| BackgroundBone metastasis is one of the most common complications in patients with advanced cancer.It is often seen in breast cancer,lung cancer,renal cancer,gastric cancer,etc.it often occurs in spine,pelvis,femur,proximal humerus,ribs,etc.it can lead to stubborn pain,pathological fracture,dyskinesia and other symptoms.At present,the symptomatic treatment of bone metastases from malignant tumors is mainly based on the "three-step analgesic program",in which non steroidal anti-inflammatory drugs are used for mild pain,such as ibuprofen,in moderate pain,such as tramadol,and in severe pain,such as oxkangding.However,opioids can lead to nausea,vomiting,vision and other adverse reactions,and long-term use should be gradually increased.Traditional Chinese medicine therapy,such as internal medicine,external application of traditional Chinese medicine,acupuncture and moxibustion,has the advantages of safety,effectiveness and overall regulation,and the efficacy has been confirmed in clinical research.Patients with bone metastasis are often combined with local edema and fascial adhesion,which is objectively suitable for massage,but traditional Chinese massage is usually used to relieve pain and pain,which has the potential to cause pathological fracture and other hidden dangers for patients with bone metastasis of malignant tumors,so they seldom participate in the treatment of bone metastasis pain in the past.The massage technique of "finger tip is easy to muscle" is a kind of gentle massage technique.It avoids the local pain and adopts the treatment idea of "from far to near,from outside to inside,from Yang to Yin first,to relieve pain without pain".In clinical practice,it has a good effect on moderate and severe bone metastasis pain.It can not only play the therapeutic role of massage technique in dredging channels and collaterals,but also avoid adverse events.It is worth further developing Bedstudy.Objectives To observe the efficacy and safety of "fingertip easy muscle" massage in the treatment of bone metastasis pain in patients with malignant tumors,we compared it with the control group which only used the standardized three-step analgesic treatment.MethodsPatients with moderate or severe bone metastasis pain who meet the entry criteria were recruited.The patients voluntarily chose whether to accept the "fingertip easy tendon"massage manipulation treatment.If they accept it,they will be included in the treatment group.On the basis of three-step analgesic treatment,they will be combined with manipulation treatment.If they don't accept it,they will be included in the control group,and only three-step analgesic treatment will be used.Both the treatment group and the control group received three-step analgesic treatment.Different analgesic drugs were selected according to the condition of the patients.On the basis of three-step analgesic treatment,the treatment group took acupoints,strength,amplitude,frequency and frequency as the patients' manual treatment according to the standard designed by the subject,and operated for 20-30 minutes each time,1-2 times a week,and 4 times a observation cycle.The comprehensive efficacy,pain score,times of breaking out pain,dosage of painkillers,physical condition score,pain influence score,adverse reactions of the two groups were compared,as well as the pain score,times of breaking out pain,physical condition score and pain influence score of the experimental group before and after manual treatment.Result? There is no significant difference in the total effective rate between the test group and the control group(P>0.05),there is a difference in the significant efficiency(63.33%in the test group and 36.67%in the control group),but in this test,the difference is not statistically significant(P>0.05);? After treatment,the NRS score of the test group was lower than that of the control group(3.30 ±2.04 in the test group and 4.67 ±2.07 in the control group),the difference was statistically significant(P<0.05);? After treatment,there was no statistically significant difference in the number of outbreak pain,dosage of opioids,physical condition score,and frequency of adverse reactions between the experimental group and the control group(P>0.05);?After treatment,the pain impact score of the test group was lower than that of the control group(30.37±12.67 in the test group and 34.33±7.82 in the control group),the difference was statistically significant(P<0.05),in which the impact of pain on mood and pain on sleep The difference between the two detailed items and the control group was statistically significant(P<0.05),but there was no statistically significant difference in daily work,walking ability,normal work,relationship with others,and life enjoyment(P>0.05);? There was no statistically significant difference in analgesic dosage before and after manual treatment in the experimental group(P>0.05),but the NRS score decreased from 4.77±1.55 to 3.3 ±2.04(P<0.001),and the number of outbreak pains decreased from 1.13 ±0.21 to 0.77± 0.17(P<0.05);?There was no statistically significant difference in the scores of physical status before and after manual treatment in the treatment group(P>0.05).The pain impact score decreased from 35.00 ±10.63 to 30.37±12.67(P<0.001).In the breakdown,in daily activities,emotions,sleep and There is a significant difference in life enjoyment(P<0.01).There is a statistical difference in the relationship between normal work and others(P<0.05),and there is no statistically significant difference in walking ability(P>0.05).ConclusionThe treatment of moderate and severe bone metastasis pain by "fingertip easy muscle"massage combined with three-step analgesic program can further alleviate the pain on the basis of opioid analgesic,improve the quality of life of bone metastasis patients to a certain extent,without obvious adverse reactions,and can be used as a supplementary therapy under the three-step analgesic program. |
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