穴位埋線加耳穴撳針配合西藥治療癌痛的臨床研究
發(fā)布時間：2018-08-27 19:05
【摘要】：目的：1、觀察穴位埋線加耳穴撳針療法對癌性疼痛患者的疼痛及生活質(zhì)量的影響。2、計算并比較穴位埋線加耳穴撳針療法治療組患者與常規(guī)西藥止痛對照組患者,在治療前后的疼痛數(shù)字評分及生活質(zhì)量評分并評價對比各組臨床療效。3、觀察穴位埋線加耳穴撳針療法對癌性疼痛患者不良事件發(fā)生情況的影響。方法：選取符合本次研究標(biāo)準的癌性疼痛患者共60例,采用簡單隨機法將患者隨機分為穴位埋線加耳穴撳針療法治療組(以下簡稱實驗組)30例,常規(guī)西藥止痛組(以下簡稱對照組)30例。對照組采用常規(guī)西藥治療,輕度疼痛(0-3分)：戴芬,口服,75mg,qd或西樂葆膠囊,口服,200mg, qd;中度疼痛(4-6分)：曲馬多緩釋片,口服,100mg,q12h；重度疼痛(7-10分)：奧施康定,口服,10mg, q12h或美施康定,口服,30mg,q12h或芬太尼透皮貼,外貼,4.2mg, q72h。實驗組在常規(guī)西藥治療基礎(chǔ)上加用穴位埋線及耳穴撳針治療,穴位埋線選穴如下：主穴足三里、天樞、關(guān)元、中脘；配穴根據(jù)不同癌癥患者病變所屬臟腑、疼痛所在部位確定取穴經(jīng)脈,以循經(jīng)取穴、以痛為腧為原則,具體運用俞募配穴、合穴、絡(luò)穴、郄穴、阿是穴為取穴方法,每10天一次,1次為1個療程,4個療程后進行療效統(tǒng)計評估。耳穴撳針選穴如下：基礎(chǔ)取穴神門、交感、皮質(zhì)下；辨證取穴依據(jù)腫瘤原發(fā)部位分別選擇肺、胃、肝、大腸、小腸及骨轉(zhuǎn)移相應(yīng)部位。每5天一次(兩耳交換),2次為1個療程,4個療程后進行療效統(tǒng)計評估。比較兩組患者治療前后的疼痛數(shù)字分級法評分、生活質(zhì)量量表EORTC QLQ C30(V3.0)評分、不良事件發(fā)生例數(shù),評定其療效。所有數(shù)據(jù)的統(tǒng)計學(xué)分析采用SPSS22.0統(tǒng)計軟件進行。成果：1、兩組治療前疼痛數(shù)字評分無顯著性差異(P0.05),具有可比性；治療后實驗組與對照組組內(nèi)、組間比較均存在顯著性差異(P0.01),有統(tǒng)計學(xué)意義。2、兩組治療前生活質(zhì)量量表EORTC QLQ C30(V3.0)評分無顯著性差異(P0.05),具有可比性。治療后,實驗組與對照組組內(nèi)比較、組間比較均存在顯著性差異(P0.01),有統(tǒng)計學(xué)意義。3、兩組治療期間不良事件發(fā)生情況的比較存在顯著性差異(P0.05),有統(tǒng)計學(xué)意義。結(jié)論：1、兩組治療方案均能改善疼痛數(shù)字評分,并且,實驗組在改善疼痛數(shù)字評分方面優(yōu)于對照組。2、兩組治療方案均能改善生活質(zhì)量量表EORTC QLQ C30(V3.0)評分,并且,實驗組在改善疼痛數(shù)字評分方面優(yōu)于對照組。3、實驗組能減少疼痛患者長期運用止痛藥出現(xiàn)的副作用等不良事件的發(fā)生。
[Abstract]:Objective to observe the effect of acupoint embedding and auricular acupuncture therapy on pain and quality of life of patients with cancer pain. The scores of pain number and quality of life before and after treatment were evaluated and compared with each group. The effect of acupoint embedding and auricular acupuncture on adverse events in patients with cancerous pain was observed. Methods: a total of 60 patients with cancer pain were selected and randomly divided into three groups (experimental group). There were 30 cases in routine western medicine group (control group). The control group was treated with routine western medicine, mild pain (0-3 points): difen, oral dose of 75 mg / g QD or Celebao capsule, oral administration of 200 mg, moderate pain of qd; (4-6 points): tramadol sustained release tablet, oral administration of 100mgg Q12h, severe pain (7-10 points): oskangding, 10 mg, Q12 h or mashkangding, 30 mg Q1 Q12h or fentanyl transdermal patch, 4. 2 mg, Q72 h. The experimental group was treated with acupoint catgut embedding and auricular acupuncture on the basis of routine western medicine treatment. The acupoints were selected as follows: the main points Zusanli, Tianshu, Guan Yuan, Zhongwan; the matching points according to the lesions of different cancer patients belong to the viscera, Where the pain is located, the meridians are selected, the acupoints along the meridian and the acupoints of pain are taken as the principle, and the points of Shu Fu, he points, collaterals, Xi points, Ashi points are used as the method of collecting points. Once every 10 days for a course of treatment, 4 courses of treatment after statistical evaluation. The selection of auricular acupoints was as follows: selecting Shenmen, sympathetic and subcortical points on the basis of acupoints; selecting the corresponding sites of lung, stomach, liver, large intestine, small intestine and bone metastasis according to the primary site of tumor. Once every 5 days (2 ears exchange) as a course of treatment, 4 courses of treatment were evaluated statistically. The scores of pain digital grading, EORTC QLQ C30 (V3.0) before and after treatment, and the number of adverse events were compared between the two groups, and the curative effect was evaluated. All the data were analyzed by SPSS22.0 software. Results: 1, there was no significant difference in the scores of pain numbers between the two groups before treatment (P0.05). There was significant difference between the two groups (P0.01), there was statistical significance. 2. There was no significant difference in the scores of EORTC QLQ C30 (V3.0) between the two groups before treatment (P0.05), which was comparable. After treatment, there were significant differences between the experimental group and the control group (P0.01), there was significant difference between the two groups during the treatment period of adverse events (P0.05). Conclusion both groups can improve the score of pain number, and the experimental group is superior to the control group in improving the score of pain number. Both groups can improve the score of EORTC QLQ C30 (V3.0), and the two groups can improve the score of EORTC QLQ C30 (V3.0). The experimental group was superior to the control group in improving the score of pain number. The experimental group could reduce the adverse events such as side effects caused by long-term use of painkillers.
