本文選題：抗癌止痛膏　切入點(diǎn)：鹽酸曲馬多緩釋片　出處：《湖南中醫(yī)藥大學(xué)》2016年碩士論文

【摘要】：目的:通過觀察我院自制抗癌止痛膏輔助治療中~重度局限性癌性疼痛(簡(jiǎn)稱“癌痛”)的臨床療效,研究抗癌止痛膏對(duì)癌痛患者疼痛及癌癥患者生活質(zhì)量等的影響。方法:按照完全隨機(jī)分組法,將符合標(biāo)準(zhǔn)的60例住院病人按就診時(shí)間順序編為1~60號(hào),隨機(jī)分為2組,每組30例,即試驗(yàn)組和對(duì)照組。兩組患者治療前一般資料、疼痛程度、疼痛數(shù)字評(píng)分(NRS評(píng)分)、鎮(zhèn)痛起效時(shí)間、疼痛影響、體能狀態(tài)(KPS評(píng)分)等均無統(tǒng)計(jì)學(xué)差異,具有齊同可比性。入組后試驗(yàn)組口服鹽酸曲馬多緩釋片+外敷抗癌止痛膏治療,對(duì)照組口服鹽酸曲馬多緩釋片+外敷安慰劑治療,并對(duì)兩組患者治療前、治療后進(jìn)行疼痛程度、NRS評(píng)分、鎮(zhèn)痛起效時(shí)間、疼痛影響、KPS評(píng)分及安全性等進(jìn)行記錄及比較。結(jié)果:(1)疼痛強(qiáng)度分布:治療后兩組差異具有統(tǒng)計(jì)學(xué)意義(P0.05),治療后無痛+輕度疼痛患者試驗(yàn)組占46.6%,對(duì)照組占20.0%;中度+重度疼痛患者試驗(yàn)組占53.4%,對(duì)照組80.0%。(2)NRS評(píng)分:治療后兩組差異有統(tǒng)計(jì)學(xué)意義(P0.05);試驗(yàn)組治療前后差異有統(tǒng)計(jì)學(xué)意義(P0.05),對(duì)照組患者差異無統(tǒng)計(jì)學(xué)意義(P0.05)。(3)鎮(zhèn)痛起效時(shí)間:治療后兩組差異無統(tǒng)計(jì)學(xué)意義(P0.05);試驗(yàn)組治療前后差異有統(tǒng)計(jì)學(xué)意義(P0.05),對(duì)照組差異無統(tǒng)計(jì)學(xué)意義(P0.05)。(4)疼痛影響評(píng)分:疼痛影響評(píng)分(總分):治療后兩組差異有統(tǒng)計(jì)學(xué)意義(P0.05);試驗(yàn)組治療前后差異有統(tǒng)計(jì)學(xué)意義(P0.05),對(duì)照組差異無統(tǒng)計(jì)學(xué)意義(P0.05)。疼痛影響因子:其中步行能力、睡眠質(zhì)量、情緒控制能力差異具有統(tǒng)計(jì)學(xué)意義(P0.05);日常生活能力、生活享受、工作能力、與他人的關(guān)系差異無統(tǒng)計(jì)學(xué)意義(P0.05)。(5)KPS評(píng)分:治療后兩組治療后差異無統(tǒng)計(jì)學(xué)意義(P0.05%);試驗(yàn)組差異有統(tǒng)計(jì)學(xué)意義(P0.05),對(duì)照組差異無統(tǒng)計(jì)學(xué)意義(P0.05)。(6)疼痛療效評(píng)估:兩組差異有統(tǒng)計(jì)學(xué)意義(P0.05);試驗(yàn)組30例病人疼痛緩解程度為56.7%,對(duì)照組30例病人疼痛緩解程度為33.3%。(7)安全性:研究過程中兩組患者出現(xiàn)了以止痛藥物引起的惡心、嘔吐、便秘、嗜睡等癥狀,且無明顯差異,未出現(xiàn)研究藥物所致的心、肝、腎等重要臟器的損傷及其他不良反應(yīng)事件。結(jié)論:抗癌止痛膏聯(lián)合鹽酸曲馬多緩釋片治療中~重度癌痛的作用優(yōu)于鹽酸曲馬多-緩釋片聯(lián)合安慰劑,對(duì)減輕疼痛、疼痛影響因子、有效率等效果明顯,能有效增強(qiáng)止痛藥物作用,且安全性好,值得進(jìn)一步臨床推廣及研究。
[Abstract]:Objective: to study the effect of anticancer analgesic ointment on pain of cancer patients and quality of life of cancer patients by observing the clinical effect of adjuvant treatment of moderate to severe localized cancer pain ("cancer pain").Methods: according to the method of complete random grouping, 60 inpatients in accordance with the standard were divided into two groups randomly, 30 cases in each group, namely the experimental group and the control group.There were no statistical differences in general data, pain degree, pain number score and NRS score, analgesia onset time, pain effect, physical fitness and KPS score between the two groups before treatment.The trial group was treated with tramadol hydrochloride sustained release tablets and the control group was treated with placebo. The patients in both groups were given NRS score before and after treatment.The onset time of analgesia, the effect of pain on KPS score and safety were recorded and compared.Results: the distribution of pain intensity: after treatment, the difference between the two groups was statistically significant (P 0.05), 46.6% in the trial group with mild pain after treatment, 20.0% in the control group, 53.4% in the trial group with moderate and severe pain, and 53.4% in the control group. The 80.0%.(2)NRS score of the control group was as follows:The difference between the two groups was statistically significant (P 0.05), the difference between the experimental group and the control group was statistically significant (P 0.05), the time of analgesic effect was not significant in the control group (P 0.05): there was no significant difference between the two groups after treatment (P 0.05); before and after treatment in the test group, there was no significant difference in analgesia (P 0.05), and there was no significant difference between the two groups before and after treatment.The difference was statistically significant (P 0.05), but there was no significant difference between the control group (P 0.05) and the control group (P 0.05): pain impact score (total score: after treatment, there was significant difference between the two groups (P 0.05); the trial group had significant difference before and after treatment (P 0.05), the control group had significant difference (P 0.05), the control group had significant difference before and after treatment (P 0.05).There was no significant difference between the two groups (P 0.05).Among them, the difference of walking ability, sleep quality, emotion control ability was statistically significant (P 0.05), the ability of daily life, life enjoyment, work ability,The pain relief degree of 30 patients in the trial group was 56.7, and the pain relief degree in the control group was 33.3. the safety: during the study, the nausea caused by analgesic drugs was found in the two groups.Vomiting, constipation, lethargy and other symptoms, and no significant difference, no drug induced heart, liver, kidney and other important organs injury and other adverse events.It can effectively enhance the analgesic effect, and the safety is good, worthy of further clinical promotion and research.
【學(xué)位授予單位】：湖南中醫(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)】：R273

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