【摘要】：目的：1、觀察穴位埋線加耳穴撳針療法對(duì)癌性疼痛患者的疼痛及生活質(zhì)量的影響。2、計(jì)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(duì)照組患者,在治療前后的疼痛數(shù)字評(píng)分及生活質(zhì)量評(píng)分并評(píng)價(jià)對(duì)比各組臨床療效。3、觀察穴位埋線加耳穴撳針療法對(duì)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(zhǔn)的癌性疼痛患者共60例,采用簡(jiǎn)單隨機(jī)法將患者隨機(jī)分為穴位埋線加耳穴撳針療法治療組(以下簡(jiǎn)稱實(shí)驗(yàn)組)30例,常規(guī)西藥止痛組(以下簡(jiǎn)稱對(duì)照組)30例。對(duì)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(shí)驗(yàn)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?yàn)樵瓌t,具體運(yùn)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(gè)療程,4個(gè)療程后進(jìn)行療效統(tǒng)計(jì)評(píng)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(gè)療程,4個(gè)療程后進(jìn)行療效統(tǒng)計(jì)評(píng)估。比較兩組患者治療前后的疼痛數(shù)字分級(jí)法評(píng)分、生活質(zhì)量量表EORTC QLQ C30(V3.0)評(píng)分、不良事件發(fā)生例數(shù),評(píng)定其療效。所有數(shù)據(jù)的統(tǒng)計(jì)學(xué)分析采用SPSS22.0統(tǒng)計(jì)軟件進(jìn)行。成果：1、兩組治療前疼痛數(shù)字評(píng)分無顯著性差異(P0.05),具有可比性；治療后實(shí)驗(yàn)組與對(duì)照組組內(nèi)、組間比較均存在顯著性差異(P0.01),有統(tǒng)計(jì)學(xué)意義。2、兩組治療前生活質(zhì)量量表EORTC QLQ C30(V3.0)評(píng)分無顯著性差異(P0.05),具有可比性。治療后,實(shí)驗(yàn)組與對(duì)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(jì)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(jì)學(xué)意義。結(jié)論：1、兩組治療方案均能改善疼痛數(shù)字評(píng)分,并且,實(shí)驗(yàn)組在改善疼痛數(shù)字評(píng)分方面優(yōu)于對(duì)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(píng)分,并且,實(shí)驗(yàn)組在改善疼痛數(shù)字評(píng)分方面優(yōu)于對(duì)照組。3、實(shí)驗(yàn)組能減少疼痛患者長(zhǎng)期運(yùn)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(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類號(hào)】：R730.5

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