Objective: To observe the effect of intradermal needling combined with heat-sensitive moxibustion for moderate to severe cancer pain.
Methods: A total of 60 patients with moderate to severe cancer pain were randomly divided into an observation group and a control group，30 cases in each one. In the control group，opioids were taken to relief pain according to the three-step analgesic method of World Health Organization. On the base of the treatment as the control group, intradermal needling combined with heat-sensitive moxibustion were applied at Neiguan (PC 6), Hegu (LI 4), Zusanli (ST 36), Taichong (LR 3), etc. in the observation group, 14 days of treatment were required. The equivalent morphine consumption at the first day and whole course, the scores of cancer quality of life questionnaire-C30 (QLQ-C30) and Hamilton anxiety scale before and after treatment, and the adverse reaction rate were compared in the two groups. The total analgesic effective rate was evaluated.
Results: The total analgesic effective rate was 93.3% (28/30) in the observation group, higher than 73.3% (22/30) in the control group (P<0.05). The total equivalent morphine consumption in the observation group was less than the control group (P<0.05). After treatment, the QLQ-C30 scores were increased (P<0.001) and the HAMA scores were decreased (P<0.001) in the both groups, and those in the observation group were superior to the control group (P<0.001). The adverse reaction rates of fatigue, dizziness, nausea and vomiting, constipation in the observation group were lower than the control group (P<0.05).
Conclusion: Intradermal needling combined with heat-sensitive moxibustion can reduce the dose of opioids, improve the quality of life, relief the anxiety in patients with moderate to severe cancer pain, and reduce the incidence of common adverse reaction of opioids.
目的：观察揿针联合热敏灸治疗中重度癌性疼痛的临床效应。方法：将60例中重度癌性疼痛患者随机分为观察组和对照组，每组30例。对照组根据世界卫生组织“三阶梯药物止痛法”选用阿片类药物进行止痛治疗；观察组在对照组治疗基础上，穴取内关、合谷、足三里、太冲等，予揿针联合热敏灸干预，疗程为14 d。比较两组患者首日及全程等效吗啡消耗量，治疗前后癌症患者生活质量测定量表（QLQ-C30）评分、汉密尔顿焦虑量表（HAMA）评分及不良反应发生率，并比较两组患者镇痛总有效率。结果：观察组镇痛总有效率为93.3%（28/30），高于对照组的73.3%（22/30，P<0.05）。观察组全程等效吗啡消耗量少于对照组（P<0.05）。治疗后，两组QLQ-C30评分增加（P<0.001），HAMA评分下降（P<0.001），且观察组评分均优于对照组（P<0.001）。观察组患者乏力、眩晕、恶心呕吐及便秘的发生率低于对照组（P<0.05）。结论：揿针联合热敏灸治疗可减少中重度癌性疼痛患者阿片类药物使用量，改善生活质量，减轻焦虑状态，且可减少阿片类药物常见不良反应的发生率。.
Keywords: cancer pain; heat-sensitive moxibustion; intradermal needling; three-step analgesic method.