| ObjectiveThis paper aims to observe the clinical efficacy and safety of external application of traditional Chinese medicine combined with acupuncture in the treatment of mild and moderate cancer pain,improve the quality of life of patients,and provide data support for external treatment of traditional Chinese medicine for mild cancer pain.MethodThe patients with mild and moderate cancer pain meeting the inclusion criteria were divided into the treatment group and the control group by a completely random method in a ratio of 1:1.Treatment group: for patients with mild cancer pain(1≤NRS≤3),patients with moderate cancer pain(3 < NRS < 7),patients with external application of Chinese medicine combined with acupuncture treatment + Oxycodone hydrochloride sustained release tablets treatment,external application of Chinese medicine on the most painful points of patients,acupuncture selected as local Ashi points;Traditional Chinese medicine was applied externally to the most painful points of the patients.Acupoints selected by acupuncture were local Ashi points.The control group was treated with three-step analgesic method(mild cancer pain was treated with celecoxib capsule 0.2g bid,and patients with moderate cancer pain were treated with oxycodone hydrochloride sustained-release tablets 10 mg Q12H).The initial dose of opioids was 10 mg,increased according to pain control,and administered according to individual differences.NRS scores were recorded for each patient at 2,6,12,and24 hours before and after treatment.If the patients had outbursts of pain during treatment,Morphine hydrochloride injection was given in time to relieve the symptoms,the dose was recorded and converted to Oxycodone hydrochloride sustained-release tablets,and the frequency of outbursts of pain was recorded.Continuous observation of a course of treatment,7 days as a course of treatment,after a course of a comprehensive assessment of the enrolled patients,finally obtained data for statistical analysis.Results1.After the end of the treatment cycle,the mild pain remission rate in the treatment group reached 100%,and the mild cancer pain remission rate in the control group was 91.7%,including 22 patients with CR(91.7%),0 patients with PR(0%),2patients with MR(8.3%),and 0 patients with NR(0%),with no statistical significance(P > 0.05).The rate of moderate pain relief in the treatment group was 69.2%,higher than that in the control group(34.6%),and the difference was statistically significant(P < 0.05).2.At the end of the treatment cycle,the average NRS score of mild cancer pain in the treatment group was lower than that in the control group,and the difference was statistically significant(P < 0.05).After treatment,the NRS score of moderate cancer pain in the treatment group was significantly lower than that in the control group,and the difference was statistically significant(P < 0.05).The average NRS score of mild cancer pain in the treatment group was higher than that in the control group before and after treatment,but the difference was not statistically significant(P > 0.05).The mean NRS difference of patients with moderate cancer pain in the treatment group before and after treatment was significantly higher than that in the control group,with statistical significance(P < 0.05).3.After the end of the treatment cycle,the comparison of KPS and QOL scores between the two groups showed that the average KPS score of patients with mild cancer pain in the treatment group was higher than that in the control group,with no statistical significance(P > 0.05).The average KPS score of patients with moderate cancer pain in the treatment group was significantly higher than that in the control group,with statistical significance(P < 0.05).After treatment,the average QOL score of mild cancer pain in treatment group was higher than that in control group,and the difference was statistically significant(P < 0.05).After treatment,the average QOL score of mild cancer pain in the treatment group was also higher than that of moderate cancer pain in the control group,and the difference was statistically significant(P <0.05).4.Before the treatment cycle,the dosage of Oxycodone Hydrochloride sustained-release tablets between the two groups was not statistically significant(P >0.05).After the end of the treatment cycle,the average daily dose of oxycodone hydrochloride sustained-release tablets in the treatment group was lower than that in the control group(P < 0.05),and the difference was statistically significant(P < 0.05).There was a significant difference in the average daily dose difference between the two groups before and after treatment,and the control group was significantly lower than the treatment group,suggesting a statistically significant difference(P < 0.05).In terms of the increase and decrease in the use of opioids,the number of cases in the treatment group with the dose reduction of oxycodone hydrochloride sustained-release tablets accounted for 50% after the end of treatment,much higher than the 12% in the control group,indicating a statistically significant difference(P <0.05).5.The average frequency of pain outbreak in the treatment group was lower than that in the control group during treatment,and the difference was statistically significant(P < 0.05).6.During the treatment period,the treatment group was significantly better than the control group in terms of TCM symptom efficacy score formula and pain relief satisfaction,with statistical significance(P < 0.05).7.The adverse reactions(nausea,vomiting,constipation,dizziness)caused by the treatment mode of external application of traditional Chinese medicine combined with acupuncture were less than those caused by the simple three-step analgesic method.The symptoms of nausea,vomiting and dizziness in the treatment group were not significantly different from those in the control group(P > 0.05).Compared with the control group,the constipation symptoms in the treatment group were statistically significant(P < 0.05).Conclusion1.Chinese medicine external treatment in combination with acupuncture therapy can effectively improve pain remission rate and more reduce pain intensity,traditional Chinese medicine external treatment with acupuncture therapy with mild pain has not weaker than the curative effect of celecoxib non-steroidal painkillers,and combined with traditional Chinese medicine external treatment in combination with the analgesic effect of acupuncture treatment of moderate pain obviously better than pure three ladder analgesia effect.2.The external application of traditional Chinese medicine combined with acupuncture has a better effect on cancer pain caused by functional lesions,such as swelling pain and prickling pain,while it has a less effective effect on cancer pain caused by organic lesions,such as blunt pain and dragging pain.3.Compared with the simple three-step analgesic method,the external application of traditional Chinese medicine combined with acupuncture can significantly improve the quality of life of patients with cancer pain and increase the satisfaction of patients with analgesia.4.External application of traditional Chinese medicine combined with acupuncture can effectively reduce the use of opioids and reduce the occurrence of outbreaks of pain.5.Traditional Chinese medicine combined with acupuncture can significantly reduce the adverse reactions caused by the use of opioids,especially constipation,nausea,vomiting and other digestive tract adverse reactions. |
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