基于子午流注纳子法予四子散外敷治疗阿片类药物所致便秘的临床研究

Clinical study of Ziwu Liuzhu Nazi method and external application of Sizisan in the treatment of opioids-induced constipation

目的观察基于子午流注纳子法予四子散外敷治疗阿片类药物所致便秘的疗效。方法 100例恶性肿瘤合并癌痛给予阿片类药物出现便秘的患者,随机分为对照组和治疗组,各50例。对照组患者给予乳果糖通便治疗,治疗组患者基于子午流注纳子法予四子散外敷治疗。观察两组近期临床效果、治疗前后排便时间及远期疗效。结果治疗组治愈5例,显效16例,有效22例,无效7例,总有效率为86.0%;对照组治愈4例,显效13例,有效17例,无效16例,总有效率为68.0%;治疗组总有效率高于对照组,差异有统计学意义(P<0.05)。治疗前,两组排便时间比较差异无统计学意义(P>0.05);治疗后,治疗组排便时间短于对照组,差异有统计学意义(P<0.05)。治疗组再发便秘15例,对照组再发便秘31例,两组比较差异有统计学意义(P<0.05)。治疗组再发便秘时间为(10.3±1.5)d,长于对照组的(6.8±3.5)d,差异有统计学意义(P<0.05)。结论基于子午流注纳子法予四子散外敷治疗阿片类药物所致便秘,疗效满意,值得推广。

Objective To observe the efficacy of Ziwu Liuzhu Nazi method and external application of Sizisan in the treatment of opioids-induced constipation. Methods A total of 100 malignant tumor and cancer pain patients with opioids-induced constipation were randomly divided into control group and treatment group, with 50 cases in each group. The control group was treated with lactulose for defecation, and the treatment group was treated with Ziwu Liuzhu Nazi method and external application of Sizisan. Observation were made on short- term clinical effect, defecation time before and after treatment and long-term effect between the two groups. Results The treatment group had 5 cured cases, 16 excellent cases, 22 effective cases and 7 ineffective cases, with total effective rate as 86.0%, while the control group had 4 cured cases, 13 excellent cases, 17 effective cases and 16 ineffective cases, with total effective rate as 68.0%. The treatment group had higher total effective rate than the control group, and the difference was statistically significant （P〈0.05）. Before treatment, both groups had no statistically significant difference in defecation time （P〉0.05）. After treatment, the treatment group had shorter defecation time than the control group, and the difference was statistically significant （P〈0.05）. The treatment group had 15 re-constipation cases, while the control group had 31 re-constipation cases, and the difference was statistically significant （P〈0.05）. The treatment group had longer re-constipation time as （10.3 ± 1.5） d than （6.8 ± 3.5）d in the control group, and the difference was statistically significant （P〈0.05）. Conclusion Ziwu Liuzhu Nazi method and external application of Sizisan shows satisfactory efficacy in treating opioids-induced constioation, and is worthy of promotion.