| Study Background:The frequency of cancer is rising year after year.Being the first reason of death of mankind in the world,most of patients with cancer suffer from different grades of cancer pain,it is one of the most distressed and most worried symptom for a cancer patient,and it seriously influences the patients' quality of life.Although The WHO Cancer Pain Relief Program such as three step analgesic ladder can relieve some pain of the patient,and the inserted remedy that can relieve intractable pain is developing rapidly,but because of the strong side-effect of the anodyne or afraid of drug addiction and drug-fast and so on,the target that "no pain of the cancer patient" can not be completed until now。Therefore,the focus of current research is to find an analgesia,which is safe,active,minimal side-effects,economic and convenience.Acupuncture is a good way to relieve pain,evenmore,previous reports showed that acupuncture was a very effctive treatment used in cancer patients for relieving pain,some researches were refered to the mechanisms of the acupuncture used in cancer pain reliveing。Ear acupuncture and injection ad acumen are the frequent used and effective treatments to relieve cancer pain in clinic,there were more studies about ear acupuncture and injection ad acumen than other acupuncture means,but little of those researches were high-quailty,randomly compared or with large samples.Objective:First to observe the analgesic effect of the treatment--the ear acupoints injection with stauntoniae in management of the moderate and severe cancer pain.Second through investing the QOL of the patients to explain the ear acupoints injection is better than western medicine in some way.Moreover to study the mechanism of the ear acupoints injection with stauntoniae to relieve cancer pain. Methods:In the clinical study,48 patients with moderate or severe cancer pain were observed,stratified the patients by different pain degrees,and then randomly divided into two groups,23 in the treating group were treated by ear acupoints injection with stauntoniae and 25 in the control group took Oxycodon tablets orally to relieve cancer pain,time of the therapy was 7 days.Evaluated outcomes included analgesic effective rate,time for onset of analgesic effect,duration of analgesic effect,KPS,BPQ andβ-EP,ET-1,PGE2 contents in peripheral blood were determined.Results:1,Ear acupoints injection with stauntoniae was effective to relieve cancer pain.①In the treating group the total effective rate was 91.3%,the obvious remission rate was 78.3%,compared with the control group,the result showed there wasn't statistical significant difference in total effective rate and obvious remission rate(P＞0.05).②The total dosage of oxycontin in the treating group was 4620mg,moderate pain 280mg and severe cancer pain 4340mg;while in the control group total dosage was 11340mg,moderate pain 1120mg and severe pain 10220mg.The result showed significant difference between them,therefore Ear acupoints injection with stauntoniae was surely effective in relieving cancer pain.③Mean time for onset of analgesic was 17.65±6.91min in the treating group,but 31.36±6.60min in the control group,there was statistical difference in mean time for onset of analgesic(P＜0.01).Ear acupoints injection with stauntoniae worked more quickly.④The mean duration of analgesic effect was 18.21±1.33h in the treating group,11.76±0.99h in the control group,compared the tow groups,there was statistical significant difference(p＜0.01),the analgesic effect of ear acupoints injection with stauntoniae could maintain longer time.2,Ear acupoints injection with stauntoniae showed better effect on the improvement of QOL for cancer pain patients.①Mean KPS of the treating group was 63.04±7.029 before the treatment,70.87±7.332 after the treatment,and in the control group it was 64.00±9.129 before the treatment,70.80±7.594 after the treatment,both of the two groups there were statistical significant differences fore-and-aft(P＜0.01),both of the treatments could improve the patients' KPS.But compared the two groups after treatment,there wasn't statistical difference(P＞0.05);②Both of the two treatments promoted the daily life,emotion,walking ability,sleeping,life joy and total integral through investigating the BPQ, compared with those after treatment,there were statistical differences pro-and-aft(P＜0.05);While daily life,emotion,sleeping,life joy and total integral of the treating group were better than the control group after treatment,there were statistical significant differences(P＜0.05);Ear acupoints injection with stauntoniae was better to improve patients' QOL.③There were 23 cancer pain patients in the treating group,none of the side effect was observed in the research;while in the control group 9 patients had the symptom of constipation,6 patients with nausea and vomiting,3 patients with dizziness,even 1 patient had the symptom of morphine poisoning. 3,One of the mechanisms of ear acupoints injection with stauntoniae maybe relate to rise the level ofβ-EP and decrease the level of ET-1.①The levels ofβ-EP was higher than normal value in both of the two groups before treatment,then in the treating group the level ofβ-EP rised to 433.415±209.337pg/ml after treatment,there was statistical significant difference in pre and post treatment(P＜0.01).While in the control group the level ofβ-EP decreased,showed statistical difference(P＜0.05);compared with the levels ofβ-EP post treatment between the two groups,it showed statistical difference(P＜0.01) too.②The levels of ET-1 were higher than normal value also in both of the groups pre-treatment,post treatment the level of ET-1 dropped to 124.477±41.693pg/ml,there was statistical significant difference in pre and post treatment(P＜0.01);However in the control group the level showed no change(P＞0.05);The levels of the two groups were statistical difference after treatment(P＜0.01).Conclusion:Ear acupoints injection with stauntoniae was effective to relieve cancer pain,the treating group had similar effect with the control group,but ear acupoints injection worked more quickly and longly;ear acupoints injection with stauntoniae improved the QOL better than the Oxycontin,and had slight side effect;the mechanism of ear acupoints injection with stauntoniae maybe relate to rise the level ofβ-EP and decrease the level of ET-1 in the body of the patients. |
PDF Full Text Request