“拈痛散”膏灸联合三阶梯止痛法治疗晚期胃癌癌性疼痛的疗效及对癌因性疲乏的影响

doi:10.3969/j.issn.1006-5725.2026.10.015

Abstract

Abstract:

Objective To analyze the efficacy of Niantong powder plaster moxibustion combined with the three-step analgesic ladder in the treatment of cancer pain in patients with advanced gastric cancer and its influence on cancer-related fatigue. Methods A total of 152 patients with advanced gastric cancer， cancer pain， and cancer-related fatigue， who were admitted to Qingdao Traditional Chinese Medicine Hospital from January 2023 to June 2025， were selected and randomly divided into a control group and a combined group， with 76 cases in each group. The control group was treated with the three-step analgesic ladder， whereas the combined group received treatment with the three-step analgesic ladder combined with Niantong powder plaster moxibustion. The efficacy was evaluated after 4 weeks of continuous treatment. In the two groups of patients， the efficacy of cancer pain， scores of the numerical rating scale （NRS）， brief pain inventory （BPI）， and revised Piper fatigue scale （PFS-R）， pain mediators ［5-hydroxytryptamine （5-HT）， substance P （SP）， neuropeptide Y （NP-Y）， prostaglandin E2 （PGE2）］， and adverse reactions were observed. Results After treatment， the cancer pain relief rate in the combined group was significantly higher than that in the control group （P < 0.05）. The combined group had lower NRS scores， BPI-pain severity scores， BPI-pain interference scores， and PFS-R scores compared to the control group （P < 0.05）. Additionally， it also presented lower serum levels of SP， 5-HT， NP-Y， and PGE2 （P < 0.05）. The incidence of adverse reactions was comparable between the two groups （P > 0.05）. Conclusions Niantong powder plaster moxibustion， when combined with the three- step analgesic ladder， demonstrates significant efficacy in treating advanced gastric cancer accompanied by cancer pain. Moreover， it can reverse the imbalance of pain factors and alleviate cancer-related fatigue.

Key words: gastric cancer, cancer pain, cancer-related fatigue, three-step analgesic ladder, niantong powder, plaster moxibustion, pain mediators

CLC Number:

R273

Jing ZHANG,Yan LI,Ni DING,Man GUO. Efficacy of Niantong powder plaster moxibustion combined with three-step analgesic ladder in the treatment of advanced gastric cancer with cancer pain and influence on cancer-related fatigue[J]. The Journal of Practical Medicine, 2026, 42(10): 1805-1810.

Figures/Tables 6

Tab.1

Comparison of baseline data between the two groups"

项目	对照组（n = 76）	联合组（n = 76）	t/χ² 值	P值
年龄（ $x ˉ ± s$ ）/岁	56.38 ± 4.38	55.78 ± 5.12	0.776	0.439
性别
男	40（52.63）	43（56.58）	0.239	0.625
女	36（47.37）	33（43.42）
体质量指数（ $x ˉ ? ± ? s$ ）/（kg/m²）	20.15 ± 0.63	20.21 ± 0.67	0.569	0.570
病程（ $x ˉ ± s$ ）/月	38.78 ± 7.38	39.21 ± 7.15	0.365	0.716
入院时卡氏功能状态评分（ $x ˉ ? ± ? s$ ）/分	60.24 ± 3.15	60.47 ± 3.23	0.444	0.657
病理分型
腺癌	70（92.11）	72（94.74）	0.428	0.513
其他	6（7.89）	4（5.26）
临床分期
Ⅲ期	26（34.21）	30（39.47）	0.452	0.501
Ⅳ期	50（65.79）	46（60.53）

