With the development of my country's economy and the increasingly serious population aging, malignant tumors have become one of the main public health problems that threaten the health of the Chinese population. Patients with advanced tumors have a variety of uncomfortable symptoms. Among them, cancer pain is one of the most common and difficult to control symptoms. How to control cancer pain and let patients walk the last part of their lives peacefully and comfortably is the direction of the Anning Care Unit's efforts. Most patients in the Anning Care ward suffer from refractory pain, and the three-step analgesia alone cannot be effectively controlled. In order to explore a safe and effective combined analgesic method, we use aromatherapy combined with three-step analgesia for patients in the Anning Care ward. A certain effect, the report is as follows. Clinical patient From November 2018 to January 2020, 50 patients with advanced malignant tumors admitted to the Anning Nursing Ward of Jiangxi Cancer Hospital were selected as the research objects, accompanied by tumor compression, tumor metastasis, tumor inflammatory factors and other causes of cancer pain . Inclusion criteria: diagnosed as malignant tumor by pathological or cytological diagnosis; cancer pain is graded according to the numerical grading method (NRS), 3 points Essential Oils used have no history of allergies. Exclusion criteria: persons with abnormal sense of smell complicated with respiratory diseases such as asthma and rhinitis; persons with expression disorder or mental illness; persons who cannot perform pain evaluation by themselves.
The random number table was divided into a combination group and a control group, with 25 cases in each group. In the combined group, there were 16 males and 9 females; 6 cases were younger than 50 years old, 19 cases were ≥50 years old; disease diagnosis: 8 cases of liver cancer, 4 cases of lung cancer, 3 cases of intestinal cancer, 2 cases of kidney cancer, and 2 cases of gastric cancer , 1 case of breast cancer, 1 case of lymphoma, 1 case of anterior mediastinal malignant tumor, 1 case of submandibular adenosquamous carcinoma, 1 case of pancreatic cancer, 1 case of vulvar cancer. In the control group, there were 9 males and 16 females; 9 were younger than 50 years old, 16 were older than 50 years old; disease diagnosis: 6 cases of bowel cancer, 5 cases of breast cancer, 3 cases of lung cancer, 2 cases of urothelial cancer, There were 2 cases of liver cancer, 2 cases of kidney cancer, 2 cases of cervical cancer, 1 case of gastric cancer, 1 case of laryngeal cancer, and 1 case of endometrial cancer. The general information of the two groups of patients is highly balanced and comparable. The study was approved by the medical ethics committee of the hospital, and the patients and their families signed an informed consent form. Clinical outcome After 3 days, the analgesic effect of the two groups was compared. The analgesic effect of the combination group was significantly higher (χ2 = 6.88, P = 0.03). See Table 1. Comparison of analgesic effects between the two groups after 7 days. The effective rate of analgesia in the combined group was significantly higher than that in the control group (χ2 = 6.37, P = 0.04). See Table 2. Clinical discussion The incidence of malignant tumors in my country has been on the rise in the past ten years, and deaths from malignant tumors accounted for 23.91% of all deaths among residents. Most cancer patients suffer from various discomforts before their deaths, including cancer pain, dyspnea, loss of appetite, etc. Anning Therapy is dedicated to alleviating these uncomfortable symptoms and improving the quality of life of dying patients. The incidence of cancer pain in patients with advanced tumors can be as high as 70%-90%, mostly due to tumor microenvironment, tumor compression, tumor nerve infiltration, treatment, etc., advanced patients often have multiple causes, so refractory cancer pain The incidence is high and the treatment effect is poor. This not only brings physical discomfort to patients, but also causes symptoms such as anxiety, depression, insomnia, fatigue, and loss of appetite, which seriously affects the patient's quality of life at the end of life. It is the focus of symptom control in the Anning Care Unit. The three-step analgesia we use clinically is often accompanied by some adverse drug side effects, such as constipation, nausea, motor and cognitive impairment, respiratory depression, addiction, etc., which affect the adequate use of drugs and ultimately affect the analgesic effect. Therefore, seeking an effective combined analgesic method to relieve refractory pain, reduce the dosage of analgesic drugs, and reduce drug side effects has become a difficult task in the nursing ward. The research on pain relief of traditional Chinese medicine has a long history, and there are many traditional Chinese medicine painkillers in clinical practice. Aromatherapy is also one of the historical records. Humans began to use natural plant essential oils to treat pain as early as 6000 years ago. There are related records in the Compendium of Materia Medica by Li Shizhen in the Ming Dynasty in my country. For example, there are 35 species of "Fragrant Wood" and 56 species of "Fragrant Grass", which have the effects of clearing heat, sterilizing and analgesic. In 1937, the chemist Rene Maurice Gattefosse confirmed the scientific basis of essential oils, that is, “plant essential oils can reach the deep tissues of the skin due to their excellent permeability. They are then covered by small blood vessels. Absorbed. Finally, it passes through the blood circulation to reach the organ to be treated". Aromatherapy is easy to use, relatively safe, and has few side effects. It is getting more and more attention, and the medical field is greatly inspired and widely used. At present, aromatherapy is mostly used clinically to improve cognitive function, regulate anxiety, and improve symptoms of insomnia. There are also some studies in the field of cancer pain, but due to the route of medication, the type of medication, the dosage of the medication, and the different cancers and stages, there is no standard unified conclusion. This study used a prospective randomized controlled study method to observe the analgesic effect of aromatherapy in addition to the three-step analgesic method in patients with cancer pain in the Anning Care Unit. The results showed that the analgesic effect of the combined group was significantly better than that of the control group, the difference was statistically significant, and no obvious side effects were observed. At present, Anning Care is still in its infancy in my country. Due to public acceptance and medical insurance policies, the survival period of patients in the Anning Care ward is relatively short. The average length of stay in our department is 11.56 days, which improves the quality of life of patients at the end of life. It is the original intention of this study that patients go through the last stages of their lives without pain. Of course, as people pay more attention to the concepts of "death" and "good death", more and more people are receiving tranquillity care. We will continue the observations of this study, hoping to see the effects of long-term treatment and give more Of dying patients bring the gospel. Original article: 1. Department of Oncology, Jiangxi Cancer Hospital Shi Min, Jian Yan
