穴位埋线加耳穴揿针配合西药治疗癌痛的临床研究
发布时间：2018-08-27 19:05
【摘要】：目的：1、观察穴位埋线加耳穴揿针疗法对癌性疼痛患者的疼痛及生活质量的影响。2、计算并比较穴位埋线加耳穴揿针疗法治疗组患者与常规西药止痛对照组患者,在治疗前后的疼痛数字评分及生活质量评分并评价对比各组临床疗效。3、观察穴位埋线加耳穴揿针疗法对癌性疼痛患者不良事件发生情况的影响。方法：选取符合本次研究标准的癌性疼痛患者共60例,采用简单随机法将患者随机分为穴位埋线加耳穴揿针疗法治疗组(以下简称实验组)30例,常规西药止痛组(以下简称对照组)30例。对照组采用常规西药治疗,轻度疼痛(0-3分)：戴芬,口服,75mg,qd或西乐葆胶囊,口服,200mg, qd;中度疼痛(4-6分)：曲马多缓释片,口服,100mg,q12h；重度疼痛(7-10分)：奥施康定,口服,10mg, q12h或美施康定,口服,30mg,q12h或芬太尼透皮贴,外贴,4.2mg, q72h。实验组在常规西药治疗基础上加用穴位埋线及耳穴揿针治疗,穴位埋线选穴如下：主穴足三里、天枢、关元、中脘；配穴根据不同癌症患者病变所属脏腑、疼痛所在部位确定取穴经脉,以循经取穴、以痛为腧为原则,具体运用俞募配穴、合穴、络穴、郄穴、阿是穴为取穴方法,每10天一次,1次为1个疗程,4个疗程后进行疗效统计评估。耳穴揿针选穴如下：基础取穴神门、交感、皮质下；辨证取穴依据肿瘤原发部位分别选择肺、胃、肝、大肠、小肠及骨转移相应部位。每5天一次(两耳交换),2次为1个疗程,4个疗程后进行疗效统计评估。比较两组患者治疗前后的疼痛数字分级法评分、生活质量量表EORTC QLQ C30(V3.0)评分、不良事件发生例数,评定其疗效。所有数据的统计学分析采用SPSS22.0统计软件进行。成果：1、两组治疗前疼痛数字评分无显著性差异(P0.05),具有可比性；治疗后实验组与对照组组内、组间比较均存在显著性差异(P0.01),有统计学意义。2、两组治疗前生活质量量表EORTC QLQ C30(V3.0)评分无显著性差异(P0.05),具有可比性。治疗后,实验组与对照组组内比较、组间比较均存在显著性差异(P0.01),有统计学意义。3、两组治疗期间不良事件发生情况的比较存在显著性差异(P0.05),有统计学意义。结论：1、两组治疗方案均能改善疼痛数字评分,并且,实验组在改善疼痛数字评分方面优于对照组。2、两组治疗方案均能改善生活质量量表EORTC QLQ C30(V3.0)评分,并且,实验组在改善疼痛数字评分方面优于对照组。3、实验组能减少疼痛患者长期运用止痛药出现的副作用等不良事件的发生。
[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.
【学位授予单位】：广州中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R730.5
本文编号：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.
【学位授予单位】：广州中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R730.5
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