阿片类药物导致便秘的机制及治疗

The Mechanism and the Treatment of Opioid Induced Constipation

阿片类药物是中重度疼痛常用的止痛药物,通过与阿片受体的结合起到止痛的作用,但同时抑制了胃肠道的蠕动和分泌,容易导致便秘、恶心、呕吐等胃肠道不良反应,引起疼痛患者的不适。便秘是阿片类药物最主要的不良反应,而传统的通便药物的治疗效果不佳,目前国外致力于研究治疗阿片类药物导致便秘的新药,这些新药通过阻滞外周阿片受体起到治疗的作用,同时不影响中枢止痛作用。该文就阿片类药物导致便秘的发病机制及目前治疗情况予以综述。

Opioids are recommended for the management of moderate/severe cancer pain, which combine with opioid receptors to control pain. As a result of the undesired action of opioids on the gastrointestinal tract,patients receiving opioid medication for chronic pain often experience opioid induced bowel dysfunc- tion, such as constipation, nausea and vomiting, the most common and debilitating symptom of which is consti- pation. The traditional drug is not effective enough to treat constipation. At present experts are devoted to the study of drugs for opioid-induced constipation, which acts through blocking peripheral opioid receptors,with- out influencing pain control. Here is to make a review of the pathogenesis and current treatment situation of opioid-induced constipation.