揿针疗法干预阿片类药物所致顽固性便秘疗效观察

Therapeutic Observation of Subcutaneous Needle Therapy for Refractory Constipation Caused by Opioids

目的观察揿针疗法干预阿片类药物所致顽固性便秘的临床疗效。方法将癌痛且服用阿片类药物镇痛所致顽固性便秘患者64例,随机分为观察组和对照组,每组32例。对照组采用通便疗法,包括常规药物疗法和合理的健康宣教;观察组在对照组基础上增加揿针治疗。治疗后比较两组患者临床疗效、便秘患者生活质量(PAC-QOL)量表评分、粪便性状评分(Bristol)、排便难度评分(CCS)结果。结果观察组总有效率为93.8%,对照组为71.9%,两组比较差异具有统计学意义(P<0.05);两组患者治疗后PAC-QOL量表评分、Bristol评分、CCS评分均有下降(P<0.05);观察组患者治疗后PAC-QOL量表评分、Bristol评分、CCS评分低于对照组(P<0.05)。结论在常规药物疗法基础上,揿针疗法干预阿片类药物所致顽固性便秘疗效显著,可有效缓解便秘患者临床不适症状,增加使用阿片类药物癌痛患者舒适度,提高其生活质量。

Objective To observe the clinical efficacy of subcutaneous needle therapy in intervening refractory constipation caused by opioids. Method Sixty-four patients with refractory constipation due to using opioids for cancerous pain were randomized into an observation group and a control group, with 32 cases in each group. The control group was intervened by cathartics including routine medications and health education;the observation group was additionally given subcutaneous needle therapy. After treatment, the clinical efficacies, Patient Assessment of Constipation Quality of Life Scale (PAC-QOL), Bristol Stool Scale (BBS) and Cleveland Clinic Score (CCS) of the two groups were compared. Result The total effective rate was 93.8% in the observation group and 71.9% in the control group, and the between-group difference was statically significant (P<0.05);after treatment, the PAC-QOL, BBS and CCS scores all declined in the two groups (P<0.05);the scores of PAC-QOL, BBS and CCS in the observation group were lower than those in the control group (P<0.05). Conclusion Subcutaneous needle therapy can produce significant efficacy for refractory constipation caused by opioids. It can effectively mitigate the symptoms, and enhance the comfort degree and quality of life in constipation patients on opioids for cancerous pain.