| Objective This thesis aimed at observing the clinical effect of acupuncture combined with opioids on cancerous pain and evaluating the efficiency of acupuncture on patients with cancerous pain degree of pain relief,and opioids dosage and its side effects,behavioral state and qualities of life. This essay provided a new perspective on research and methods for clinical acupuncture treatment of cancerous pain, as well as a reference for further research.Method60 qualified patients were randomly divided into 2 even groups, the treatment group and the control group, each group with 30 cases. The treatment group was treated with acupuncture combined with opioids, and the control group was treated with opioids alone. In this study, opioid drugs were hydrochloride oxycodone ketone sustained release tablets(Oxycontin). According to the NRS pain evaluation scale, the initial drugs were taken orally ranging from 10 mg to 30 mg, Q12 H. The conditions were evaluated every 24 hours. According to the NRS pain evaluation scale, the dosage would be added everyday by 25% ~ 50% to the total amount of the day before. while taking Oxycodone Hydrochloride Prolonged-release Tablets, patients in the treatment group received needling treatment, the main acupoints being Hegu(LI4), Neiguan(PC6),Zusanli(ST36), Sanyinjiao(SP6). According to the coordination between the primary lesions and acupoints in painful part, Shu Points, Xi point, Ashi and corresponding points have been inserted to ease side effects. Acupuncture treatment has been applied2 weeks, once a day, 30 minutes each time, and 7 days each course. Patients in both groups were treated with symptomatic and supportive treatment, with no further pain-killing measures. During the test, daily dosage of Oxycodone Hydrochloride Prolonged-release Tablets' s and the occurrence of side effects were observed and recorded. NRS pain level determined the curative effects and the behavior state KPS combined with the qualities of life QOL rating scale was also utilized to rate the effect.Objective evaluation has been analyzed based on statistics.Results1. The comparison between degree of pain relief in both groups: In the treatment group, 13 cases of complete remission(CR) accounted for 43.33% of the whole cases,14 cases of partial remission(PR) for 46.67%, 2 cases of mild remission(MR) for6.67%, 1 case of none remission(NR) for 3.33%. Therefore, the pain remission rate(ORR=CR+PR) was 90%. In the control group: 11 cases of complete remission(CR)accounted for 36.67%, 12 cases of partial remission(PR) for 40%, 5 cases of mild remission(MR) for 16.67%, 2 cases of non remission(NR) for 6.67%. Therefore, pain remission rate(ORR=CR+PR) was 76.67%. Based on statistical analysis, the pain remission rate in the treatment group was higher than that of the control group, and the difference was significant(P<0.05).2. The comparison between opioids dosage of the two groups: After treatment,opioids dosage within 24 hours in the treatment group was significantly less than that of the control group, suggesting significant difference(P< 0.01). Opioids dosage within 24 hours in treatment group was significantly less than the used before the therapy, which suggesting significant difference(P<0.01). Opioid dosage used within 24 hours in the control group was larger than that before the treatment, and the result was of statistical significance(P<0.05).3. The comparison of adverse reactions between opioids used in the two groups:the adverse reaction of the treatment group included 6 cases of constipation(20%), 4cases of nausea and vomiting,(13.33%), 3 cases of dizziness(10%), and 1 case of urinary retention(3.33%). The total incidence rate was 46.67%. Opioid adverse reactions in the control group included 13 cases of constipation(43.3%), 8 cases of nausea and vomiting(26.7%), 5 cases of dizziness(16.67%), and 2 cases of urinary retention(6.67%). The total incidence rate was 93.33%. After statistical analysis,incidence rate among treatment group patients was lower than that of the control group,which was statistical difference(P<0.05). But the dizziness, the adverse reaction of urinary retention rate between the two groups were not significant(P>0.05). And the incidence of adverse reactions in the treatment group was remarkably lower than that of the control group, with significant difference(P<0.01).4. The comparison between performance status KPS score from the two groups:After treatment, the KPS score of the treatment group was higher than that of the control group, and there was a significant difference(P<0.01). The KPS score in the treatment group was significantly higher than that before the treatment, and there was significant difference(P<0.01). After treatment, the KPS score in the control group was significantly higher than that before the treatment, there was significant difference(P<0.01).5. The comparison between qualities of life QOL score in two groups: After the treatment, qualities of life QOL score in the treatment group were higher than those of the control group, and the difference was statistically significant(P<0.05). After the treatment, qualities of life QOL score were significantly higher than before, with statistical difference(P<0.01). After treatment, the qualities of life in the control group was significantly higher than that before treatment, with significant difference(P<0.01).Conclusion1. Acupuncture combined with opioids could raise the remission rate of treating cancerous pain, and the effect is better.2. Acupuncture combined with opioids treatment of cancer pain can significantly reduce the dosage of opioids.3. Acupuncture treatment can significantly reduce the adverse reactions of opioid drugs,especially the adverse reactions of the gastrointestinal tract, such as constipation, nausea and vomiting.4. Acupuncture combined with opioids therapy and sole use of opioid therapy could improve patients' behavior and qualities of life, but the former increase is more obvious. |
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