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目的探讨综合疗法对阿片类药物治疗癌性疼痛患者的增效减毒作用。方法选取2016年5月至2017年6月间海南省中医院收治的100例癌性疼痛患者,采用随机数表法分为治疗组与对照组,每组50例。两组患者均给予阿片类药物止痛,治疗组患者给予止痛方联合通腑方治疗,对照组患者联合乳果糖口服溶液治疗。比较两组患者镇痛疗效、疼痛评分、体力状况评分(KPS)及不良反应情况。结果治疗组患者镇痛总有效率为92.0%,优于对照组患者的76.0%,差异有统计学意义(P<0.05)。治疗组患者疼痛评分及KPS评分优于对照组,差异均有统计学意义(均P<0.01)。治疗组患者便秘、恶心呕吐和尿潴留发生率均显著低于对照组患者,差异均有统计学意义(均P<0.05),两组患者皮肤瘙痒和头晕等不良反应比较,差异无统计学意义(P>0.05)。结论综合疗法运用于阿片类药物治疗癌性疼痛患者中,能够提高癌痛控制度,减轻阿片类药物的不良反应,改善患者生活质量。
Objective To investigate the synergistic and attenuated effects of combination therapy on opioid cancer patients with cancer pain. Methods A total of 100 patients with cancer pain who were admitted to Hainan Provincial Hospital of Traditional Chinese Medicine between May 2016 and June 2017 were randomly divided into treatment group and control group with 50 cases in each group. Two groups of patients were given opioid analgesics, patients in the treatment group were given Tongzhifang analgesic prescription side treatment, the control group patients with lactulose oral solution treatment. Analgesic efficacy, pain score, physical status score (KPS) and adverse reactions were compared between the two groups. Results The total effective rate of the analgesic in the treatment group was 92.0%, which was better than that in the control group (76.0%), the difference was statistically significant (P <0.05). The pain scores and KPS scores of the treatment group were better than those of the control group, the differences were statistically significant (all P <0.01). The incidences of constipation, nausea, vomiting and urinary retention in the treatment group were significantly lower than those in the control group (all P <0.05). There was no significant difference in adverse reactions such as pruritus and dizziness between the two groups (P> 0.05). Conclusion The combination of opioid therapy for cancerous pain patients can improve the control of cancer pain, reduce the adverse reactions of opioids and improve the quality of life of patients.