| [Background]Metastatic bone pain seriously impact on the patient’s quality of life. With the implementation of the three-steps analgesic solution, and the application of bone metastasis drug and non-drug therapy, pain has obtained satisfactory control. The treatment of bone metastases pain is also from pure drug therapy, to model development of multi-disciplinary comprehensive treatment. Opioids drugs have become the first choice for moderately severe pain, but because of its side effects, and fear of narcotic analgesic drugs in patients with psychological, restricting the use of opioids.External treatment of Chinese medicine administeres directly through the body surface with rapid analgestic pain, avoiding gastrointestinal discomfort caused by oral, and the drug liver first-pass effect. Especially for cancer patients with deficiency of vital qi which is not particularly suitable for resistance to attack. And external application of Chinese medicine analgesia of low cost, less adverse reaction, high compliance, it is worthy of clinical promotion and research. Metastatic bone pain behaves day light night heavy or rainy days increase. Therefore, dialectic is caused by cold, phlegm and blood stasis syndrome of Yin, and the hypothesis of "Poision damage collaterals" says cancer patients have a long course of disease, and the evil staying leads "disease collaterals", so for a long time it leads pain.Evil invads collaterals and damages Qi collateral, resulting in blood stasis and phlegm stagnation etc. Therefore Warming, activating blood, detoxifying and freeing the collateral vessels as the treatment rule,. Based on it,we rased Gu Tong Fang for metastatic bone pain,which includes clove, asarum, cinnamon, ginger, scorpion, pangolin, Pinellia.[Objective]Through the observation of clinical cases, access to topical treatment of Gu Tong Fang painful bone metastases clinical data and the effectiveness of content-rich three ladder analgesic treatment.[Methods]Before treatment, according to the presence or absence of oral opioid analgesics to 33 patients met the inclusion criteria were divided into two groups of traditional Chinese medicine, the combination therapy group, all patients were given Gu Tong Fang, giving the combined group of opioid analgesics according to three ladder analgesic therapy, recorded daily pain NRS scores before and after treatment, to observe local adverse reactions. After a course of treatment, all patients and compare before and after treatment in each group pain intensity score was calculated for all patients in both groups after treatment and pain relief and efficient record before and after treatment dose of pain medication.[Results]1. Pain intensity:before and after treatment found NRS score with the progress of treatment, showed a gradual downward trend, pure traditional Chinese medicine group and the combined group could significantly relieve pain.33 patients treatmentNRS score before treatment was (4.97 ± 1.20), after treatment NRS score was (2.58 ± 1.15), and the difference was statistically significant (P<0.05). Simple Chinese group before treatment NRS score was (4.27 ± 1.01), after treatment NRS score was (1.73 ± 1.01), and the difference was statistically significant (P<0.05).2. The amount of morphine:After treatment, the dosage of morphine showed a gradual downward trend, with the statistical analysis, P> 0.05, the difference was not statistically significant.3. Pain relief and effective:pain relief rate and efficiency show a gradual upward trend, after treatment 60.6%, respectively,93.9%. In Medicine group pain relief rate and effective rate were respectively 81.8% and 100%; in Combined group pain relief rate and effective rate were 50%,90.9%.4. KPS:For 33 patients before treatment KPS score was (66.06 ± 4.15), after treatment KPS score was (70.15 ± 4.68), and the difference was statistically significant (P<0.05).In Medicine group before treatment KPS score was (64.55 ± 6.79), after treatment KPS score was (68.64 ± 7.20), and the difference was statistically significant (P<0.05); in Combined group KPS score before treatment was (66.82 ± 5.32), after treatment KPS score was (70.91 ± 6.14), and the difference was not statistically significant after treatment (P> 0.05)5. Adverse reactions:It is safe to use with no significant local adverse reactions[Conclusion]In this study, we treat the topical bone metastasis cancer pain with Chinese medicine, through clinical observation of cases to verify the efficacy of topical treatment of pain of bone metastasis cancer pain Yin syndrome, we get the following conclusions:1. Gu Tong Fang can improve pain from bone metastases, Medicines can relieve pain NRS(?) 5 minutes, pain relief rate and effective rate were 81.8% and 100%, respectively; the combined group can relieve pain NRS(?) 7 minutes, pain relief and efficiency of 50.0%, 90.9% respectively.2. Gu Tong Fang can improve the quality of life in bone metastases painful patients。3. It is safe to use with no significant local adverse reactions... |
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