| [Background]Cancer pain is a common symptom of cancer patients, and seriously affects the quality of life of patients. It is one of the four key points of cancer prevention strategy listed by the World Health Organization (WHO). Although programs to control cancer pain, in accordance with the "three-tiered drug pain principle" promoted by WHO and the NCCN pain guidelines, have relatively accurate efficacy, long-term use will cause toxic side effects and strong dependency. Further more, some patients have poor analgesic effect due to tolerance limit. In order to improve the quality of life of cancer patients, reduce or even relieve their pain, scholars around the world are struggling to find new treatments of cancer pain. In recent years, traditional Chinese medicine, which has a unique theoretical system, achieved the exact effect in the treatment of cancer pain with Chinese Herbs. The Chinese herb absorbed by the skin near the sick local directly affects, and avoid the inactivation of oral absorption in the digestive tract. Further more, there are fewer side effects, and it will reduce toxicity, improve the quality of life, extend the survival period in conjunction with other therapies. The present study investigates the clinical efficacy of external treatment of cancer pain in Chinese medicine combined with opioids. It aims at enriching the cancer pain treatments, further enhancing the analgesic effect, reducing the dosage and adverse effects of western medicine and analgesic drugs, and the overall improvement of the quality of life of cancer pain by Chinese and Western medicine combined with each other.[Objective and methods]In this prospective study, we observed and analyzed the status of the Thir-d Affiliated Hospital of Beijing University of Chinese Medicine Oncology hosp-italized patients with cancer pain. We selected60eligible patients with canc-er pain, and divided them into treatment and control groups randomly. In thi-s study, we use dual standards to evaluate the efficacy, combinating the W HO pain efficacy standards with the NRS method. At the same time, KPS sco re is used in this experiment to observe the patient’s quality of life, and w e comprehensive analyze and judge the efficacy of Traditional Chinese Medi cinal treatment of cancer pain. By observing the usage and efficacy of opioid s during treatment, we can explore Traditional Chinese Medicinal topical prep arations are effective, efficient, economic, and adverse reactions of small feat ures.[Results]1. The improvement in the degree of pain. In this study, we use the combination of the WHO pain efficacy standard and NRS to judge the efficacy. The results showed that the pain relief rate in the treatment group was86.67%, while60.00%in the control group, and the former was higher. We use therapeutic NRS score to reduce the value judgment of this research. The Results indicate that the degree of pain relief in the treatment group dropped by an average of4.9±2.07, while3.7±2.17in the control group, the former was higher, The difference is statistically significant (P<0.05), and the therapeutic effect of the treatment group is obvious.2. Improvement in quality of life. The average KPS score in the treatment group are raised by an average of13.67±1.62, while8.67±1.64in the control group, and the difference was statistically significant (P<0.05). The results indicate that the pain block elimination cream, which can significantly improve the quality of life of cancer pain, are more efficient than pure oral western medicine.3. The increase and decrease of opioid dose. In terms of comparative treatment of the first and the last day every24hours total opioid dose changes, treatment group was reduced by an average of17.83±4.30mg, while control group-10.833±3.02mg, and the difference was statistically significant (P<0.05). The results indicate that opioid use in the treatment group decreased, while the control group increased significantly.4. Security. Physical examination and routine inspection were compared between patients before and after treatment. The safety rate of the treatment group was83.33%, while the control group60.00%, and the difference was statistically significant (P<0.05). The results indicate that there were no significant adverse reactions in the treatmenst group. and relatively small influence to blood, urine, stool routine, liver and kidney function, and heart function. While in the control group, the main adverse reactions are constipation, nausea and vomiting.5. Satisfaction of the analgesic effect. Satisfaction rate was83.33%in the treatment group and60.00%in the control group. The difference was statistically significant (P<0.05). The results suggest that the analgesic effect of the treatment group than the control group. 6. Comprehensive treatment satisfaction. The satisfaction rate was83.33%in treatment group, while56.67%in the control group, and the difference was statistically significant (P<0.05). Prompt the treatment group in the comprehensive treatment satisfaction is better than the control group. Topical pain elimination cream were more welcomed by patients.[Conclusion]With "three-tiered drug pain principle", the elimination of topical pain block cream can achieve synergies, and the clinical efficacy was better than western medicine alone. For patients with mild cancer pain, only pain block elimination cream topical can achieve a good analgesic effect. For patients with moderate cancer pain, pain block elimination cream topical with the three-step analgesic ladder treatment efficacy is superior to a simple three-step analgesic ladder treatment. And topical pain block elimination cream with the three-step analgesic ladder for the treatment of patients can get better quality of life. This comprehensive treatment of integrative analgesic has good effect and low adverse reactions. However, the role of traditional Chinese medicine (TCM) is a slow and complex process, so use of drugs in patients should be with different clinical manifestations. Patients with advanced cancer have poor gastrointestinal function, and often have severe nausea, vomiting and other symptoms. With opioids of the treatment of severe cancer pain, there are also common adverse reactions, such as nausea and vomiting. Oral medicine will cause gastrointestinal damage, but topical pain elimination cream can avoid the occurrence of these adverse reactions. Further more, in order to reduce the loss of volatile components and enhance the ability of transdermal drug, we make a special treatment in brewed plaster process, and this ensures efficacy. This study shows that treatment of cancer pain with pain block elimination cream is fast and convenient, improves the quality of patient life, and reduces the adverse reactions of oral medicine pain. |
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