【作者】 张立平；

【导师】 张洪亮；

【作者基本信息】 新疆医科大学 ， 中医内科学， 2009， 硕士

【摘要】 目的：通过温胆汤协同第三阶梯止痛药治疗痰湿中阻型重度癌痛患者,观察其疼痛缓解率、中医症状积分、恶心呕吐纳差的发生率及生活质量的变化。方法：随机选取80例痰湿中阻型重度癌痛的患者,随机分为治疗组对照组,治疗组采用温胆汤(处方：竹茹6g,半夏6g,枳实6g,陈皮9g,甘草3g,茯苓4.5g,生姜5片,大枣1枚)+常规止痛治疗,对照组采用常规止痛治疗,疗程为七天,比较两组患者疼痛缓解率、中医症状积分、恶心呕吐纳差的发生率、生活质量的变化。结果：疼痛缓解率,治疗组与对照组比较无统计学意义(P>0.05)；中医症状积分,治疗组治疗前后相比,P<0.01,有统计学意义,可以认为治疗组治疗前后中医症状积分有差异,治疗后中医症状积分较治疗前明显减少；对照组治疗前后相比,P>0.05,无统计学意义,尚不能认为对照组治疗前后中医症状积分有差异；两组治疗前相比,P>0.05,无统计学意义,尚不能认为治疗组与对照组治疗前中医症状积分有差异；两组治疗后相比,P<0.01,有统计学意义,可以认为治疗组与对照组治疗后中医症状积分有差异。恶心呕吐的发生率,两组比较,P<0.05,有统计学意义,可以认为治疗组恶心呕吐的发生率较对照组低；生活质量测定积分,治疗组治疗前后相比,P<0.01,有统计学意义,可以认为治疗组治疗前后QLQ评分有差异,治疗后QLQ评分较治疗前明显减少；对照组治疗前后相比,P<0.01,有统计学意义,可以认为对照组治疗前后QLQ评分有差异,治疗后QLQ评分较治疗前明显减少；两组治疗前相比,P>0.05,无统计学意义,尚不能认为治疗组与对照组治疗前QLQ评分有差异；两组治疗后相比,P>0.05,无统计学意义,尚不能认为治疗组与对照组治疗前QLQ评分有差异。结论：温胆汤协同第三阶梯止痛药治疗痰湿中阻型重度癌痛,可以起到减轻止痛药物不良反应的功效,对患者临床症状改善显著。更多还原

【Abstract】 Objective:To observe the effect of Wendan decoction combined with the third grade anodyue for patients of retention of phlegmatic dampness syndrome with severe cancer pain on the rate of releasing cancer pain、the chang of syndromes of TCM、the frequency of queasoness and anorexia and the grade quality of life. Methods:80 patients with severe cancer pain were divided into two groups randomly. The treatment group was treated by Wendan decoction (medical prescription:6g of Banxia,6g of zhishi,9g of Chenpi,3g of Gancao,4.5g of Fuling,five piece of Shengjiang, a Dazao) and the conventional anodyue. The control group was treated only by conventional anodyue. The treatment continued 7 days and the rate of releasing cancer pain, the changes of syndromes of TCM, frequency of queasiness, the rate of anorexia, the chang of the patients quality of life were observed. Results:Compared with the control group, the rate of the releasing cancer pain in treatment group has no difference (P>0.05). After treatment of the treatment group, the scores in syndromes of TCM was significantly decreased, There was significant difference in syndromes of TCM before and after treatment (P<0.01). Compared to the scores before the treatment of the control group, there was no difference in syndromes of TCM (P>0.05). Comparing with the scores of the two group before the treatment, there was no difference in syndromes of TCM (P>0.05). However, there was significant difference in syndromes of TCM. Compared with the scores of the two groups after the treatment.The frequency of queasoness and the rate of anorexiain in the treat group was less than that in control group (P<0.05) and there was difference. After treatment of the treatment group, the scores of the patients quality of life was significantly decreased and there was difference (P<0.01). There was significant difference in the patients quality of life before and after treatment (P<0.01). Comparing with the date before the treatment of the two group, there was no difference in the patients quality of life (P>0.05). There was no difference in the patients quality of life compared with the data of the two groups after the treatment (P>0.05). Conclusion:Wendan decoction combined with the third grade anodyue for patients of retention of phlegmatic dampness syndrome with severe cancer pain can reduce the side effects of anodyue and improve the effect of controlling pain markedly.更多还原