摘要
目的:探索穴位揿针结合补阳还五汤化裁方改善原发性肝癌患者经导管动脉化疗栓塞术(TACE)后疼痛的临床效果。方法:选取行TACE的130例原发性肝癌术后疼痛(气虚血瘀证)患者作为研究对象,通过随机数字法随机分为观察组和对照组各65例。对照组患者予以常规西医止痛药物,观察组在对照组基础上进行穴位揿针结合补阳还五汤化裁方进行治疗。比较两组患者治疗前及治疗4周后的疼痛状态[视觉模拟评分(VAS)]、疼痛通路相关因子[β-内啡肽、P物质、5-羟色胺(5-HT)]、中医证候积分、血流动力学指标[搏动指数(PI)、阻力指数(RI)、收缩期峰值流速(PSV)]、血清炎症因子[肿瘤坏死因子-α(TNF-α)、白细胞介素-1β(IL-1β)、白细胞介素-6(IL-6)]、生活质量[欧洲癌症研究与治疗组织生活质量核心量表(EORTC QLQ-C30)]。比较两组患者在治疗期间的不良反应发生状况(肝、肾功能异常、凝血功能异常、皮肤过敏、胃肠道不适等)。结果:治疗4周后,两组患者VAS评分、中医证候积分、部分血流动力学指标(PI、RI)、血清炎症因子、部分疼痛通路相关因子(P物质、5-HT)水平及EORTC QLQ-C30(疼痛症状)评分均较治疗前显著降低,且观察组低于同期对照组(P<0.05),而β-内啡肽、PSV水平及EORTC QLQ-C30(整体健康状况、躯体功能)评分则较治疗前显著升高,且观察组高于同期对照组(P<0.05);两组患者治疗期间不良反应发生率比较无统计学差异(P>0.05)。结论:穴位揿针结合补阳还五汤化裁方改善肝癌TACE术后疼痛的临床效果理想,患者疼痛症状、炎症反应及血流动力学状态改善显著。
Objective:To explore the clinical effect of acupoint press-needle combined with modified Buyang Huanwu decoction on improving pain in patients with primary liver cancer after transcatheter arterial chemoembolization(TACE).Methods:130 cases with postoperative pain of primary liver cancer(qi deficiency and blood stasis syndrome)who received TACE were selected as research subjects,and were randomly divided into observation group and control group by random number table method,with 65 cases in each group.The patients in the control group were treated with conventional western medicine analgesic drugs,while the patients in the observation group were given acupoint press-needle combined with modified Buyang Huanwu decoction on the basis of the control group.The pain status[visual analogue scale(VAS)],pain pathway related factors[β-endorphin,substance P,5-hydroxytryptamine(5-HT)],TCM syndromes scores,hemodynamic indexes[pulsatility index(PI),resistance index(RI),peak systolic velocity(PSV)],serum inflammatory factors[tumor necrosis factor-α(TNF-α),interleukin-1β(IL-1β),interleukin-6(IL-6)]and quality of life[European Organization for Research and Treatment of Cancer Quality of Life Core Scale(EORTC QLQ-C30)]before treatment and after 4 weeks of treatment and occurrence status of adverse reactions(abnormal liver-kidney function,abnormal coagulation function,skin allergy,gastrointestinal discomfort,etc.)during treatment were compared between the two groups of patients.Results:After 4 weeks of treatment,the VAS score,TCM syndromes scores,parital hemodynamic indexes(PI,RI),serum inflammatory factors,partial pain pathway related factors(substance P,5-HT)and EORTC QLQ-C30 score(pain symptom)in the two groups of patients were significantly reduced compared with those before treatment,and the above indexes in observation group were lower than those in control group(P<0.05),and theβ-endorphin,PSV and EORTC QLQ-C30 scores(overall health status,physical function)were significantly enhanced compared to before treatment,and the indexes were higher in observation group than those in control group(P<0.05).No statistical differences were observed in the incidence rates of adverse reactions between the two groups during treatment(P>0.05).Conclusion:Acupoint press-needle combined with modified Buyang Huanwu decoction has an ideal clinical effect on improving pain after TACE for liver cancer,and can significantly improve the pain symptoms,inflammatory response and hemodynamic status.
作者
王丹
朱吕群
徐春阳
沈建军
WANG Dan;ZHU Lvqun;XU Chunyang;SHEN Jianjun(Department of Traditional Chinese Medicine,Nanjing Hospital,Nanjing Second Hospital,Nanjing University of Traditional Chinese Medicine,Nanjing 210003,China)
出处
《陕西中医》
2025年第12期1702-1706,共5页
Shaanxi Journal of Traditional Chinese Medicine
基金
江苏省中医药科技发展计划项目(YB2020038)。
关键词
肝癌TACE术
疼痛
穴位揿针
补阳还五汤化裁方
气虚血瘀证
中医证候积分
TACE for liver cancer
Pain
Acupoint press-needle
Modified Buyang Huanwu decoction
Qi deficiency and blood stasis syndrome
TCM syndromes scores
