中医药治疗阿片类药物所致便秘新进展

New Progress on Chinese Medicine for Opioid-induced Constipation

便秘是晚期癌痛病人服用阿片类药物最常见的并发症,发生率高达90%～100%,不仅出现在用药早期,而且贯穿整个治疗过程。临床主要表现为腹胀、便量减少、排便不尽感及里急后重,甚至引起恶心呕吐、呼吸困难、情绪异常、焦虑、抑郁等,严重干扰患者生活,增加癌痛患者额外痛苦。中医药治疗阿片类药物所致便秘(Opioid-induced constipation,OIC)方法多样,疗效肯定,优势显著,近年来涌现了较多的临床报道和研究。现就OIC的病因病机及治疗方法作简要综述。

As the most common complication of patients with advanced cancer pain after the administration of opioids,constipation occurs in the early stage of medication and throughout the whole treatment process,of which the incidence is up to 90% to 100%. The main clinical manifestations include abdominal distention,reduce in defecation amount,sense of incomplete defecation and tenesmus, even leading to nausea and vomiting,dyspnea,emotional disorder,anxiety and depression,which seriously disturb the life of patients and result in extra pain of patients with advanced cancer pain. Opioid-induced constipation is treated with Chinese medicine,added to which the methods are various,the clinical effect is definite and the advantages are significant. In this way,numerous clinical reports and researches spring up in recent years. The etiology and pathogenesis of OIC as well as its treatment will be briefly reviewed in the passage.