Clinical Observation Of Oxycodone Hydrochloride Sustained-release Tablets Combined With Compound Kushen Injection In The Treatment Of Gynecological Cancer Pain

Background:In recent years, more and more women are suffering painful experience from gynecologic malignancies, including cervical cancer, endometrial cancer, and ovarian cancer. The incidence rate is in the trend which rises gradually. Surgical operation, radiotherapy and chemotherapy are combined and taken as comprehensive routine therapeutic treatment. However, metastasis rate is significantly elevated and cancer pain increasing as its main complication of severe impact on quality of life of patients. There are reports of ovarian cancer pain with high incidence of60%, especially end-stage gynecological tumor patients. How to alleviate the cancer pain and how to improve quality of life in patients with gynecologic tumor has become the primary goal of treatment. Medication for pain, surgical operation, radiotherapy and chemotherapy are current treatments toward stopping pain of cancer. According to WHO three ladder principle, oral drug are the preferred. Oxycodone hydrochloride sustained release tablets by representative of opioids in the treatment of cancer pain with other analgesics irreplaceable position. Oxycodone hydrochloride sustaied releasne tablets are opioid receptor pure agonist, its mechanism is associated with pain sensitive neurons of the opioid receptor binding to realize the inhibition of substance P. It is of high oral bioavailability, good analgesic effect and no ceiling effect. In recent years, Chinese medicine treatment of cancer pain, achieved good results. The representative drugs such as compound Kushen injection mainly comprise flavescent sophora root, tuckahoe, clay. Chinese medicinal composition, through inhibition of central nervous system responses to pain, dilated vessels, improve microcirculation state comprehensive role in the pain. Based on the above, we propose oxycodone hydrochloride sustained release tablets combined compound Kushen Injection in the treatment of gynecologic cancer pain, improve quality of life in patients with the clinical thinking. Validation of two whether has the synergistic analgesic effect, combine traditional Chinese and Western Medicine in treatment of cancer pain with more theoretical basis through the observation of the two union treatment efficacy for cancer.Purpose:Observe the curative effective of Oxycodone Hydrochloride Controlled-release Tablets(OXYCONTIN) with Compound Kushen Injection to gynecological cancer ache and improve the efficacy of the quality of lifeMethods:This thesis apply random and comparison clinical research method, use NRS pain scores and life quality testing QLQ-C30Table as the observation index.The total68patients are all come from Dongzhimen Hospital affiliated to Beijing University of Chinese Medcine hematology/oncology during Feb.2011to Feb.2012. Random clinical research method include treatment group((Oxycodone Hydrochloride Controlled-release Tablets(OXYCONTIN) combined with compound Kushen injection))and comparison group.(Oxycodone Hydrochloride Controlled-release Tablets). The two group scale is1:1and all the patients are treated and observe for15days as1term. The1st,8th and15th day's observations as the related judgment index.Using SPSS13.0software to statistics and analysis the data:all the information apply sided statistical test method, if p?0.05it indicates there is discrepancy about the result and which is mean to statistics. The counting data use chi-square (x2) testing as statistical description; measurement data use equal±standard deviation (x±s) to discerp statistics; in the measurement data groups, before and after treatment if the data meet the normal distribution then apply the paired t test, otherwise apply two related samples nonparametric test. And between the measurement data groups, if the data meet the normal distribution then apply the paired t test, otherwise apply two related samples nonparametric test.Results:1The NRS Pain Scores:The experiment results prove that the two groups could be rather successful control cancerous pain.?Treatment group:Comparing the15th day with the8th day, complete response rate (P>0.05), no significant difference.?Control group: Comparing the15th day with the8th day, complete response rate (P>0.05), no significant difference.?Comparison between groups, Day8:There are no significant different between treatment and control group on the the complete response rate(P>0.05). Day15:The treatment group surpasses control group (P=0.0288<0.05) obviously in the overall complete response rate aspect, has significance difference.2Quality of life scores:?The treatment group:Comparing the1st day with the15th day, the score points of quality of life went up in the fields of physical function, while went down in the fields of pain, fatigue, insomnia symptoms and loss of appetite,with statistically significant (P<0.05).?The control group:Comparing the1st day with the15th day, the score points of quality of life went up in the fields of physical function,nausea and vomiting,constipation, while went down in the fields of pain, fatigue and insomnia symptoms,with statistically significant (P<0.05).?Comparing the test group with the control group:In the15th day, the score points of quality of life in the fields of fatigue, pain, loss of appetite, nausea and vomiting and constipation was better than that of the control group. These were considered statistical significant (P<0.05).Conclusions:Oxycodone Hydrochloride Controlled-release Tablets(OXYCONTIN) combined with compound Kushen injection therapy have a synergistic effect to the gynecological cancer ache and can significantly relieve the patients' pain also improve patients' life quality.