CAJ | 학술논문

目的：探讨在癌症疼痛诊疗规范（2011年版）指导下癌痛规范化治疗的意义。方法：收集自2012年3月至2013年12月就诊于河北医科大学第四医院肿瘤内科126例癌痛患者的临床资料，比较NRS评分、爆发痛次数、生存质量影响评分3个方面改善的情况；分析不同疼痛分级、病种与治疗效果之间的关系；通过Logistic回归分析癌痛缓解的影响因素。结果：规范化治疗后NRS评分的改善率在不同疼痛分级（P=0.001）、不同性别患者间有显著性差异（P<0.001），在不同病种间无显著性差异（P=0.112）；规范化治疗后生存质量影响总分下降和爆发痛次数减少的改善率各组内均差异无统计学意义。疼痛分级、病种对癌痛缓解情况影响不大。抗肿瘤治疗、无远处转移两个因素是促使NRS评分、生存质量影响评分下降的独立因素；无远处转移（P=0.046）是促使爆发痛次数减少的独立因素。结论：规范化治疗癌痛带来NRS评分、爆发痛次数、生存质量影响评分的获益；接受抗肿瘤治疗、无远处转移的患者止痛治疗效果明显。
목적：탐토재암증동통진료규범（2011년판）지도하암통규범화치료적의의。방법：수집자2012년3월지2013년12월취진우하북의과대학제사의원종류내과126례암통환자적림상자료，비교NRS평분、폭발통차수、생존질량영향평분3개방면개선적정황；분석불동동통분급、병충여치료효과지간적관계；통과Logistic회귀분석암통완해적영향인소。결과：규범화치료후NRS평분적개선솔재불동동통분급（P=0.001）、불동성별환자간유현저성차이（P<0.001），재불동병충간무현저성차이（P=0.112）；규범화치료후생존질량영향총분하강화폭발통차수감소적개선솔각조내균차이무통계학의의。동통분급、병충대암통완해정황영향불대。항종류치료、무원처전이량개인소시촉사NRS평분、생존질량영향평분하강적독립인소；무원처전이（P=0.046）시촉사폭발통차수감소적독립인소。결론：규범화치료암통대래NRS평분、폭발통차수、생존질량영향평분적획익；접수항종류치료、무원처전이적환자지통치료효과명현。
Objective:To discuss the significance of standardized treatment for cancer pain, according to the Cancer Pain Treat-ment Specification (2011 Edition) issued by the Ministry of Health, PR China. Methods:Clinical data of 126 patients with cancer pain, who were admitted to the Department of Medical Oncology, The Fourth Hospital of Hebei Medical University, were collected to com-pare the improvement of the Numeric Rating Scale (NRS) score, number of breakthrough pain, and quality of life score after treatment. The relationships between different pain grades, disease entities, and treatment effect were analyzed. The influence factors of pain relief were also analyzed by using Logistic regression analysis. Results:1). Following standardized treatment, the improvement rate of NRS score has shown significant differences in pain grading (P=0.001) and gender (P=0.000). However, no significant differences were ob-served between different diseases (P=0.112). The improvement rate of the life quality score and the number of breakthrough pain had no significant difference after standardized treatment. 2). The grading of cancer pain and the disease entities had little effect on cancer pain relief. 3). The anti-tumor treatment and“no distant metastasis”were the independent factors that brought about the decrease in NRS and quality of life scores.“No distant metastasis”(P=0.046) was the independent factor that reduced the number of pain out-breaks. Conclusion: The standardized treatment positively affects the NRS score, number of breakthrough pain, and quality of life score. Patients who received anti-neoplastic therapy and who had no distant metastasis showed significant treatment effectiveness in pain management.