抗癌止痛膏治疗局限性癌性疼痛的临床研究

发布时间：2018-04-02 16:05

本文选题：抗癌止痛膏　切入点：盐酸曲马多缓释片　出处：《湖南中医药大学》2016年硕士论文

【摘要】：目的:通过观察我院自制抗癌止痛膏辅助治疗中~重度局限性癌性疼痛(简称“癌痛”)的临床疗效,研究抗癌止痛膏对癌痛患者疼痛及癌症患者生活质量等的影响。方法:按照完全随机分组法,将符合标准的60例住院病人按就诊时间顺序编为1~60号,随机分为2组,每组30例,即试验组和对照组。两组患者治疗前一般资料、疼痛程度、疼痛数字评分(NRS评分)、镇痛起效时间、疼痛影响、体能状态(KPS评分)等均无统计学差异,具有齐同可比性。入组后试验组口服盐酸曲马多缓释片+外敷抗癌止痛膏治疗,对照组口服盐酸曲马多缓释片+外敷安慰剂治疗,并对两组患者治疗前、治疗后进行疼痛程度、NRS评分、镇痛起效时间、疼痛影响、KPS评分及安全性等进行记录及比较。结果:(1)疼痛强度分布:治疗后两组差异具有统计学意义(P0.05),治疗后无痛+轻度疼痛患者试验组占46.6%,对照组占20.0%;中度+重度疼痛患者试验组占53.4%,对照组80.0%。(2)NRS评分:治疗后两组差异有统计学意义(P0.05);试验组治疗前后差异有统计学意义(P0.05),对照组患者差异无统计学意义(P0.05)。(3)镇痛起效时间:治疗后两组差异无统计学意义(P0.05);试验组治疗前后差异有统计学意义(P0.05),对照组差异无统计学意义(P0.05)。(4)疼痛影响评分:疼痛影响评分(总分):治疗后两组差异有统计学意义(P0.05);试验组治疗前后差异有统计学意义(P0.05),对照组差异无统计学意义(P0.05)。疼痛影响因子:其中步行能力、睡眠质量、情绪控制能力差异具有统计学意义(P0.05);日常生活能力、生活享受、工作能力、与他人的关系差异无统计学意义(P0.05)。(5)KPS评分:治疗后两组治疗后差异无统计学意义(P0.05%);试验组差异有统计学意义(P0.05),对照组差异无统计学意义(P0.05)。(6)疼痛疗效评估:两组差异有统计学意义(P0.05);试验组30例病人疼痛缓解程度为56.7%,对照组30例病人疼痛缓解程度为33.3%。(7)安全性:研究过程中两组患者出现了以止痛药物引起的恶心、呕吐、便秘、嗜睡等症状,且无明显差异,未出现研究药物所致的心、肝、肾等重要脏器的损伤及其他不良反应事件。结论:抗癌止痛膏联合盐酸曲马多缓释片治疗中~重度癌痛的作用优于盐酸曲马多-缓释片联合安慰剂,对减轻疼痛、疼痛影响因子、有效率等效果明显,能有效增强止痛药物作用,且安全性好,值得进一步临床推广及研究。
[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.
【学位授予单位】：湖南中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R273

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