Tab.1

Tab.2

Tab.3

Tab.4

Tab.5

Tab.6

References 25

[1]	LØHRE E T， THRONÆS M， KLEPSTAD P. Breakthrough cancer pain in 2020［J］. Curr Opin Support Palliat Care， 2020， 14（2）： 94-99. doi： 10.1097/SPC.0000000000000494 . doi: 10.1097/SPC.0000000000000494
[2]	ATA F， YOUSAF Z， KALAJI B N AL， et al. Back pain as an initial feature of advanced gastric cancer mimicking multiple myeloma： A case report and literature review［J］. Qatar Med J， 2022， 2022（4）： 53. doi： 10.5339/qmj.2022.53 . doi: 10.5339/qmj.2022.53
[3]	WANG D， JIANG T， ZHENG L， et al. Analgesic treatment for refractory cancer pain caused by gastric cancer bone metastasis： A case report and literature review［J］. Medicine （Baltimore）， 2024， 103（28）： e38851. doi： 10.1097/MD.0000000000038851 . doi: 10.1097/MD.0000000000038851
[4]	TAKEI D， TAGAMI K. Management of cancer pain due to bone metastasis［J］. J Bone Miner Metab， 2023， 41（3）： 327-336. doi： 10.1007/s00774-022-01382-y . doi: 10.1007/s00774-022-01382-y
[5]	BROZOVIĆ G， LESAR N， JANEV D， et al. CANCER PAIN AND THERAPY［J］. Acta Clin Croat， 2022， 61（）： 103-108. doi： 10.20471/acc.2022.61.s2.13 . doi: 10.20471/acc.2022.61.s2.13
[6]	《慢性癌性疼痛中医诊疗规范专家共识》制订专家组. 慢性癌性疼痛中医诊疗规范专家共识［J］. 江苏中医药， 2025， 57（7）： 69-72. doi： 10.19844/j.cnki.1672-397X.2025.07.018 . doi: 10.19844/j.cnki.1672-397X.2025.07.018
[7]	李壮苗，燕文娟，刘芳，等. 姜黄天灸膏穴位贴敷治疗脑卒中偏瘫肩痛临床疗效观察［J］. 中国针灸， 2023， 43（12）： 1373-1378. doi： 10.13703/j.0255-2930.20230130-0001 . doi: 10.13703/j.0255-2930.20230130-0001
[8]	TAN C， WONG J F， YEE C M， et al. Methadone rotation for cancer pain： An observational study［J］. BMJ Support Palliat Care， 2022， 12（e6）： e736-e739. doi： 10.1136/bmjspcare-2019-002175 . doi: 10.1136/bmjspcare-2019-002175
[9]	MAO J J， LIOU K T， BASER R E， et al. Effectiveness of Electroacupuncture or Auricular Acupuncture vs Usual Care for Chronic Musculoskeletal Pain Among Cancer Survivors： The PEACE Randomized Clinical Trial［J］. JAMA Oncol， 2021， 7（5）： 720-727. doi： 10.1001/jamaoncol.2021.0310 . doi: 10.1001/jamaoncol.2021.0310
[10]	中国抗癌协会癌症康复与姑息治疗专业委员会，中国临床肿瘤学会肿瘤支持与康复治疗专家委员会. 癌症相关性疲乏诊断与治疗中国专家共识［J］. 中华医学杂志， 2022， 102（3）： 180-189. doi： 10.3760/cma.j.cn112137-20210811-01789 . doi: 10.3760/cma.j.cn112137-20210811-01789
[11]	李鑫，解晓芳，张光，等. 玄乌止痛膏穴位贴敷联合加味芍药甘草汤对癌性疼痛患者的疗效［J］. 辽宁中医杂志， 2024， 51（5）： 164-167. doi： 10.13192/j.issn.1000-1719.2024.05.044 . doi: 10.13192/j.issn.1000-1719.2024.05.044
[12]	MESTDAGH F， STEYAERT A， LAVAND'HOMME P. Cancer Pain Management： A Narrative Review of Current Concepts， Strategies， and Techniques［J］. Curr Oncol， 2023， 30（7）： 6838-6858. doi： 10.3390/curroncol30070500 . doi: 10.3390/curroncol30070500
