照组,差异有统计学意义(P0.05)。研究组患者的NRS评分、爆发痛次数显著低于对照组(P0.05),两组患者均未见严重的不良反应。结论:中药止痛贴与吗啡联合应用于癌症疼痛的可有效提高镇痛效果,改善患者的中医证候,减少吗啡使用量,且安全性高。

Analgesic Effect and Safety of Traditional Chinese Medicine Analgesic Ointment Combined with Morphine in the Treatment of Cancer Pain

ABSTRACT Objective: To explore the analgesic effect and safety of traditional Chinese medicine analgesic ointment combined with morphine in the treatment of cancer pain. Methods: 100 patients with moderate severe cancer pain were selected as the subjects from May 2006 to May 2017. According to random number table method, all patients were divided into the control group and the study group. 50 patients in each group were treated with morphine treatment, the study group was additionally given TCM analgesic ointment treatment. All the patients were continuously treated for 14 days. The clinical effect, NRS, the number of eruptions, the amount of morphine used and the traditional Chinese medicine (TCM) syndrome score were compared between two groups. Results: The total effective rate of experimental group was obviously higher than that of the control group (96.0% vs 86.0%) (P<0.05). The amount of morphine of two groups were 83.23 ±23.14 mg/d and 110.13±25.23 mg/d, respectively (P<0.05). There was no significant differences in the TCM syndrome score between the two groups before treatment (P>0.05). After treatment, the TCM syndrome scores of both groups were significantly reduced, which was significantly lower in the study group than that of the control group(P<0.05). The numerical rating scale (NRS) and the number of eruptions of study group were significantly decreased, which were significantly lower in the study group(P<0.05). No serious adverse reactions was found in both groups. Conclusion: TCM analgesic ointment combined with morphine can effectively increase the analgesic effect in the treatment of patients with cancer pain, it can improve the TCM syndrome, reduce the use of morphine with high safety.