【目的】 观察揿针联合盐酸羟考酮缓释片治疗恶性肿瘤重度癌痛患者的临床疗效。【方法】 选取2023年11月至2024年 12月期间复旦大学附属中山医院青浦分院中医科病房收治的60例明确诊断为重度癌性疼痛患者为研究对象。按随机数字表 将患者随机分为观察组和对照组，每组各30例。对照组给予常规西医止痛治疗，观察组在对照组治疗的基础上，给予揿针 治疗。连续治疗 2周。治疗 2周后，评价 2组临床疗效。观察 2组患者治疗前后欧洲五维健康量表（EQ-5D）评分、数字疼痛 评分法（NRS）评分、癌痛自我效能量表（CPSS）评分的变化情况，以及欧洲癌症研究与治疗组织生活质量问卷（EORTC QLQC30）评分的情况。比较2组患者治疗前后血清前列腺素E2、内皮素-1、β-内啡肽、P物质水平的变化情况。并评价2组的安 全性及不良反应的发生情况。【结果】（1）观察组镇痛总有效率76.67%（23/30），对照组为46.67%（14/30），观察组总有效率明 显高于对照组，差异有统计学意义（P＜0.05）。（2）治疗后，2组患者的前列腺素E2、内皮素-1、β-内啡肽、P物质水平明显 改善（P＜0.05），且观察组在改善前列腺素E2、内皮素-1、β-内啡肽、P物质水平方面明显优于对照组，差异有统计学意义 （P＜0.05）。（3）治疗后，2 组患者的 EQ-5D 评分、NRS 评分、CPSS 评分明显改善（P＜0.05），且观察组在改善 EQ-5D 评分、 NRS评分、CPSS评分方面明显优于对照组，差异有统计学意义（P＜0.05）。（4）治疗后，2组患者的EORTC QLQ-C30评分明显 改善（P＜0.05），且观察组在改善EORTC QLQ-C30评分方面明显优于对照组，差异有统计学意义（P＜0.05）。（5）观察组不良 反应发生率为 53.33%（16/30），对照组为 83.33%（25/30）。观察组不良反应发生率明显低于对照组，差异有统计学意义（P＜ 0.05）。【结论】 揿针联合盐酸羟考酮缓释片治疗恶性肿瘤重度癌痛，能明显减轻患者的疼痛症状，提高患者的健康状态和自 我效能，从而提高患者的生活质量。

Objective To observe the clinical efficacy of thumb-tack needling therapy combined with Oxycodone Hydrochloride Sustained-Release Tablets in treating patients with severe cancer pain caused by malignant tumors. Methods A total of 60 patients diagnosed with severe cancer pain who were admitted to the Traditional Chinese Medicine Department of Qingpu Branch，Zhongshan Hospital Affiliated to Fudan University between November 2023 and December 2024 were selected as study subjects. Patients were randomly divided into an observation group and a control group using a random number table， with 30 cases in each group. The control group received conventional western medicine pain management， while the observation group received additional thumb-tack needling therapy based on the control group’s treatment. The treatment duration was 2 weeks. After treatment，clinical efficacy was evaluated by observing changes in European Quality of Life-5 Dimensions （EQ-5D） scores， Numerical Rating Scale （NRS） scores， Cancer Pain Self-Efficacy Scale （CPSS） scores， and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire （EORTC QLQ-C30） scores in both groups before and after treatment. Changes in serum levels of prostaglandin E2，endothelin-1，β-endorphin， and substance P were also compared. Safety and adverse reactions were assessed. Results （1） The total analgesic effective rate was 76.67% （23/30） in the observation group and 46.67% （14/30） in the control group. The total effective rate in the observation group was significantly higher than that in the control group，with a statistically significant difference （P＜0.05）. （2） After treatment， serum levels of prostaglandin E2， endothelin-1， β-endorphin，and substance P were significantly improved in both groups （P＜0.05），and the improvement in the observation group was significantly greater than that in the control group， with a statistically significant difference （P＜0.05）.（3） After treatment， EQ-5D scores， NRS scores， and CPSS scores were significantly improved in both groups （P＜0.05），and the improvement in the observation group was significantly greater than that in the control group，with a statistically significant difference（P＜0.05）.（4） After treatment，EORTC QLQC30 scores were significantly improved in both groups （P＜0.05），and the improvement in the observation group was significantly greater than that in the control group， with a statistically significant difference（P＜0.05）. （5）The incidence of adverse reactions was 53.33% （16/30） in the observation group and 83.33% （25/30） in the control group. The incidence of adverse reactions in the observation group was significantly lower than that in the control group， with a statistically significant difference （P＜0.05）. Conclusion Thumb-tack needling therapy combined with Oxycodone Hydrochloride Sustained-Release Tablets significantly alleviates pain symptoms， improves health status and self-efficacy， and enhances the quality of life in patients with severe cancer pain caused by malignant tumors.

R246.9

上海市卫健委中医特色专科建设项目（编号：ZYTSZK2-17）；上海市卫生健康委员会中医药科研项目（编号：2022QN004）