Clinical Study Of Acupuncture Combined With Auricular Plaster Therapy And Oxycontin In The Treatment Of Cancer Pain

Objective:According to the theory of traditional Chinese medicine,in the study of cancer pain TCM pathological mechanism is put forward on the basis of the “Strengthening yang and regulating liver” principle of treatment,comparison of acupuncture through controlled clinical study,clinical curative effect of auricular plaster therapy combined with analgesic drugs in the treatment of cancer pain.Methods:This project from September 2015 to December 2016,during the trial,in Wuhan Union Hospital Tumor Center Department of traditional Chinese medicine,a total of 175 patients were collected.The screening process,through clinical examination,repetitive treated,serious illness is not suitable for this study and mild pain patients(VAS score less than 3 points),age more than 85 years of age patients undergoing chemotherapy and surgery in patients with cancer pain,patients with impaired immune function,severe liver and kidney dysfunction in patients with allergic patients opioids,refused to participate in the test of patients.The initial 90 cases,each group 30 cases,and according to the relevant cases at the end of the trial and drop out of follow-up,and finally determine compliance with the conditions of the test patients,75 cases,34 men,41 women,25 cases in each group.75 cases of cancer patients had pain symptoms,and the VAS score was 4--10.According to the order of collecting cases,patients were divided into acupuncture + auricular plaster therapy + oxycontin(group A),acupuncture + oxycontin(group B),oxycontin(C group),three groups,25 cases in each group.The treatment principle of "Strengthening yang and regulating liver" and "analgesia" based.Concrete method:Acupuncture prescription: Zusanli(ST36),Hegu(LI4),Taichong(LR3),Ligou(LR5),Waiguan(TE5),combined with positive reaction point;The auricular acupoints are chosen as the Shenmen,adrenal gland,brain,liver,sympathetic,subcortical,endocrine,thalamus;Selection of analgesic drugs produced by Pfizer Inc Oxycontin sustained release tablets(Oxycodone hydrochloride sustained release tablets)specifications for 10mg/ tablets.Treatment group A in drug use on the basis of complex prescription of acupuncture and auricular plaster therapy;Treatment group B in drug use with the prescription of acupuncture based on the treatment of group C is simple;the use of analgesic drugs like oxycontin.Acupuncture: reasonable position,conventional acupuncture and disinfection,according to the site selection of needle,the main choice of 0.30 mm * 40 mm,0.30 mm * 50 mm,0.25 mm * 25 mm global brand disposable acupuncture needle,bilateral acupoints of daily routine for one side into the needle,twirling lifting and thrusting manipulation 3-5 minutes,reinforcing reducing,patients feel stop the manipulation when the needle to needle sensation,feeling weaker and disappear when continued rapid twirling lifting and thrusting manipulation,keep the needle feeling,every acupuncture 15 min.Ear pressure pills: first select one ear,routine disinfection,75% alcohol cotton cleaning ears and associated parts of Vaccaria seeds produced by auricular point sticking each put a hand thumb and index finger point relative rubbing applicator parts,cause pain and discomfort feeling,general plaster therapy once every 2-3 days long,not more than 3 days,at the time after acupuncture.Drug use time and dosage: take orally,once a 12 h,one tablet each,10 mg.Note: 1.The control drug dose;2.Strict medication time;3.Monitoring medication and drug reaction,to prevent the emergence of drug dependence and tolerance;4.To be a pill taking,not broken or damaged,so as to avoid the effective components on the release caused by poisoning or serious adverse reactions.The treatment time and treatment: Patients after diagnosis and treatment to meet the conditions,can carry out acupuncture treatment,five times a week;ear pressure pills two times a week;medication every 12 h,one at a time,each piece of 10 mg,taking around.The three group total 4 weeks,4 weeks of follow-up.Evaluation index and evaluation cycle:(1)Safety index: routine blood routine,urine routine,stool routine,liver and kidney function,electrocardiogram;(2)Curative effect index:(1)Main outcome measures: visual analogue scale(VAS)score;(2)Secondary indicators: A.biochemical index: NK cell activity value,T lymphocyte subsets(CD3+/CD4+/CD8+)activity value;B.questionnaire: Cancer patient quality of life scale(EORTC,QLQ-C30),Health survey form(SF-36),Hamilton Anxiety Scale(HAMA),Pittsburgh sleep quality index(PSQI);Patients admitted to hospital within 24 h degree of pain assessment and pain treatment.The treatment period of 4 weeks,4 weeks of follow-up.During the treatment,and evaluate the treatment according to the adverse events of acupuncture and drugs;improve the case report form;the tumor related complications timely treatment(1-4 weeks).Before treatment,second week,fourth weeks a safety index and efficacy index examination.Follow up: a follow-up after treatment in fourth weeks,the follow-up included reviewing the safety index and efficacy index related content,registration of pain status and medication.The loss of registration cases ultimately improve the case report form(eighth weeks later).Result:According to the analysis of multiple indexes before and after treatment comparison,A group(acupuncture+ear sticking+oxycontin)in pain suppression,control of inflammation,improve kidney function,improve the quality of life of patients,improve the health status of the patients,control of anxiety and improve sleep were better than group B(acupuncture + oxycontin)C group(oxycontin).At the same time,according to the analysis of the data of each group before and after treatment,in eighth weeks of follow-up,patients in the A group the data is compared with the other two groups were dominant;the data of A group and B group can be found in the B group,pain control,control of inflammation,improve kidney function,improve the quality of life of patients,improve the health status of the patients.Control of anxiety and improve sleep and other aspects are inadequate,the comprehensive treatment effect than acupuncture combined with ear sticking + oxycontin.Through three groups of data comparison,the effect of treatment with acupuncture combined with ear sticking +oxycontin is the best,followed by acupuncture + oxycontin.oxycontin only by the relatively poor.Conclusion:Acupuncture and auricular point based analgesic drug use deposited in the stick can effectively improve the patients with cancer pain,improve the quality of life of patients,prolong the survival period of patients with cancer,has very important significance for the treatment of cancer pain.