高建清 雷艳容 陈红蓓

[摘要] 目的 觀察中药外敷痛处及腧穴配合针刺在肺癌患者癌痛治疗中的应用效果。 方法 选取2016年1月～2018年1月于成都中医药大学附属医院接受治疗肺癌疼痛者114例，按照随机数字表法将其分成两组，对照组（57例）行中药外敷腧穴及痛处，观察组（57例）在对照组的基础上配合腧穴针刺。观察两组患者治疗效果状况，采用生活质量综合评定问卷（CQOL-74）检测患者治疗前生活质量改善状况，酶联免疫吸附测定（ELISA）法检测血清肿瘤坏死因子-α（TNF-α）、白细胞介素-6（IL-6）的含量，检测治疗前后患者医院焦虑抑郁量表（HADS）评分。 结果 观察组总有效率（92.98%）明显高于对照组（78.95%），差异有统计学意义（P < 0.05）。治疗后两组患者物质生活状态、躯体功能、社会功能、心理功能及总体生活质量较治疗前显著升高，且观察组与对照组比较效果更佳，差异有统计学意义（P < 0.05）。治疗后两组患者血清TNF-α、IL-6及HADS评分较治疗前显著降低，且观察组与对照组比较效果更佳，差异有统计学意义（P < 0.05）。 结论 中药外敷痛处及腧穴配合针刺可明显缓解肺癌患者癌痛情况，降低体内血清炎性细胞因子含量，提升患者生活质量。

[关键词] 肺癌；癌痛；生活质量；针刺；中药外敷

[中图分类号] R273 [文献标识码] A [文章编号] 1673-7210（2018）10（b）-0092-04

[Abstract] Objective To observe the application effect of external application of Chinese herbs on sore and acupoints in combination with acupuncture in the treatment of cancer pain in patients with lung cancer. Methods From January 2016 to January 2018， 114 cases of patients with lung cancer pain treated in the Affiliated Hospital of Chengdu University of TCM were randomly divided into two groups by random number table method. The control group （57 cases） was treated with external application of Chinese herbs on acupoints and sore， and the observation group （57 cases） was treated with acupoints acupuncture on the basis of the control group. The therapeutic effect of the two groups was observed， the quality of life improvement before and after treatment was detected by comprehensive quality of life questionnaire （CQOL-74）， serum tumor necrosis factor-α （TNF-α） and leukocytes-6 （IL-6） were detected by enzyme-linked immunosorbent assay （ELISA）. The status of hospital anxiety and depression scale （HADS） before and after treatment was detected. Results The total effective rate of the observation group （92.98%） was higher than that of the control group （78.95%）， the difference was statistically significant （P < 0.05）. After treatment， the material living state， body function， social function， psychological function and overall quality of life of the two groups were significantly higher than those before treatment， and the effect of the observation group was better than that of the control group， the differences were statistically significant （P < 0.05）. After treatment， the levels of serum TNF-α， IL-6 and HADS scores of the two groups were significantly lower than those before treatment， and the observation group was better than the control group， the differences were statistically significant （P < 0.05）. Conclusion External application of Chinese herbs on sore and acupoints in combination with acupuncture can significantly alleviate the pain of lung cancer patients， reduce the contents of serum inflammatory factors and improve the quality of life of patients.

[Key words] Lung cancer； Cancer pain； Quality of life； Acupuncture； External application of Chinese herbs

癌性疼痛为肿瘤细胞扩散、浸润、压迫或者转移相关组织所造成的，为癌症患者临床出现率最高的症状，相关研究显示，90%晚期癌症患者会发生疼痛。除了呼吸、体温、脉搏与血压，疼痛已被列为临床患者的第五大生命体征[1-2]。欧洲IASP宪章联盟与国际疼痛研究会于2004年10月提出“免除疼痛为患者基本权利”，同时把每年10月11月定为“世界疼痛日”，中华医学会疼痛学会把10月11日开始那1周定成“中国疼痛周”，显示了临床对疼痛治疗的重点关注[3-4]。因此，本研究通过分析中药外敷痛处及腧穴配合针刺在肺癌患者癌痛治疗中的作用及其对患者生存质量的影响，为临床治疗提供一些借鉴。

1 资料与方法

1.1 一般资料

选取2016年1月～2018年……