[13]	张馨予. 中药外敷抗癌止痛贴联合针刺三阶梯药物止痛法治疗癌症疼痛的临床研究［J］. 辽宁中医杂志， 2022， 49（2）： 165-169. doi： 10.13192/j.issn.1000-1719.2022.02.046 . doi: 10.13192/j.issn.1000-1719.2022.02.046
[14]	魏世民，董宝强，富昱，等. 经筋刺法联合艾灸治疗阳虚型肺癌患者癌性疼痛的临床研究［J］. 辽宁中医杂志， 2020， 47（2）： 169-171. doi： 10.13192/j.issn.1000-1719.2020.02.052 . doi: 10.13192/j.issn.1000-1719.2020.02.052
[15]	THONG M S Y， VAN NOORDEN C J F， STEINDORF K， et al. Cancer-Related Fatigue： Causes and Current Treatment Options［J］. Curr Treat Options Oncol， 2020， 21（2）： 17. doi： 10.1007/s11864-020-0707-5 . doi: 10.1007/s11864-020-0707-5
[16]	TANAKA K， KONDO T， NARITA M， et al. Cancer aggravation due to persistent pain signals with the increased expression of pain-related mediators in sensory neurons of tumor-bearing mice［J］. Mol Brain， 2023， 16（1）： 19. doi： 10.1186/s13041-023-01001-5 . doi: 10.1186/s13041-023-01001-5
[17]	SÁNCHEZ M L， RODRÍGUEZ F D， COVEÑAS R. Neuropeptide Y Peptide Family and Cancer： Antitumor Therapeutic Strategies［J］. Int J Mol Sci， 2023， 24（12）： 9962. doi： 10.3390/ijms24129962 . doi: 10.3390/ijms24129962
[18]	石明宏，刘占伟，朱洋，等. 氨酚羟考酮联合局部放疗对老年恶性肿瘤骨转移癌痛患者血清细胞因子的影响［J］. 实用医学杂志， 2025， 41（11）： 1718-1723. doi： 10.3969/j.issn.1006-5725.2025.11.016 . doi: 10.3969/j.issn.1006-5725.2025.11.016
[19]	莫威，曾繁睿，易炜，等. "围放疗期"动态调整盐酸羟考酮缓释片剂量对肺癌骨转移患者镇痛效果的影响［J］. 实用医学杂志， 2022， 38（24）： 3150-3154. doi： 10.3969/j.issn.1006-5725.2022.24.023 . doi: 10.3969/j.issn.1006-5725.2022.24.023
[20]	LI C， CAI Q， WU X， et al. Anti-inflammatory Study on the Constituents of Angelica sinensis （Oliv.） Diels， Angelica dahurica （Hoffm.） Benth. & Hook.f. ex Franch. & Sav.， Angelica pubescence Maxim and Foeniculum vulgare Mill. Essential Oils［J］. J Oleo Sci， 2022， 71（8）： 1207-1219. doi： 10.5650/jos.ess22031 . doi: 10.5650/jos.ess22031
[21]	HUSSAIN H， RASHAN L， HASSAN U， et al. Frankincense diterpenes as a bio-source for drug discovery［J］. Expert Opin Drug Discov， 2022， 17（5）： 513-529. doi： 10.1080/17460441.2022.2044782 . doi: 10.1080/17460441.2022.2044782
[22]	PENG J， SONG X， YU W， et al. The role and mechanism of cinnamaldehyde in cancer［J］. J Food Drug Anal， 2024， 32（2）： 140-154. doi： 10.38212/2224-6614.3502 . doi: 10.38212/2224-6614.3502
[23]	DENG J， HAN J， CHEN J， et al. Comparison of analgesic activities of aconitine in different mice pain models［J］. PLoS One， 2021， 16（4）： e0249276. doi： 10.1371/journal.pone.0249276 . doi: 10.1371/journal.pone.0249276
[24]	张珂洋，张永清，杨春淼，等. 全蝎的炮制历史沿革、化学成分及药理作用研究进展［J］. 中国中药杂志， 2024， 49（4）： 868-883. doi： 10.19540/j.cnki.cjcmm.20230814.202 . doi: 10.19540/j.cnki.cjcmm.20230814.202
[25]	刘丽丽，尧章洪，李童，等. 吴茱萸现代药理作用、剂型设计与临床外用研究进展［J］. 中华中医药学刊， 2025， 43（6）： 52-60. doi： 10.13193/j.issn.1673-7717.2025.06.009 . doi: 10.13193/j.issn.1673-7717.2025.06.009

