【摘要】：目的:探討加味芍甘附子湯聯(lián)合鹽酸羥考酮緩釋片治療陽虛寒凝型癌痛患者的療效。本課題將從臨床角度通過對陽虛寒凝型癌痛患者在阿片類藥物止痛的基礎(chǔ)上加用中藥湯劑加味芍甘附子湯與單純的阿片類藥物止痛進(jìn)行療效的對比觀察,從而評價其對患者疼痛緩解情況、生存質(zhì)量及藥物副作用的影響,為加味芍甘附子湯治療陽虛寒凝型癌痛提供臨床基礎(chǔ)依據(jù),能使其在臨床上運(yùn)用更加廣泛。方法:本研究主要收集在新會區(qū)中醫(yī)院腫瘤科治療癌痛患者,按設(shè)定的標(biāo)準(zhǔn),納入78例陽虛寒凝型的患者,按照隨機(jī)對照的原則,分為對照組和試驗組,對照組入組38例患者,主要采用鹽酸羥考酮緩釋片止痛治療,試驗組入組40例患者,均在對照組治療的基礎(chǔ)上內(nèi)服中藥制劑加味芍甘附子湯治療,觀察兩組患者的臨床療效、生活質(zhì)量改善情況、疼痛評分及藥物副作用等。結(jié)果:治療組的平均鎮(zhèn)痛維持時間明顯長于對照組(P0.01);治療組的鹽酸羥考酮緩釋片日均需用量明顯少于對照組(P0.01);治療組療效的總有效率為92.5%,明顯優(yōu)于對照組的76.3%(P0.05);治療組Karnofsky評分的總有效率為90.0%,明顯優(yōu)于對照組的65.8%(P0.05);治療組發(fā)生便秘和惡心嘔吐的毒副反應(yīng)亦比對照組少(分別是P0.01及P0.05)。結(jié)論:本研究表明,中藥制劑加味芍甘附子湯聯(lián)合鹽酸羥考酮緩釋片能夠明顯降低陽虛寒凝型癌痛患者的疼痛評分,提高臨床療效,改善癌痛患者生存質(zhì)量,并且減輕鹽酸羥考酮緩釋片在嘔吐、便秘方面的毒副反應(yīng)。
[Abstract]:Objective: to study the curative effect of modified Shaojiangfuzi decoction combined with hydroxycodone hydrochloride sustained release tablet in treating cancer pain of Yang deficiency and cold coagulation type. From the clinical point of view, the clinical effect of the patients with cancer pain caused by Yang deficiency and cold coagulation on the basis of opioid drug analgesia was compared with that of traditional Chinese medicine decoction and simple opioid medicine. So as to evaluate its effect on pain relief, quality of life and side effects of drugs, to provide a clinical basis for the treatment of Yang deficiency and cold coagulation cancer pain with Jiawei Shao Ganfuzi decoction, and to make it more widely used in clinical practice. Methods: in this study, 78 patients with cancer pain were included in the department of oncology of Xinhui District traditional Chinese Medicine Hospital. According to the set standards, 78 patients with Yang deficiency and cold coagulation were divided into control group and experimental group according to the principle of random control, and 38 patients in control group. 40 patients in the experimental group were treated with hydroxycodone hydrochloride sustained-release tablets to relieve pain. All the patients in the experimental group were treated with traditional Chinese medicine preparation plus Shaoyaoganzi decoction on the basis of the control group. The clinical efficacy and the improvement of quality of life of the two groups were observed. Pain score and side effects. Results: the average duration of analgesia in the treatment group was significantly longer than that in the control group (P0.01), the daily average dosage of hydroxycodone hydrochloride sustained-release tablets in the treatment group was significantly less than that in the control group (P0.01), the total effective rate of the treatment group was 92.5, which was significantly better than that in the control group (76.3%) (P0.05). The total effective rate of Karnofsky score in the treatment group was 90.0%, which was significantly better than that in the control group (65.8%); the side effects of constipation and nausea and vomiting in the treatment group were also less than those in the control group (P0.01 and P0.05 respectively). Conclusion: this study shows that the Chinese traditional medicine preparation plus Shaoganfuzi decoction combined with hydroxycodone hydrochloride sustained release tablets can significantly reduce the pain score of patients with cancer pain caused by Yang deficiency and cold coagulation, improve the clinical efficacy and improve the quality of life of patients with cancer pain. It also alleviates the side effects of hydroxycodone hydrochloride sustained release tablets on vomiting and constipation.
【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】：R273

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