1. 上海中医药大学附属龙华医院肿瘤科,上海,200032
2. 上海市杨浦区中医医院肿瘤科,上海,200090
3. 上海市第十人民医院崇明分院中医肿瘤科,上海,202157
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王立芳, 吕英, 鲁叶云, 等. 骨痛灵方对肺癌骨转移疼痛影响的临床观察[J]. 上海中医药杂志, 2016,50(5):35-38.
WANG Li-fang, LYU Ying, LU Ye-yun, et al. Clinical research of “Gutongling Decoction” in relieving pain due to bone metastatic pulmonary cancer[J]. Shanghai Journal of Traditional Chinese Medicine, 2016,50(5):35-38.
目的:观察骨痛灵方联合肺岩宁方及西药治疗肺癌骨转移疼痛的临床疗效。 方法:将100例肺癌骨转移疼痛患者随机分为治疗组(51例)和对照组(49例)。两组均予基础三阶梯止痛治疗,对照组加予唑来膦酸钠及中药肺岩宁方治疗,治疗组在对照组治疗措施基础上加服骨痛灵方。两组疗程均为2个月,观察镇痛疗效和安全性,比较生活质量评分、体力状况评分、血清钙及碱性磷酸酶水平的变化情况。 结果:①最终完成试验者98例,治疗组50例,对照组48例。②治疗组、对照组镇痛总有效率分别为80.00%、54.17%;组间镇痛疗效比较,差异有统计学意义,治疗组优于对照组(P<0.05)。③组间治疗后比较,生活质量核心量表中的躯体功能、角色功能、社会功能、总健康状况、疲倦、失眠领域差异具有统计学意义(P<0.05),肺癌子量表中的胸痛、其他部位痛差异有统计学意义(P<0.05)。④组间治疗后比较,体力状况评分的疗效差异有统计学意义(P<0.05);治疗组好转率明显高于对照组(P<0.05)。⑤治疗前后组内比较,两组血清碱性磷酸酶水平差异有统计学意义(P<0.05);组间治疗后比较,血清碱性磷酸酶水平差异有统计学意义(P<0.05)。⑥两组不良反应发生率比较,差异无统计学意义(P>0.05)。 结论:骨痛灵方联合肺岩宁方及西药治疗肺癌骨转移,可显著镇痛,改善患者的生活质量与体力,其作用机制可能与抑制碱性磷酸酶有关。
Objective:To estimate the clinical effect of the “Gutongling Decoction” with “Feiyanning Decoction” and chemical drug in the treatment of pain caused by bone metastatic pulmonary cancer. MethodsTotal 100 patients with bone metastatic pulmonary cancer, who were identified as essence deficiency ones and suffered moderate or severe pain, were randomly divided into 51 cases as treatment group and 49 cases as control group. All patients were given the fundamental analgesic treatment. Besides, the patients in control group were treated with zoledronic acid and “Feiyanning Decoction” additionally, while the treatment group was also given “Gutongling Decoction”. Both groups were treated for 2 months. The analgesic effect and safety of the medicine were observed and the score used for the evaluation of life quality and physical situation of patients were compared as well as the level of serum calcium and alkaline phosphatase. Results:①Ninety-eight cases completed the whole trials at last, 50 cases in the treatment group and 48 cases in the control group. ②The total analgesic efficiency was 80% in the treatment group and 54.17% in control group, and the analgesic effect in the treatment group were significantly increased compared with control group (P<0.05). ③The score difference in physical function, role function, social function, health status, fatigue, and insomnia in the core scale of life quality was statistically significant between two groups after treatment(P<0.05), as well as the score in the chest pain and pains in other parts in the lung cancer specific sub scale(P<0.05). ④The difference of physical condition score was statistically significant between two groups after treatment(P<0.05), and the improvement rate of the treatment group was significantly higher than that of the control group (P<0.05). ⑤Compared within each group and between two groups before and after treatment, the difference of serum alkaline phosphatase levels were statistically significant (P<0.05). ⑥There was no significant difference in adverse reactions between two groups(P>0.05). Conclusion:The “Gutongling Decoction” with “Feiyanning Decoction” and chemical drug are effective to relieve pain and improve life quality by inhibiting alkaline phosphatase in the treatment of pain caused by bone metastatic pulmonary cancer.
肺癌骨转移骨痛灵镇痛生活质量碱性磷酸酶
lung cancerbone metastasisGutongling Decoctionpain reliefquality of lifealkaline phosphatase
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