论文部分内容阅读
目的:观察护骨消积方联合唑来膦酸治疗骨转移癌痛的临床疗效,并探讨骨转移患者中医证型与Ⅰ型胶原交联氨基末端肽(NTx)水平的关联性。方法:将48例既往未接受过唑来膦酸治疗的新发骨转移癌痛患者,采用流行病学方法采集中医证候信息,按肾虚诊断标准判断有无肾虚证候,并检测患者血清NTx水平,统计分析NTx水平与中医肾虚证候的关联性。其中符合纳入标准的32例患者中,轻度疼痛18例,中重度疼痛14例,随机分为中药组和对照组各16例。中药组给予护骨消积方联合唑来膦酸治疗,对照组单纯使用唑来膦酸。治疗过程中若出现中重度疼痛者加服吗啡,治疗2月后观察患者的镇痛效果及生存质量KPS评分的改善。结果:31例肾虚证型的骨转移患者中,血清NTx(17.39±9.31)nmol BCE/L,17例非肾虚证型患者血清NTx(12.93±1.83)nmol BCE/L,差异有统计学意义(P<0.05)。符合纳入标准的32例患者中,2组疼痛疗效比较,中药组患者止痛总有效率81.3%,高于对照组56.3%,2组比较,差异无统计学意义(P>0.05)。治疗后,2组KPS评分分别与治疗前比较,差异均有统计学意义(P<0.05);治疗后,2组KPS评分比较,差异有统计学意义(P<0.05)。结论:骨转移癌痛患者的中医证型以肾虚多见,且肾虚证型与NTx水平之间有一定的关联性。护骨消积方联合唑来膦酸治疗恶性肿瘤骨转移癌痛具有一定的协同作用。
Objective: To observe the curative effect of Huogu Xiaoji Decoction combined with zoledronic acid in the treatment of bone metastatic cancer pain, and to explore the correlation between TCM syndrome types and the level of collagen type Ⅰ collagen cross-linking amino terminal peptide (NTx) in patients with bone metastasis. Methods: Forty-eight patients with newly diagnosed bone metastasis cancer who had not been treated with zoledronic acid were recruited. Epidemiological methods were used to collect TCM syndrome information and kidney deficiency syndrome according to diagnostic criteria of kidney deficiency. Serum NTx Level, statistical analysis of NTx levels and the association of kidney deficiency syndrome. Of the 32 patients who met the inclusion criteria, 18 had mild pain and 14 had moderate-to-severe pain. They were randomly divided into two groups: control group (16 cases) and control group (16 cases). The traditional Chinese medicine group was treated with Bonezhengji prescription combined with zoledronic acid and the control group with zoledronic acid alone. In the course of treatment if moderate to severe pain plus serving morphine, after 2 months of treatment observed in patients with analgesic effect and quality of life KPS score improvement. Results: The serum levels of NTx (17.39 ± 9.31) nmol BCE / L and 17 cases of non-kidney deficiency type NTx (12.93 ± 1.83) nmol BCE / L in 31 patients with kidney deficiency syndrome were significantly different P <0.05). Among the 32 patients who met the inclusion criteria, the total effective rate of pain relief was 81.3% in the two groups compared with 56.3% in the control group. There was no significant difference between the two groups (P> 0.05). After treatment, the KPS scores of the two groups were significantly different from those before treatment (P <0.05). After treatment, the KPS scores of the two groups were significantly different (P <0.05). Conclusion: TCM syndromes of patients with bone metastatic cancer are more common in the kidney, and kidney deficiency syndrome and NTx levels are related to each other. Prescriptions for the treatment of bone metastases and cancer pain in combination with zoledronic acid for the treatment of malignant tumors have certain synergistic effects.