加味温胆汤与芬太尼透皮贴剂合用治疗重度癌痛30例

目的观察加味温胆汤化裁而成的中药汤剂与芬太尼透皮贴剂合用是否可减轻重度癌痛患者不良反应与强化控痛效果,并探讨使用后患者的生活质量改善程度。方法2001-02/2002-02对30例重度癌痛患者采用芬太尼透皮贴剂治疗起始剂量25μg/h,每3日更换1次,期间根据疼痛情况进行剂量调整直到患者无痛或基本不痛为止,同时每天口服以加味温胆汤化裁成的中药汤剂1剂,治疗15d,观察治疗前后的疼痛强度,生活质量评分,用药不良反应。结果加味温胆汤与芬太尼贴剂合用治疗后,疼痛完全缓解24例(80%),明显缓解6例(20%)(t=24.27,P<0.001)。患者用药后食欲、睡眠、精神状态、日常生活、与人交往等均得到明显改善(t=-11.12～-1.50,P<0.001),患者不良反应程度轻,其中头晕3例,便秘3例,嗜睡2例,恶心呕吐2例。结论芬太尼贴剂合用加味温胆汤中药治疗重度癌痛,控制癌痛效果好,不良反应轻微,能够明显改善癌症患者的生活质量。

Treatment of severe cancer pain of 30 patients with Jiaweiwendan tang combined with transdermal fentanyl

Aim To observe the effect of Jiaweiwendan tang combined with transdermal fentanyl fentanvl through-skin plaster on alleviating side response and controlling pain and to explore the improvement extent of quality of life.Methods From February 2001 to February 2002,30 patients with severe cancer pain in the Affiliated Second Clinical Hospital,Guangzhou University of Traditional Chinese Medicine were treated with initial dose of transdermal fentanyl 25 μ g/h,changed once every three days.During the period the dose was regulated until patients had no pain or almost had no pain.Meantime,one dose of soup of traditional Chinese medicine come from Jiaweiwendan tang was taken orally.The treatment continued for 15 days and the pain extents before and after treatment,quality of life scale assessment and side effect after medication were observed.Results After the treatment of Jiaweiwendan tang combined with transdermal fentanyl,complete pain alleviation was in 24 cases(80% ) and obvious alleviation was in 6 cases(20% )(t=24.27, P< 0.001). After medication,the appetite,sleep,mental status,daily life and social communication of patients have been improved significantly(t=- 11.12 to - 1.50,P< 0.001).The side effects were slight.Of them,3 cases were with dizziness,2 cases with drowsiness and 2 cases with nausea and vomiting. Conclusion The treatment of Jiaweiwendan tang combined with transdermal fentanyl presents the advantages of effectively controlling pain,slight side effects and significantly improving the quality of life of patients with cancer.