【學(xué)位授予單位】：廣州中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R730.5
本文編號：2208164
[Abstract]:Objective to observe the effect of acupoint embedding and auricular acupuncture therapy on pain and quality of life of patients with cancer pain. The scores of pain number and quality of life before and after treatment were evaluated and compared with each group. The effect of acupoint embedding and auricular acupuncture on adverse events in patients with cancerous pain was observed. Methods: a total of 60 patients with cancer pain were selected and randomly divided into three groups (experimental group). There were 30 cases in routine western medicine group (control group). The control group was treated with routine western medicine, mild pain (0-3 points): difen, oral dose of 75 mg / g QD or Celebao capsule, oral administration of 200 mg, moderate pain of qd; (4-6 points): tramadol sustained release tablet, oral administration of 100mgg Q12h, severe pain (7-10 points): oskangding, 10 mg, Q12 h or mashkangding, 30 mg Q1 Q12h or fentanyl transdermal patch, 4. 2 mg, Q72 h. The experimental group was treated with acupoint catgut embedding and auricular acupuncture on the basis of routine western medicine treatment. The acupoints were selected as follows: the main points Zusanli, Tianshu, Guan Yuan, Zhongwan; the matching points according to the lesions of different cancer patients belong to the viscera, Where the pain is located, the meridians are selected, the acupoints along the meridian and the acupoints of pain are taken as the principle, and the points of Shu Fu, he points, collaterals, Xi points, Ashi points are used as the method of collecting points. Once every 10 days for a course of treatment, 4 courses of treatment after statistical evaluation. The selection of auricular acupoints was as follows: selecting Shenmen, sympathetic and subcortical points on the basis of acupoints; selecting the corresponding sites of lung, stomach, liver, large intestine, small intestine and bone metastasis according to the primary site of tumor. Once every 5 days (2 ears exchange) as a course of treatment, 4 courses of treatment were evaluated statistically. The scores of pain digital grading, EORTC QLQ C30 (V3.0) before and after treatment, and the number of adverse events were compared between the two groups, and the curative effect was evaluated. All the data were analyzed by SPSS22.0 software. Results: 1, there was no significant difference in the scores of pain numbers between the two groups before treatment (P0.05). There was significant difference between the two groups (P0.01), there was statistical significance. 2. There was no significant difference in the scores of EORTC QLQ C30 (V3.0) between the two groups before treatment (P0.05), which was comparable. After treatment, there were significant differences between the experimental group and the control group (P0.01), there was significant difference between the two groups during the treatment period of adverse events (P0.05). Conclusion both groups can improve the score of pain number, and the experimental group is superior to the control group in improving the score of pain number. Both groups can improve the score of EORTC QLQ C30 (V3.0), and the two groups can improve the score of EORTC QLQ C30 (V3.0). The experimental group was superior to the control group in improving the score of pain number. The experimental group could reduce the adverse events such as side effects caused by long-term use of painkillers.
【學(xué)位授予單位】：廣州中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R730.5
【參考文獻】
相關(guān)期刊論文 前10條
1 丁慶剛;;癌性疼痛的西醫(yī)療法探析[J];中國醫(yī)藥指南;2015年17期
2 饒愛華;;腫瘤深部熱療聯(lián)合羥考酮緩釋片治療骨轉(zhuǎn)移癌痛的臨床療效觀察[J];中國現(xiàn)代醫(yī)生;2015年03期
3 周杰;梁宜;陳勤;方劍喬;;耳針治療癌痛隨機對照研究的Meta分析[J];中華中醫(yī)藥學(xué)刊;2014年10期
4 王玉林;劉碩;高亮;;柴胡疏肝散輔助芬太尼透皮貼治療肝癌疼痛98例療效觀察[J];河北中醫(yī);2014年09期
5 王湘;寧曉紅;;關(guān)于改善我國癌痛控制的思考[J];中國新藥雜志;2014年17期
6 曹啟旺;徐慧巧;;癌性神經(jīng)病理性疼痛的診治進展[J];湖北民族學(xué)院學(xué)報(醫(yī)學(xué)版);2014年03期
7 劉永軍;楊亞琴;;溫陽止痛散治療癌性疼痛的臨床觀察[J];中醫(yī)臨床研究;2014年13期
8 武林鑫;孫莉;;癌痛治療不足的現(xiàn)狀與原因[J];腫瘤防治研究;2014年04期
9 史清華;程玲;陳高峰;張念華;高海利;;穴位埋線聯(lián)合中藥硬膏雙柏散外敷治療癌性疼痛40例[J];江西中醫(yī)藥;2014年04期
10 劉琳;;癌性疼痛規(guī)范化治療的原則及研究進展[J];中國現(xiàn)代藥物應(yīng)用;2013年22期
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