Clinical And Experimental Study Of Compound Zhitong Capsule On Cancer Pain

The clinical practice has proved Chinese traditional medicine has a preferable effect of relieving pain, and then it has been widely used in treatment of patients with painful symptoms. Based upon this, we constitute a formula Compound Zhitong Capsule(中药复方止痛胶囊,ZTC) formulated by Rhizoma ligustici chuanxiong, Herba asari, Radix paeoniae alba, Pycnostelmae paniculae. Our previous study had showed that ZTC had the preferable effect of analgesia on several acute pain models.. In this experiment, we selected AA rats as pain model and observed the effect of ZTC on chronic pain and studied its underlying mechanism.AIM: To observe clinical effect and side-effect on patients with cancer pain. To observe the analgesic effect of ZTC and study its underlying mechanism in adjuvant arthritis (AA) rats. METHOD1) clinical trial: A number of fifty patients with cancer pain was randomly divided into treatment group and control group. The control group were treated with WHO 3-grade analgesic program, and the treatment group was treated with ZTC in the 1st step and ZTC simultaneously with 3-grade analgesic program in the 2nd and 3rd step. The analgesic effect and quality of life and side-effect were observed. 2)Experimental study: The analgesic effect of ZTC on chronic pain was observed by radiant heat and the degree of swelling in both hind paws was detected in AA rats. The activities and contests of superoxide dismutase (SOD) and lipid peroxides (LPO) inserum were observed by spectrophotometry, and the level of inducible nitric oxidesynthase (iNOS) and beta-endorphin (P -EP) in hypothalamus were determined by themethod of immunohistochemistry.RESULTS:l)Result of clinical trial: The complete response(CR) and partial response (PR) areconsidered as effective. The efficacy was evaluated with VRS methods showed thattreatment group had an effective rate of 80% and control group of 52%, with statisticaldifference (p<0.05) . The therapeutic efficacy with VAS methods revealed that theefficacy of treatment group vs control group being 76% vs 48%, with statisticaldifference (p<0.05) . The influence of quality of life had no significant differencebetween treatment group and control group. The incidence of side-effect in treatmentgroup was less than that of control group (p<0.05) .2)Result of experimental study:?Effect on the pain threshold It appeared effect after treatment about 20min withZTC, The analgesic effect lasted for about 150min, and peak value was observedbetween 30min and 90min. It had no significant difference berween high dose group ofZTC and ASA group during 90min (P>0.05 ) , but it appeared obvious difference after90min (p<0.05, p<0.01) .?Effect on degree of swelling of both-hind paws The degree of swelling in bothhind paws were reduced since ZTC (250mg/kg> 500mg/kg> lOOOmg/kg) used. Since the4th day, it had significant difference between ZTC (500mg/kg> lOOOmg/kg) groups andmodel group.?Effect on SOD> LPO level in serum After treatment by ZTC (250mg/kg>500mg/kgN lOOOmg/kg) , the activities of SOD were improved. Compared with modelgroup, no significant difference was observed among all groups except high dose groupof ZTC (p<0.05) . The contents of LPO were significantly increased in rats of modelgroup. Significant differences were observed between model group and the therapeuticgroup (p<0.01) .?Effect on the level of iNOS and f3 -EP in rat hypothalamus The expression ofiNOS in ZTC (250mg/kgN 500mg/k^ lOOOmg/kg) group was significantly lower thanthat in model group (p<0.01) , but the relative content of 0-EP was evidently higherthan that in model group (p<0.01) .CONCLUSIONS: ZTC possesses better analgesic effect and lower side-effect onpatients with cancer pain, and combined with western medicine in the 2nd and 3rd stepcan enhance the analgesic effect and reduce the adverse effect. The result ofexperimental study show that ZTC has significant effect of analgesia on AA rats. Itsmechanism of analgesic effect was probably associated with its effect on inhibitingoxygen free radicals level in serum and reducing iNOS and...