复方苦参注射液联合硫酸吗啡缓释片治疗癌痛效果分析
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摘要
目的探究复方苦参注射液(CKI)联合硫酸吗啡缓释片对癌痛的缓解效果及其对患者生活质量(QOL)的改善。方法将180例恶性肿瘤伴癌痛患者按随机数字表法随机分为研究组(n=90)与对照组(n=90)。两组均采用相同的基础治疗,研究组采用复方苦参注射联合硫酸吗啡缓释片进行镇痛,对照组仅使用硫酸吗啡缓释片进行镇痛,治疗2周期后,比较两组患者疼痛缓解情况及生活质量变化。结果研究组和对照组患者疼痛缓解率分别为90.00%(81/90)和78.89%(71/90),差异具有统计学意义(P﹤0.05)。本组治疗前后,患者娱乐、情绪、行走能力、正常工作、睡眠、一般活动、社交7项生活质量评分比较,差异具有统计学意义(P﹤0.05)。治疗前,两组患者的QOL7项生活质量评分比较,差异无统计学意义(P﹥0.05);治疗后,两组患者娱乐、情绪、行走能力、正常工作、睡眠和一般活动评分比较,差异具有统计学意义(P﹤0.05)。结论复方苦参注射液联合硫酸吗啡缓释片治疗能够明显缓解癌痛,其效果优于单纯应用硫酸吗啡缓释片,且可有效提高患者生存质量,值得临床推广。
Objective To evaluate the efficacy of compound kushen injection combined with morphine sulfate in the treatment for patients with cancer pain, and the effect on quality of life(QOL). Method A total of 180 patients with cancer pain were included and randomized into study group(n=90) or control group(n=90) according to a random number table, same background treatment were administered in both groups, while the study group received compound kushen injection combined with morphine sulfate and the control group was given morphine sulfate alone to relieve the cancer pain, respectively. After 2 cycles, the pain severity and QOL of both groups were measured. Result The total pain control rate was 90.00%(81/90) and 78.89%(71/90) in study and control group, respectively, with significant difference observed(P<0.05). All 7 assessments of QOL, including entertainment, emotion, ambulation, work, sleep, general activities and social life in both groups were improved after treatment(P<0.05). Before treatment, the two groups had similar QOL observations(P>0.05), while after treatment, the study group was superior in all aspects of QOL measures compared with those of control group(P<0.05). Conclusion Compound kushen injection combined with morphine sulfate effectively relieves the cancer pain, with better effect than morphine sulfate alone, which may improve patients' quality of life, and is clinically applicable.
Objective To evaluate the efficacy of compound kushen injection combined with morphine sulfate in the treatment for patients with cancer pain, and the effect on quality of life(QOL). Method A total of 180 patients with cancer pain were included and randomized into study group(n=90) or control group(n=90) according to a random number table, same background treatment were administered in both groups, while the study group received compound kushen injection combined with morphine sulfate and the control group was given morphine sulfate alone to relieve the cancer pain, respectively. After 2 cycles, the pain severity and QOL of both groups were measured. Result The total pain control rate was 90.00%(81/90) and 78.89%(71/90) in study and control group, respectively, with significant difference observed(P<0.05). All 7 assessments of QOL, including entertainment, emotion, ambulation, work, sleep, general activities and social life in both groups were improved after treatment(P<0.05). Before treatment, the two groups had similar QOL observations(P>0.05), while after treatment, the study group was superior in all aspects of QOL measures compared with those of control group(P<0.05). Conclusion Compound kushen injection combined with morphine sulfate effectively relieves the cancer pain, with better effect than morphine sulfate alone, which may improve patients' quality of life, and is clinically applicable.
引文
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[5]李泓锡,姚鹏.非甾体抗炎镇痛药物用于癌痛治疗的最新进展[J].中国新药杂志,2015,24(18):2081-2084.
[6]Kumar SP.Cancer pain:A critical review of mechanismbased classification and physical therapy management in palliative care[J].Indian J Palliat Care,2011,17(2):116-126.
[7]元建华,赵清梅,廖燕,等.复方苦参注射液联合硫酸吗啡缓释片治疗中重度癌痛的临床观察[J].中国疼痛医学杂志,2015,21(1):79-80.
[8]宋莉,吴超然,刘慧,等.关于华西医院肿瘤中心住院患者癌痛情况的调查分析[J].中国疼痛医学杂志,2014,20(9):630-634.
[9]Schneider G,Voltz R,Gaertner J.Cancer pain management and bone metastases:An update for the clinician[J].Breast Care(Basel),2012,7(2):113-120.
