内科

目的观察膈下逐瘀汤联合硫酸吗啡缓释片治疗气滞血瘀型癌痛的临床疗效。方法将120例气滞血瘀型癌痛患者随机分为A组和B组，每组60例。A组采用硫酸吗啡缓释片治疗，B组采用膈下逐瘀汤联合硫酸吗啡缓释片治疗。两组患者均治疗28 d为1个疗程。比较两组患者治疗后癌痛评分程度（NRS评分）、疼痛治疗效果、止痛起效时间、止痛持续时间、生活质量（KPS评分）及硫酸吗啡日均用量情况。结果治疗28 d后，A组患者疼痛治疗总有效率为78.3%，B组为96.7%，两组比较差异具有统计学意义(P＜0.01)。治疗后两组患者NRS评分均明显下降、KPS评分明显升高(P＜0.05)，B组患者的NRS评分明显低于A组，KPS评分明显高于A组(P＜0.01)。B组患者止痛起效时间明显短于A组，止痛持续时间明显长于A组(P＜0.01)。B组患者治疗第1～4周的硫酸吗啡缓释片日均用量明显小于A组(P＜0.01)。结论膈下逐瘀汤联合硫酸吗啡缓释片治疗气滞血瘀型癌痛能够明显提高癌痛患者的疼痛治疗效果和生活质量，减少硫酸吗啡缓释片的日均用量。

ObjectiveTo observe the clinical effect of Gexia Zhuyu Decoction Combined with Morphine Sulfate Sustained-release Tabelets in the treatment of patients with Qi stagnation and blood stasis type cancer pain. Methods120 patients with Qi stagnation and blood stasis type cancer pain were randomly divided into group A and group B, with 60 cases in each group. Group A was treated with Morphine Sulfate Sustained-release Tabelets, and group B was treated with Gexia Zhuyu Decoction Combined with Morphine Sulfate Sustained-release Tabelets for 28d 1 courses. The pain severity (NRS score), pain treatment effect, analgesic onset time, quality of life (KPS score) and daily dosage of morphine sulfate were compared between the two groups after treatment. ResultsAfter the treatment of 28d, the total effective rate of pain treatment in group A was 78.3% and that in group B was 96.7%. The difference between the two groups was statistically significant (P＜0.01). After treatment, the NRS scores of the two groups were decreased and the KPS score increased (P＜0.05). The NRS score of patients in group B was lower than that in group A. The score of KPS was higher than that in A group (P＜0.01). The onset time of analgesic effect in group B was shorter than that in group A, and the duration of analgesic duration was longer than that in group A (P＜0.01). The daily average dosage of Morphine Sulfate Sustained-release Tabelets in group B was less than that of group Afor the 1-4 week treatment (P＜0.01) . ConclusionGexia Zhuyu Decoction Combined with Morphine Sulfate Sustained-release Tabelets in the treatment of patients with Qi stagnation and blood stasis type cancer pain can significantly improve the pain treatment effect and quality of life of cancer pain patients, and reduce the daily dose of Morphine Sulfate Sustained-release Tabelets.