Clinical Research Of Standardized Outpatient Drug Treatment For Patients With Cancer Pain

Objective:To analyze the clinical effect of standardized outpatient drug treatment for patients with cancer pain and provide references for standardized treatment of cancer pain. Methods:According to NCCN clinical practice guidelines in Adult Cancer Pain, establishment of the standardized diagnosis of clinic patients with cancer pain clinical. Data of 75 patients undergoing standardized treatment of cancer pain were collected from December, 2012 to December, 2014 in pain clinic of Anesthesiology Department. The diseases induced cancer pain, location and classification of pain, use of analgesics, and drug adverse reactions were also analyzed. In addition, the relief of cancer pain and improvement of life quality of enrolled patients before and after standardized outpatient treatment were analyzed bynumerical rating scale and Karnofsky Performance Status scale. This study had compared the variation of pain relief and improvement of life quality among different pain classification, genders and diseases. Results:1. The kinds of diseases inducing cancer pain and the location and classification of pain. There were 28 patients suffered from lung cancer(37.3%), 28 patients suffered from gastrointestinal cancer(37.3%) and 19 patients suffered from other cancers(25.3%) among 75 patients. 33 patients had the abdominal pain and 27 patients had the chest pain. There were 31 cases of visceral pain(41.3%), 43 cases of somatoform pain(57.4%), and 1 case of neuropathic pain(1.3%).2. Usage of analgesics and their adverse reactions: There were 18.7% patients were administrated with morphine sulfate controlled-release tablets only, 17.3% patients with oxy ER only;6.7% patients with fentanyl transdermal system only and 6.7% patients with morphine hydrochloride. and there were 8.0% patients were administrated with morphine sulfate controlled-release tablets + transdermal fentanyl system accounted for; 4.0% patients with oxy ER + transdermal fentanyl system, 26.6% patients with oxy ER + morphine sulfate tablets,5.3% patients with morphine sulfate controlled-release tablets + diclofenac sodium and codeine phosphate, and 6.7% patients with morphine sulfate controlled-release tablets + bucinnazine hydrochloride tablets. Meanwhile, drug adverse reaction, constipation occurred in 57.3% patients, accounting for, and nausea and vomiting occurred in 17.3% patients.3. Remission rate of cancer pain and improvement rate of life quality. Total remission rate of cancer pain after standardized outpatient treatment was 86.7%. There was statist ical significance in the remission rate of cancer pain among three groups of pain ratings( P = 0.033); there was no statistical significance in different diseases(χ2 = 0.174, P = 0.917). Total improvement rate of life quality after standardized outpatient treatment was 85.3%. There was statistical significance in three groups of pain ratings(P = 0.038); there was no statistical significance in different genders(χ2 = 0.001, P = 1.000) and different diseases(χ2 = 0.174, P = 0.917).4. Change of NRS scores and KPS scores. There was statistical significance in NRS scores and KPS scores before and after standardized outpatient treatment. When compared between moderate pain group and severe pain group, there was statistical significance in NRS scores and KPS scores before and after the treatment(P <0.05). When compared between different diseases, there was statistical significance in NRS scores and KPS scores before and after three group treatment(P <0.05). Conclusions:The pain score was reduced, life quality score was improved, the pain was relieved, and no serious adverse reactions existed after standardized outpatient treatment for patients with cancer pain.