Clinical Study On The Treatment Of Bone Metastasis And Pain Yin Syndrome By External Application Of Clove Bone Pain And Its Effect On ET-1

Research Background:In recent years,the incidence of malignant tumors continued to rise,lung cancer,breast cancer and other common malignant tumors in China have a high incidence of bone metastases,and bone pain is the most common clinical manifestations of malignant bone metastases,to patients with a very Big pain.Although the treatment of bone metastases in Western medicine has achieved remarkable results,but there are still inadequate aspects of the three ladder analgesic,radiotherapy,surgery and other remedies there are many adverse reactions,so that part of,especially the frail patients can not tolerate,Which seriously affected their quality of life.Chinese medicine outside the law has a long history,as an important part of the traditional Chinese medicine,in recent years widely used in the treatment of cancer pain,has its unique effect.Chinese medicine outside the rule by dialectical medication,dialectical care,the skin or mucosal surface absorption,the drug can be directly to the disease,analgesic effect is good,lasting effect,while avoiding the direct oral administration of patients suffering,especially for malignant bone metastasis Pain in patients with advanced,traditional Chinese medicine treatment is more practical significance.Research purposes:To observe the effect of "clove bone pain" acupoint application on the treatment of bone metastases pain and the effect of plasma endothelin-1(ET-1)level,and elucidate the mechanism of external application of "clove bone pain" The establishment of the promotion of cancer pain in traditional Chinese medicine treatment program and clarify the mechanism of external application of traditional Chinese medicine lay the foundation.Research methods:A total of 80 patients with malignant bone metastases were randomly divided into treatment group(n=40)and control group(n=40).The treatment group was treated with opioid(NRS)before and after treatment,the control group received the opioid + "clove bone pain side" placebo patch,a course of treatment(7 days)after the end of the two groups before and after treatment of pain(NRS)Score,pain relief rate,plasma ET-1 concentration,analgesic drug dose,burst pain condition,quality of life(QOL)score,adverse effects and safety.Result:In this study,80 patients with bone metastases were divided into three groups:the control group(n=38)and the control group(n=39).1.pain degree:① after completion of the titration,the two groups were decreased NRS score,the treatment group NRS score(2.21 ± 1.143),the control group NRS score(2.36 ±1.112),the statistical analysis,no difference between the two groups.② After 3 days of treatment,the NRS score of the treatment group was(2.18 + 0.87),and the NRS score of the treatment group was(2.26 + 1.04).There was no significant difference between the two groups.③ The NRS score of the treatment group(1.87 + 0.96)and the NRS score(2.36 +0.81)in the treatment group were significantly lower than those in the control group(P<0.05).The NRS score of the treatment group was further decreased Group decline is more obvious.2.pain relief rate(CR + PR):The remission rate was 89.5%in the treatment group and 79.5%in the control group(P = 0.383,P>0.05).There was no significant difference between the two groups after 7 days of treatment.3.analgesic drug dose:24h morphine dose after titration with the end of treatment after comparison,The control group decreased(2.31 ± 19.93)mg,the statistical analysis P>0.05,no significant difference between the two groups.4.burst pain situation:(1,45 ± 1.61)times in the treatment group and(2.49 ± 2.17)in the control group,the number of bursts of pain in the treatment group was less than that in the control group(P = 0.042).5.Plasma ET-1 concentration:① Before treatment,the plasma ET-1 concentration in the treatment group was(118.04 ± 22.74),the control group was(116.96 ± 21.52)pg/ml,the statistical analysis P>0.05,no statistics There was no difference in plasma ET-1 concentration between the two groups before treatment.② After treatment,the plasma ET-1 concentration in the treatment group was(107.12 ± 22.19)pg/ml,the control group(121.66 ± 24.53)pg/ml,the statistical analysis P = 0.01(P<0.05),after treatment The concentration of ET-1 in the treatment group was significantly lower than that in the control group(P<0.05).③The difference of the concentration of ET-1 in the treatment group was(10.92 ± 17.10)pg/ml,(-4.71 ± 21.49)pg/ml.After statistical analysis,P<0.05,the two groups of patients after treatment were statistically significant,the treatment group ET-1 concentration decreased the degree of more obvious than the control group.6.Quality of life evaluation:Quality of life(QOL)before and after treatment of the difference between the treatment group(-5.32 ± 3.70),The control group(-0.64 ± 4.77),the statistical analysis,P<0.05,the two groups of patients after treatment was statistically significant,the quality of life of the treatment group was higher than the control group of patients.7.safety and adverse reactions:① two groups of patients with blood,liver and kidney function,ECG were not due to clinical research and cause abnormal changes.② After treatment,the adverse reactions were almost the same in the two groups.All the adverse reactions were opioid,namely,nausea,vomiting,constipation and lethargy.The level of constipation in the treatment group was lighter than that in the control group(P = 0.048).The difference was statistically significant.③ topical application of traditional Chinese medicine adverse reactions:treatment group 1 case,due to paste after 3 days after the patient Ⅱ degree of adverse reactions,paste appears itching,rash,to determine the dressing allergy,immediately disable the topical drugs,after treatment improved.The control group 1 case found that I degree of adverse reactions,paste the skin redness,the emergence of flaky erythema,immediately disable the external drug after the better.Conclusion:1.moderate to severe bone metastases cancer patients,based on opioid therapy,plus"clove bone pain side" acupoints can further reduce the pain,pain relief rate of 89.5%,but also reduce the number of bursts of pain,improve the patient The quality of life.2.For patients with moderate to severe bone metastases,the plasma ET-1 concentration decreased with the decrease of pain NRS score,and the combination of "clove bone pain"acupoints combined with analgesic drugs could effectively reduce the plasma ET-1 concentration.3."clove bone pain side" paste safe and effective,non-toxic side effects,to a certain extent,improve the use of opioids in patients with constipation.