Clinical Observation On Modified Duhuo Jisheng Decoction Combined With Opioid Drugs In The Treatment Of Spinal Metastatic Cancer Pain

Objective: To evaluate the clinical effect on Modified Duhuo Jisheng decoction combined with opioids on pain relief and quality of life in patients with spinal metastatic cancer pain.Methods:A total of 70 patients with cancer pain in spinal metastasis who met the inclusion criteria from December 2019 to March 2021 were randomly divided into control group(35cases)and treatment group(35 cases).The control group was treated with oxycodone hydrochloride sustained-release tablets,q12 h,7days a course of treatment.The treatment group was treated with Modified Duhuo Jisheng Decoction on the basis of the control group.If two groups of patients in the course of treatment outbreak pain to morphine hydrochloride injection rescue.The pain degree score,pain relief rate,opioid use,number of outbreaks of pain,quality of life score,clinical efficacy score of traditional Chinese medicine,analgesic satisfaction,adverse reactions and safety indicators of the two groups were observed and recorded.Results:Both groups were followed up completely.There was no significant difference in gender,age,disease type,pain degree,NRS score and KPS score between the two groups before treatment(P > 0.05).1.Pain degree : There was no significant difference in NRS score between the two groups after titration(P > 0.05).The NRS scores of the two groups after treatment were compared,and the difference was statistically significant(1.07±0.74 vs 1.53±0.82,P = 0.031).There was no significant difference in NRS score between before treatment and after titration(P >0.05).There was no significant difference in NRS score between before treatment and after treatment(P > 0.05).The difference in NRS score after titration was statistically significant compared with that after treatment(0.86±0.51 vs 0.57±0.68,P = 0.034).2.Pain relief rate : After opioid titration,the total effective rate of pain relief in the two groups was 90 % in the treatment group and 83.3 % in the control group.At the end of treatment,the total effective rate was 96.6 % in the treatment group and 93.3 % in the control group.There was no significant difference in the pain relief rate between the two groups after titration and after treatment before and after treatment.3.Use of oxycodone hydrochloride sustained-release tablets : There was no significant difference in daily dose between the two groups at the end of treatment(P > 0.05).The difference between the daily dose after titration and that after treatment in the two groups was statistically significant(14.33±11.35 mg vs 7.00±14.42 mg P < 0.05).At the end of treatment,the number of patients with dose changes of oxycodone sustained-release tablets was statistically significant(P < 0.05).4.Explosive pain times : the two groups at the end of treatment on the number of explosive pain,the difference was statistically significant(0.13±0.35 times VS 0.53±0.82 times P =0.041).5.KPS score : The difference between the two groups after treatment was statistically significant(68.67±8.60 vs 63.67±9.28,P = 0.037).The difference of KPS score before and after treatment was statistically significant(22.67±7.40 vs 17.00±6.51,P = 0.004).6.Analgesic satisfaction : the treatment group 93.3%,73.3% in the control group,the difference was statistically significant(P = 0.046).7.TCM clinical efficacy score : the effective rate of the treatment group was 90 %,and that of the control group was 60 %,with statistical difference between the two groups(27effective vs 18 effective P = 0.031).8.Adverse reactions and safety indicators : Compared with the adverse reactions at the end of treatment in the two groups,the constipation symptoms and grades were statistically different(P = 0.018).The safety indexes of the two groups were normal during the observation period.Conclusion: Oxycodone Sustained Release Tablets combined with Modified Duhuo Jisheng Decoction in the treatment of spinal metastatic cancer pain can not only relieve pain,improve pain relief rate and reduce opioid dosage,but also reduce the number of outbreaks of pain,improve the quality of life,improve the satisfaction rate of analgesia,improve TCM syndromes,and improve constipation symptoms caused by opioids.