项目	对照组（n =76）	联合组（n = 76）	U/χ²值	P值
完全缓解	0（0.00）	0（0.00）	9.025	0.011
部分缓解	26（34.21）	37（48.68）
轻度缓解	26（34.21）	30（39.47）
无效	24（31.58）	9（11.84）
总有效	52（68.42）	67（88.16）	8.709	0.003

项目		对照组（n = 76）	联合组（n = 76）	t值	P值
NRS评分	治疗前	6.61 ± 1.34	6.55 ± 1.42	0.268	0.789
NRS评分	治疗后	3.37 ± 0.69^*	2.85 ± 0.57^*	5.065	0.000
BPI-疼痛程度	治疗前	6.68 ± 1.26	6.62 ± 1.35	0.283	0.777
BPI-疼痛程度	治疗后	3.26 ± 0.72^*	2.81 ± 0.62^*	4.129	< 0.001
BPI-疼痛干扰	治疗前	6.34 ± 1.23	6.39 ± 1.31	0.243	0.809
BPI-疼痛干扰	治疗后	3.15 ± 0.66^*	2.66 ± 0.47^*	5.272	< 0.001

项目		对照组（n = 76）	联合组（n = 76）	t值	P值
行为	治疗前	5.76 ± 0.88	5.71 ± 0.86	0.354	0.724
行为	治疗后	4.14 ± 0.85^*	3.36 ± 0.78^*	5.894	< 0.001
情感	治疗前	6.57 ± 1.01	6.54 ± 1.07	0.178	0.859
情感	治疗后	4.34 ± 1.11^*	3.27 ± 1.02^*	6.188	< 0.001
感觉	治疗前	4.66 ± 0.89	4.73 ± 0.92	0.477	0.634
感觉	治疗后	3.14 ± 0.82^*	2.71 ± 0.73^*	3.415	0.001
认知	治疗前	4.55 ± 0.82	4.62 ± 0.86	0.514	0.608
认知	治疗后	3.22 ± 0.74^*	2.93 ± 0.64^*	2.584	0.011
总分	治疗前	5.38 ± 0.90	5.40 ± 0.93	0.135	0.893
总分	治疗后	3.71 ± 0.88^*	3.07 ± 0.79^*	4.718	< 0.001

组别		对照组（n = 76）	联合组（n = 76）	t值	P值
5-HT/（ng/mL）	治疗前	94.54 ± 14.65	95.23 ± 12.57	0.312	0.756
5-HT/（ng/mL）	治疗后	84.24 ± 8.11^*	76.44 ± 7.26^*	6.247	< 0.001
SP/（pg/mL）	治疗前	139.60 ± 19.27	138.86 ± 20.14	0.231	0.817
SP/（pg/mL）	治疗后	120.24 ± 12.19^*	110.65 ± 14.08^*	4.489	0.000
PGE2/（pg/mL）	治疗前	663.73 ± 96.84	661.89 ± 90.57	0.121	0.904
PGE2/（pg/mL）	治疗后	528.64 ± 58.22^*	480.24 ± 60.25^*	5.036	< 0.001
NP-Y/（pg/mL）	治疗前	299.77 ± 29.28	297.58 ± 30.14	0.454	0.650
NP-Y/（pg/mL）	治疗后	249.66 ± 19.58^*	233.47 ± 20.05^*	5.036	< 0.001

不良反应	对照组（n = 76）	联合组（n = 76）	χ²值	P值
恶心/呕吐	4（5.26）	5（6.58）
便秘	4（5.26）	2（2.63）
头晕	5（6.58）	4（5.26）
刺激性皮炎	0（0.00）	1（1.32）
局部皮肤干燥	0（0.00）	3（3.95）
总发生	13（17.11）	15（19.74）	0.175	0.676

Efficacy of Niantong powder plaster moxibustion combined with three-step analgesic ladder in the treatment of advanced gastric cancer with cancer pain and influence on cancer-related fatigue

RichHTML

PDF (PC)

