加味芍甘附子汤治疗癌痛的临床研究

发布时间：2018-08-31 17:01

【摘要】：目的:探讨加味芍甘附子汤联合盐酸羟考酮缓释片治疗阳虚寒凝型癌痛患者的疗效。本课题将从临床角度通过对阳虚寒凝型癌痛患者在阿片类药物止痛的基础上加用中药汤剂加味芍甘附子汤与单纯的阿片类药物止痛进行疗效的对比观察,从而评价其对患者疼痛缓解情况、生存质量及药物副作用的影响,为加味芍甘附子汤治疗阳虚寒凝型癌痛提供临床基础依据,能使其在临床上运用更加广泛。方法:本研究主要收集在新会区中医院肿瘤科治疗癌痛患者,按设定的标准,纳入78例阳虚寒凝型的患者,按照随机对照的原则,分为对照组和试验组,对照组入组38例患者,主要采用盐酸羟考酮缓释片止痛治疗,试验组入组40例患者,均在对照组治疗的基础上内服中药制剂加味芍甘附子汤治疗,观察两组患者的临床疗效、生活质量改善情况、疼痛评分及药物副作用等。结果:治疗组的平均镇痛维持时间明显长于对照组(P0.01);治疗组的盐酸羟考酮缓释片日均需用量明显少于对照组(P0.01);治疗组疗效的总有效率为92.5%,明显优于对照组的76.3%(P0.05);治疗组Karnofsky评分的总有效率为90.0%,明显优于对照组的65.8%(P0.05);治疗组发生便秘和恶心呕吐的毒副反应亦比对照组少(分别是P0.01及P0.05)。结论:本研究表明,中药制剂加味芍甘附子汤联合盐酸羟考酮缓释片能够明显降低阳虚寒凝型癌痛患者的疼痛评分,提高临床疗效,改善癌痛患者生存质量,并且减轻盐酸羟考酮缓释片在呕吐、便秘方面的毒副反应。
[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.
【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】：R273

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