关键词: 癌, 经皮神经电刺激, 镇痛, 阿片类药物, 骨转移癌痛, 治疗结果

Abstract: Background　Moderate and severe cancer pain has become one of the reasons for the decline in the quality of life of cancer patients.Although strong opioids represented by morphine are effective for it, there are 40% to 60% of patients still cannot adequately control their cancer pain, and the way in which transcutaneous electrical nerve stimulation（TENS） assists drugs in the treatment of cancer pain has been gradually recognized by scholars. Objective　To explore the effect of TENS on the efficacy and safety of opioid analgesic insufficiency in bone metastatic cancer pain. Methods　A total of 48 patients with bone metastatic cancer pain in Jiangnan Hospital Affiliated to Zhejiang Chinese Medicine University and Zhejiang Cancer Hospital from September 2017 to May 2018 were selected and then divided into the opioid group（24 cases） who treated with opioid only and the combined treatment group（24 cases） who treated with TENS combined with opioid according to the random number table method.The pain was assessed by Brief Pain Inventory; the 24-hour equivalent morphine dosage, the number of breakthrough pain and adverse drug reactions for 24 hours were recorded before treatment, 2 weeks and 4 weeks after treatment.The differences between the two groups were compared. Results　The most severe pain, average pain and current pain scores after 2 weeks and 4 weeks of treatment in the combined treatment group were lower than those in the opioid group（P<0.05） . The most severe pain and average pain after 2 weeks and 4 weeks of treatment in the two groups were significantly lower than those before treatment in the same group（P<0.05）．The equivalent morphine dosage after 2 weeks and 4 weeks of treatment was higher than that before treatment in two groups（P<0.05） , and the dosage of the combined treatment group was significantly lower than that of the opioid group in the same period（P<0.05） ．The number of breakthrough pain episodes after 2 weeks and 4 weeks of treatment in two groups was less than that before treatment（P<0.05） , and the reduction was more obvious in the combined treatment group than that in the opioid group （P<0.05）．During the treatment period, the adverse reactions of opioids in the two groups mainly included nausea, vomiting, constipation, dizziness, and pruritus, without any adverse reactions such as drowsiness and respiratory depression. The incidence of nausea, vomiting and constipation in the combined treatment group was lower than that in the opioid group（P<0.05） ．Conclusion　Combined with opioid therapy, TENS can effectively alleviate bone metastatic cancer pain, slow down opioid dosage process in patients with cancer pain, and reduce the incidence of adverse reactions, with relatively higher efficacy and safety.

Key words: Carcinoma, Transcutaneous electrical nerve stimulation, Analgesia, Opioids, Bone metastatic cancer pain, Treatment outcome