Clinical Study Of Huayu Zhitong Powder External Application Based On The Theory Of Pathogenesis Of Stasis And Toxin In The Treatment Of Moderate And Severe Bone Metastasis And Cancer Pain

Objective: To verify the clinical effect of external application of traditional Chinese medicine in the treatment of cancer pain,and further explore the possibility of combination of traditional Chinese medicine and Western medicine in the treatment of cancer pain.Methods: Sixty patients were randomly divided into two groups: the experimental group(Huayu Zhitong powder group)and the control group(placebo group)were treated with external application of Huayu Zhitong powder combined with opioid analgesics Degree score,overall pain relief rate,opioid use,pain impact assessment,quality of life and adverse reactions.Results: Sixty patients were included in this study,30 in Huayu Zhitong powder group and 30 in placebo group.1.Pain intensity score: after titration,the NRS scores of the two groups decreased.The NRS scores of Huayu Zhitong powder group(3.10±0.66)and placebo group(3.33±0.55),there was no statistical difference between the two groups.After 7 days of treatment,NRS score of Huayu Zhitong powder group(1.23±0.82)and placebo group(1.9±1.12)were significantly lower than that of placebo group(P<0.05).2.Pain relief rate: after 7 days of treatment,the overall pain relief rate of Huayu Zhitong powder group was 90.0%,and that of placebo group was 80.0%.According to statistical analysis,P = 0.083(P>0.05),there was no significant difference between the two groups.3.Opioid use: 24 hours after oxycodone dosage titration,compared with the end of the test,Huayu Zhitong powder group decreased(3.83±5.85)Mg,placebo group decreased(0.50±9.04)Mg,through statistical analysis,P > 0.05,there was no statistical difference between the two groups.The total oral administration of oxycodone was(365.33±52.62)Mg in Huayu Zhitong powder group and(424.00±69.50)Mg in placebo group on the 7th day of the experiment,with statistical difference between the two groups(P>0.05).4.Outbreak of pain: during the 7-day treatment,the number of outbreaks of pain in Huayu Zhitong powder group was(2.23±1.07),and that in placebo group was(2.87±0.94).The number of outbreaks of pain in Huayu Zhitong powder group was less than that in the control group,P = 0.023(P<0.05),which was statistically different between the two groups.5.Evaluation of pain impact and quality of life: the scores of pain impact evaluation before and after the two groups were statistically significant(P<0.05).The difference of KPS score before and after the test was(-12.00±7.14)in the test group and(-6.33±5.56)in the placebo group,P<0.05.There was statistical significance between the two groups.The quality of life in Huayu Zhitong powder group was better than that in the placebo group.6.Safety and adverse reactions:(1)for the common adverse reactions of opioids,constipation,nausea,vomiting,dizziness and drowsiness were the most common.Through statistical analysis,the incidence of constipation,nausea and vomiting in Huayu Zhitong powder group was lower than that in placebo group(P<0.05),and there was no statistical significance for dizziness and drowsiness.(2)Skin adverse reactions: there were 2 cases of mild skin adverse reactions in Huayu Zhitong powder group and 1 case of mild skin adverse reactions in placebo group.Conclusion: In patients with moderate or severe bone metastasis and cancer pain,the pain can be further reduced by the use of opioids and Huayu Zhitong powder.The pain relief rate can reach 90%,the number of outbreaks of pain can be reduced,and the quality of life of patients can be improved.The external application of Huayu Zhitong powder is safe and effective,which can reduce the total use of opioids and reduce the adverse reactions of the digestive tract of opioids to a certain extent.