[10]De Gregori S,De Gregori M,Ranzani GN,et al.Morphine metabolism,transport and brain disposition[J].Metab Brain Dis,2012,27(1):1-5.
[11]陈丽娟,叶桂云,王辉,等.规范应用阿片受体激动剂对癌痛治疗的临床价值探讨[J].中国医院药学杂志,2015,35(24):2250-2254.
[12]刘倩,张宏桂,刘永刚,等.HPLC-MS~n法分析复方苦参注射液的化学成分[J].中成药,2006,28(10):1488-1491.
[13]李道睿,林洪生.大剂量复方苦参注射液治疗中晚期恶性肿瘤的有效性和安全性[J].中华肿瘤杂志,2011,33(4):291-294.
[14]范春香,林春丽,梁璐,等.复方苦参注射液对晚期非小细胞肺癌化疗的增强作用[J].中华肿瘤杂志,2010,32(4):294-297.
[15]马春华,姜镕,李金铎,等.复方苦参注射液联合介入化疗治疗非小细胞肺癌伴癌痛患者的疗效观察[J].中国新药杂志,2013,22(17):2071-2074.
[16]李瑞萍,胡雪梅,吕银凤,等.苦参碱对人卵巢癌细胞增殖的影响及其机制[J].西安交通大学学报(医学版),2010,31(5):621-624.
[17]李竟长,倪秉强,秦佳宁,等.盐酸吗啡缓释片联合复方苦参注射液治疗中重度癌痛的临床观察[J].检验医学与临床,2014,11(11):1562-1563;1565.
[2]潘长生.吗啡缓释片联合复方苦参注射液治疗重度癌性疼痛的疗效观察[J].中国医院药学杂志,2010,30(18):1605-1606.
[3]严广斌.NRS疼痛数字评价量表numerical rating scale[J].中华关节外科杂志(电子版),2014,8(3):92.
[4]严敏.癌痛规范化治疗及2010年《NCCN成人癌痛临床实践指南》(中国版)解读[J].现代实用医学,2012,24(2):127-129.
[5]李泓锡,姚鹏.非甾体抗炎镇痛药物用于癌痛治疗的最新进展[J].中国新药杂志,2015,24(18):2081-2084.
[6]Kumar SP.Cancer pain:A critical review of mechanismbased classification and physical therapy management in palliative care[J].Indian J Palliat Care,2011,17(2):116-126.
[7]元建华,赵清梅,廖燕,等.复方苦参注射液联合硫酸吗啡缓释片治疗中重度癌痛的临床观察[J].中国疼痛医学杂志,2015,21(1):79-80.
[8]宋莉,吴超然,刘慧,等.关于华西医院肿瘤中心住院患者癌痛情况的调查分析[J].中国疼痛医学杂志,2014,20(9):630-634.
[9]Schneider G,Voltz R,Gaertner J.Cancer pain management and bone metastases:An update for the clinician[J].Breast Care(Basel),2012,7(2):113-120.
[10]De Gregori S,De Gregori M,Ranzani GN,et al.Morphine metabolism,transport and brain disposition[J].Metab Brain Dis,2012,27(1):1-5.
[11]陈丽娟,叶桂云,王辉,等.规范应用阿片受体激动剂对癌痛治疗的临床价值探讨[J].中国医院药学杂志,2015,35(24):2250-2254.
[12]刘倩,张宏桂,刘永刚,等.HPLC-MS~n法分析复方苦参注射液的化学成分[J].中成药,2006,28(10):1488-1491.
[13]李道睿,林洪生.大剂量复方苦参注射液治疗中晚期恶性肿瘤的有效性和安全性[J].中华肿瘤杂志,2011,33(4):291-294.
[14]范春香,林春丽,梁璐,等.复方苦参注射液对晚期非小细胞肺癌化疗的增强作用[J].中华肿瘤杂志,2010,32(4):294-297.
[15]马春华,姜镕,李金铎,等.复方苦参注射液联合介入化疗治疗非小细胞肺癌伴癌痛患者的疗效观察[J].中国新药杂志,2013,22(17):2071-2074.
[16]李瑞萍,胡雪梅,吕银凤,等.苦参碱对人卵巢癌细胞增殖的影响及其机制[J].西安交通大学学报(医学版),2010,31(5):621-624.
[17]李竟长,倪秉强,秦佳宁,等.盐酸吗啡缓释片联合复方苦参注射液治疗中重度癌痛的临床观察[J].检验医学与临床,2014,11(11):1562-1563;1565.