| Objective:This topic starts with oral opioid drugs combined with external application of traditional Chinese medicine to explore the understanding of traditional Chinese medicine on cancer pain.Through prospective and randomized controlled clinical observation tests,the advantages and characteristics of opioid drugs combined with external treatment of traditional Chinese medicine compared with western medicine alone are illustrated.Digging up and sorting out the academic theories and experiences of Chinese medicine in preventing and treating moderate and severe cancer pain;Enrich and develop the theory and practice of traditional Chinese medicine in the prevention and treatment of cancer pain,and explore its therapeutic mechanism;To seek new treatment methods for cancer pain.Method:Randomized controlled trials were used to divide patients who met the inclusion criteria into two groups.The control group was treated with oxycodone hydrochloride sustained-release tablets to relieve pain.The treatment group was treated with combination of oxycodone hydrochloride sustained-release tablets and Bing Wu Analgesic Plaster for external application to relieve pain.Morphine hydrochloride injection was given to relieve pain when outbreak occurred.One course of treatment(7 days)was observed.The pain degree(NRS)score,pain relief rate,opioid use,number of outbreak pain,quality of life(KPS)score,TCM syndrome score,analgesic satisfaction,adverse reactions and safety indicators were compared between the two groups.Result:A total of 60 patients were included in this study.3 patients were excluded from the treatment.57 patients finally entered the efficacy evaluation,28 patients in the treatment group and 29 patients in the control group.1.Pain degree: NRS score(1.86±1.177)in the treatment group and(2.17±1.311)in the control group after titration are lower than those before treatment,and there is no statistical difference between the two groups;On the 7th day after treatment,NRS scores(1.04±0.744)in the treatment group and(1.28±0.751)in the control group were significantly lower than those before treatment,with statistical differences between the two groups.After opioid titration,NRS scores of the two groups of patients were significantly reduced.The treatment group was reduced by(3.57±0.836)points,while the control group was reduced by(3.21±0.861)points.The difference was not statistically significant.The NRSscore of the two groups was further reduced on the 7th day of treatment.The treatment group was reduced by(0.82±0.670)points,while the control group was reduced by(0.86 ± 0.990)points.The difference was statistically significant.On the 7th day after treatment,the NRS scores of the two groups were significantly lower than before treatment,the treatment group decreased by(4.321±0.863)points and the control group decreased by(4.103±0.900)points,the difference was statistically significant.2.Pain relief rate: After opioid titration,the pain relief rate in the treatment group was89.29%,while that in the control group was 75.86%.There was no statistical difference between the two groups.After 7 days of treatment,the pain relief rate in the treatment group was 92.86%,while that in the control group was 86.21%.There was no statistical difference between the two groups.3.Opioid drug usage: the dose of oxycodone hydrochloride sustained-release tablets after titration was(40.00±16.102)mg in the treatment group,(35.17±12.711)mg in the control group,(28.21±13.348)mg in the treatment group and(32.76±11.921)mg in the control group on the 7th day.The difference between the treatment group(11.07±12.573)mg and the control group(2.41±9.124)mg of oxycodone hydrochloride sustained-release tablets after titration and after treatment was not statistically different between the treatment group and the control group after treatment.The difference between the dose of oxycodone hydrochloride sustained-release tablets after titration and after treatment was statistically different.After 7 days of treatment,the number of patients in the treatment group with reduced dosage of oxycodone hydrochloride sustained-release tablets was more than that in the control group,with statistical difference between the two groups.4.Outbreak of pain: During the treatment period,the number of outbreaks of pain in the treatment group(0.18±0.390)was lower than that in the control group(0.31±0.761).The difference was statistically significant.5.Quality of life evaluation: KPS scores of the two groups of patients increased after treatment compared with before treatment.The treatment group increased by(16.43±7.31)points and the control group increased by(16.21±9.42)points.The two groups of patients not only had statistical differences after treatment,but also had statistical differences before and after treatment.6.Evaluation of TCM syndrome curative effect: the effective rate of the treatment group was 89.29%,and that of the control group was 65.52%,with significant difference between the two groups.7.Analgesic satisfaction: The analgesic satisfaction rate in the treatment group was 92.86%,while that in the control group was 72.41%.The difference between the two groups was statistically significant.8.Adverse reactions and safety indicators: A total of 1 patient in this study had skin allergy,with no statistical difference.The degree of nausea,vomiting and lethargy in the treatment group had no statistical difference compared with the control group,while the degree of constipation in the treatment group had statistical difference compared with the control group.During the observation,the safety indexes of both groups were within the normal range.Conclusion: Compared with oxycodone hydrochloride sustained-release tablets alone,oxycodone hydrochloride sustained-release tablets combined with Bing Wu Analgesic Plaster in the treatment of moderate and severe cancer pain can relieve the pain degree of patients,improve the pain relief rate,reduce the dosage of opioid drugs,and the longer the treatment time,the more obvious the effect will be.It can reduce the number of outbreaks of pain,improve the quality of life,increase the satisfaction rate of analgesia,and improve the syndrome of traditional Chinese medicine.Moreover,Bing Wu Analgesic Plaster is safe for external use,has no obvious adverse reactions,and can improve constipation caused by opioid drugs. |
PDF Full Text Request