耳穴贴压辨证干预强阿片相关性便秘的效果评价

Effect evaluation of auricular plaster therapy based on the pattern/syndrome differentiation in patients with constipation induced by strong opioid drugs for pain

目的 评价耳穴贴压对阿片类便秘患者便秘相关症状和生活质量的影响.方法 将符合纳入、排除标准的60例阿片相关性便秘患者采用随机数字表法分为干预组和对照组（乳果糖）各30例.干预组采用前期探查出的阿片类便秘人群阳性率较高的耳穴点结合辨证取穴进行干预;对照组给予乳果糖口服溶液15 ml/次,3次/d,同时结合便秘常规护理.运用阿片类便秘专用评估量表（BFI）、自制伴随症状量表、生活质量测定量表（PAC-QOL）对2组干预前后的便秘相关症状和生活质量水平进行测试,同时测定干预组停止干预2周后的持续效果.结果 2组干预前后BFI、PAC-QOL各维度及总分得分下降水平比较差异均有统计学意义,2组干预前后伴随症状各条目得分较干预前略低,但得分下降水平组间比较差异无统计学意义.干预组2周后的随访发现耳穴贴压的远期疗效与干预前比较差异有统计学意义,但与干预后即时相比则明显降低,便秘症状和生活质量得分值都有所回升.结论 科学合理的选穴处方辨证干预阿片类便秘可有效改善便秘症状,提高患者的生活质量.

Objective To explore the effect of auricular plaster therapy on associated symptoms and quality of life in patients with constipation induced by strong opioid drugs for pain.Methods A total of 60 patients selected were randomly divided into the intervention group and the control group with 30 cases in each group.The intervention group was treated with auriculotherapy based on the pattern/syndrome differentiation after detecting the auricular sensitive acupoints＆#39; distribution in patients with opioid-induced constipation after receiving opioid therapy.BFI,self-made scale on symptoms accompanied by constipation and PAC-QOL were used to collect data about constipation symptoms and the level of quality of life before or after the intervention,and still with a subset of the intervention group followed for more than two weeks.Results The BFI and PAC-QOL scores of the intervention and control group were lower after intervention,and the decline score of the two groups showed significant difference.But for the self-made scale,the score of each item was slightly lower compared with that before treatment,which showed no statistically significant difference between groups.A follow-up of 2 weeks showed that the long-term efficacy of auricular plaster therapy was significantly lower than before,but was less desirable than short-term.Conclusions Scientific and reasonable choice of acupoint prescription according to syndrome differentiation can effectively improve symptoms accompanied by constipation and patients＆#39; quality of life.