Clinical Observation Of Chanlong Zhentong Paste In Treating Cancer Pain And Research Of Its Analgesic Mechanism In Rat Model Of Bone Cancer Pain

ObjectiveTo evaluate the clinical efficacy of Chanlong Zhentong Paste(CZP)combine with OxyContin in the treatment of cancer pain,and explore the analgesic effect and mechanism of CZP on rat model of bone cancer pain.MethodPart?:Sixty patients with cancer pain were divided into western medicine group and combination therapy group.Numerical Rating Scale(NRS)of cancer pain,Karnofsky Performance Status(KPS),dose of OxyContin and adverse reactions were observed.Part?:Fifty female SD rats were selected to establish a rat model of bone cancer pain by injecting Walker256 breast cancer cell suspension into the right hind limb.Rats with successful modeling were randomly divided into model group,CZP normal-dose group,CZP high-dose group and Voltaren group,and the corresponding drugs were given to each group for 21 days.The analgesic effect of CZP was evaluated by observing the changes of pain behavior in rats.The serum levels of Inflammatory factors and?-endorphin(?-EP)were detected by ELISA.The expression of Glial Fibrillary Acidic Protein(GFAP),Cluste of Differentiation 11b(CD11b),Protein38(p-P38)and Extracellular Regulated Kinase(p-ERK1/2)in rat spinal cord was detected by IHC and Western blot to explore the possible analgesic mechanism of CZP.ResultPart?1.The NRS on the 7~thh day and 14~thh day in combination therapy group were significantly lower than those of the western medicine group(P<0.05);2.The maintenance dose of OxyContin in the combined group was significantly lower than that in the western medicine group(P<0.05);3.The KPS of the combined group was significantly higher than that of the western medicine group(P<0.05),and the curative effect evaluation was better(P<0.05);4.There was no difference in adverse reactions between the two groups(P<0.05).Part?1.CZP can significantly increase PWL and PWT in rats with bone cancer pain(P<0.05);2.CZP can significantly reduce the serum levels of PGE2,IL-1?,IL-6 and TNF-?in rats with bone cancer pain(P<0.05),and increase the serum levels of?-EP(P<0.05);3.CZP can significantly inhibit the expression of GFAP,CD11b,p-P38 and p-ERK in the spinal cord of rats model of bone cancer pain(P<0.05).Conclusion1.CZP combine with OxyContin can improve the symptoms of patients with cancer pain,improve the quality of life,reduce the maintenance dose of OxyContin,and does not cause an increase in adverse reactions;2.CZP can significantly induce PWL and PWT in rats;3.The analgesic mechanism of CZP may be related to inhibiting the release of inflammatory factors and promoting the release of endorphins.At the same time,by inhibiting the activation of spinal astrocytes and microglia,and regulates the expression of p-P38 and p-ERK1/2 in the MAPK signaling pathway.