针药并用治疗阿片类药物相关便秘的临床疗效

Clinical efficacy of "acupuncture combined with herbal medicine" in treating opioid related constipation

目的探讨针刺联合新加黄龙汤治疗阿片类药物相关便秘(OIC)患者的临床疗效。方法选取2016年10月至2018年8月大连市金州区中医医院收治的108例口服羟考酮控释片后出现便秘症状的癌痛患者作为研究对象。根据患者入院病历号应用随机数字表法分为观察组(54例)和对照组(54例)。对照组患者采用乳果糖口服溶液进行治疗,观察组患者予以穴位针刺联合新加黄龙汤进行治疗。比较两组患者的肠功能、生命质量、中医症候疗效、血管活性肠肽(VIP)及胃动素(MTL)水平。结果治疗后两组患者的肠功能指数(BFI)评分明显降低,卡氏(KPS)评分显著升高,且观察组改善幅度均明显高于对照组,差异均有统计学意义(均P<0.05);对照组和观察组的有效率分别为68.52%和92.59%,两组比较,差异有统计学意义(P<0.05);治疗后,观察组患者的MTL水平显著高于对照组,VIP水平明显低于对照组,差异均有统计学意义(均P<0.05)。结论穴位针刺联合新加黄龙汤治疗OIC疗效确切,能够改善患者胃肠道功能,提高其生命质量。

Objective To investigate the clinical efficacy of acupuncture combined with Xinjia Huanglong Decoction in the treatment of opioid-related constipation.Methods During the period of 2016.10-2018.8,108 patients with cancer pain who had constipation symptoms after oral administration of oxycodone controlled release tablets were enrolled in Dalian Jinzhou District Hospital of traditional Chinese Medicine.Patients were divided into observation group（54 cases）and control group（54 cases）according to the patient admission number.The control group was treated with lactulose solution orally;the observation group was treated with acupoint acupuncture combined with Xinjia Huanglong Decoction for treatment,7 days for 1 course of treatment,and a total of 2 courses of treatment.The changes of intestinal function index score（BFI）,quality of life（KPS score）,TCM symptom score,vasoactive intestinal peptide（VIP）and motilin（MTL）levels before and after treatment were compared between the two groups.Results After treatment,the intestinal function index score of the two groups was significantly reduced,and the KPS score was significantly increased,and the improvement of the observation group was significantly higher than that of the control group,the difference was statistically significant（P〈0.05）;the effective rate of the control group and the observation group were 68.52%and 92.59%,respectively.After treatment,the MTL level in the observation group was significantly higher than that in the control group,and the VIP level was significantly lower than that in the control group（P〈0.05）.Conclusion Acupoint acupuncture combined with Xinjia Huanglong Decoction for the treatment of opioid-related constipation is effective,can improve the gastrointestinal function of patients and improve the quality of life of patients.