Knowledge

Abstract

Cite this article

share this article

Figures/Tables 6

References 25

Related Articles 15

Recommended Articles

Metrics

Comments

[1]	Fengxue DAI,Zhenfei WANG. Predictive analysis of serum COL10A1， miRNA-21 and miRNA-320c expression levels for peritoneal metastasis and prognosis of gastric cancer [J]. The Journal of Practical Medicine, 2026, 42(7): 1201-1207.
[2]	Yanyan DING,Shenglin ZHOU,Linlin WU,Yanling WANG. Efficacy and prognosis of trastuzumab deruxtecan combined with IP chemotherapy regimen in the treatment of HER2-positive advanced gastric cancer [J]. The Journal of Practical Medicine, 2026, 42(5): 742-749.
[3]	Zonglin LI,Chunlin FENG,Xin LIU,Xingming SHU,Min. SONG. CCCTC⁃binding factors promote the formation of oxaliplatin related gastric cancer drug-tolerant cells by resisting apoptosis [J]. The Journal of Practical Medicine, 2025, 41(4): 490-499.
[4]	Danping WANG,Yufeng CAI,Dehua HU,Liang. ZHANG. The role of LncRNA RMST in gastric cancer： Expression levels， diagnostic value， and prognostic implicationssion [J]. The Journal of Practical Medicine, 2025, 41(3): 409-413.
[5]	Fangyu SHI,Pengfei HAO,Like ZHANG,Quanxiao. XU. Expression characteristics of GZMB and CXCL9 and their regulatory significance in the tumor immune microenvironment and prognosis in gastric cancer patients [J]. The Journal of Practical Medicine, 2025, 41(23): 3744-3752.
[6]	Xiaoying DING,Zhichao DONG,Jianna MAO,Changqing GUO,Aimin. YUE. Expression and clinical significance of serum CXCL1 and PRDM5 in lymph node metastasis of progressive gastric cancer [J]. The Journal of Practical Medicine, 2025, 41(20): 3206-3213.
[7]	Xuman LU,Zhengyi SHI,Yuanrui LEI,Haibin HUANG,Renmiao DENG,Xudong DONG,Yuliang HUANG,Fanbiao KONG,Xiaotong. WANG. The expression of PCBP1 in gastric cancer and its relationship with ferroptosis factor STUB1 [J]. The Journal of Practical Medicine, 2025, 41(19): 3026-3033.
[8]	Jian ZHAO,Min DAI,Ran SUN,Yajun XU. Analysis of the relationship between Hp infection and the expression of p27， CyclinD1， MMP⁃9 proteins and the related microRNAs and clinicpathological features in gastric cancer [J]. The Journal of Practical Medicine, 2025, 41(18): 2890-2897.
[9]	Qian ZHANG,Yuntai CAO,Zhijie WANG,Boqi. ZHOU. Advances in deep learning for endoscopic image⁃based diagnosis of early gastric cancer [J]. The Journal of Practical Medicine, 2025, 41(14): 2160-2166.
[10]	Minghong SHI,Zhanwei LIU,Yang ZHU,Lili XIA,Gang CHENG,Youguo LU. Influence of oxycodone-acetaminophen combined with local radiotherapy on serum cytokines in elderly patients with malignant tumor bone metastasis complicated with cancer pain [J]. The Journal of Practical Medicine, 2025, 41(11): 1718-1723.
[11]	Xiaomei CHEN,Anqi WANG,Jizhen YANG,Miao YU. Prognosis and immune correlation analysis of m1A/m5C/m6A/m7G regulated genes in gastric cancer [J]. The Journal of Practical Medicine, 2024, 40(9): 1230-1237.
[12]	Jianliang YAN,Zeyu XIE,Rongrong JING,Ming. CUI. Research on establishing gastric cancer lymph node metastasis prediction model based on machine learning and routine laboratory indicators [J]. The Journal of Practical Medicine, 2024, 40(6): 844-849.
[13]	Shu CHEN,Jinglei ZHANG,Kang RONG,Nan ZHANG,Weiyi SUN. Research progress of exosomes in distant metastasis and drug resistance of gastric cancer [J]. The Journal of Practical Medicine, 2024, 40(6): 870-876.
[14]	Li XU,Shanshan HU,Haiming. ZHAO. LncRNA GNAS⁃AS1 participates in the proliferation and migration of gastric cancer cells by regulating the miR⁃449a/Notch1 axis [J]. The Journal of Practical Medicine, 2024, 40(4): 483-489.
[15]	Jian ZHAO,Songjie LIU,Guanchao ZHANG,Yuhou SHEN,Fengchen LI,Bing XU. Expression of CENPF and miR⁃1⁃3p in the serum of patients with advanced gastric cancer and their correlation with prognosis [J]. The Journal of Practical Medicine, 2024, 40(3): 365-370.