加味麻子仁汤治疗阿片类药物所致便秘临床研究

Clinical Effect of Modified Maziren Decoction in the Treatment of Opioid Induced Constipation

目的分析自拟加味麻子仁汤治疗阿片类药物所致便秘的临床疗效。方法选取我院肿瘤科2014年10月-2016年10月收治的因服用阿片类药物导致便秘的48例恶性肿瘤癌性疼痛患者,以随机数字表法分为两组,各24例。观察组采用自拟加味麻子仁汤治疗,对照组予乳果糖口服溶液,比较两组临床疗效、治疗前后中医症状积分、疼痛控制情况及生活质量。结果与对照组的66.67%相比,观察组总有效率为91.67%,显著提高(P<0.05)。治疗后两组首次排便时间、每次排便时间、排便间隔时间、排便难度、排便性状症状积分及总积分均较治疗前明显下降(P<0.01),且观察组治疗后改善情况优于对照组(P<0.01)。与治疗前比较,两组疼痛数字评分法(NRS)评分均明显下降,KPS功能状态评分明显上升(P<0.01),且观察组治疗后疼痛控制及生活质量评分改善情况均优于对照组(P<0.01)。结论自拟加味麻子仁汤治疗阿片类药物所致便秘疗效显著,可改善临床症状,减轻患者痛苦,提高生活质量。

Objective To analyze the clinical effect of self-made Modified Maziren Decoction in the treatment of opioid induced constipation. Methods To select 48 cases of malignant tumor patients with cancer pain who got constipation caused by opioids in our hospital from October 2014 to October 2016. they were randomly divided into two groups, 24 cases in each group. The observation group was treated with self-made Modified Maziren Decoction, and the control group was treated with Lactulose Oral Solution. To compare the clinical curative effect, TCM symptom score, pain control and quality of life between the two groups before and after treatment. Results Compared with the control group, the total effective rate of the observation group was 91.67%, which was significantly improved （P〈0.05）. After treatment the first defecation time, each defecation time, defecation interval, defecation difficulty, defecate symptoms score and total score in the two groups were significantly lower than that before treatment （P〈0.01）, and the patients in the observation group improved better than the control group（P〈0.01 ）. Compared with before treatment, the digital pain score（NRS）in the two groups were significandy decreased and the KPS score also increased significandy （P〈0.01）, and after treatment the pain control and the score of life quality improved significantly better than that in the control group （P〈0.01）. Conclusion The self-made Modified Maziren Decoction is effective in treating opioid induced constipation, improving clinical symptoms, reducing the pain of patients, and improving the quality of life.