芪蓉通便汤联合耳穴贴压预防阿片性便秘的疗效

Effect of Qirong Tongbian Decoction combined with auricular acupressure on the prevention of opioid constipation

目的探究芪蓉通便汤联合耳穴贴压预防阿片性便秘的临床疗效及安全性。方法纳入120例初次服用盐酸羟考酮缓释片(奥施康定)的中重度癌性疼痛患者,采用随机数字表法均分为2组,对照组患者(60例)口服杜密克(乳果糖口服溶液)防治阿片性便秘,观察组患者(60例)给予芪蓉通便汤联合耳穴贴压防治阿片性便秘,比较2组患者服用奥施康定1周后阿片性便秘的发生率、2组便秘患者的治疗效果、治疗前后临床评分量表(CCS)评分、大便性状相关量表(BSFS)评分、便秘症状中医积分、血浆胃动素(MTL)、血管活性肠肽(VIP)、便秘患者生存质量(PAC-QOL)评分以及所有患者对本次防治方案的总满意率。结果经不同方案预防后,观察组患者阿片性便秘发生率(33.33%)低于对照组(58.33%),P<0.05;观察组便秘治疗总有效率(100.00%)高于对照组(77.14%),P<0.05;治疗前,2组阿片性便秘患者CCS评分、BSFS评分、便秘症状中医积分、PAC-QOL评分、MTL及VIP水平比较差异无统计学意义(P>0.05);治疗后各组患者CCS评分、BSFS评分、便秘症状中医积分、PAC-QOL评分、MTL及VIP水平均改善,且观察组优于对照组(P<0.05);观察组患者总满意率(96.67%)高于对照组(85.00%),P<0.05。结论芪蓉通便汤联合耳穴贴压可有效预防阿片性便秘,且治疗效果显著,患者症状改善、恢复良好,患者满意率高。

Objective To explore the clinical efficacy and safety of Qirong Tongbian Decoction combined with auricular acupressure to prevent opioid constipation.Methods 120 patients with moderate to severe cancer pain who took Oxycodone Hydrochloride Sustained-release Tablets(OxyContin)for the first time were included,and were divided into 2 groups by using the random number table method.Patients in the control group(60 cases)were given Duphalac(lactulose oral solution)orally to prevent and treat opioid constipation,while patients in the observation group(60 cases)were given Qirong Tongbian Decoction combined with auricular acupressure to prevent and treat opioid constipation.The incidence of opioid constipation after 1 week treatment of OxyContin in the 2 groups of patients were compared.The treatment effect of the 2 groups of constipation patients,the clinical score scale(CCS)score before and after treatment,the stool characteristics related scale(BSFS)score,the TCM scores of constipation symptoms,plasma motilin(MTL),and vasoactive intestinal peptide(VIP),the quality of life of constipation patients(PAC-QOL)score and the satisfaction rate of all patients with this prevention and treatment plan were compared.Results After different treatments,the incidence of opioid constipation in the observation group(33.33%)was lower than that in the control group(58.33%),P<0.05;the effective rate of constipation treatment in the observation group(100.00%)was higher than that of the control group(77.14%),P<0.05;before treatment,there was no significant difference in CCS score,BSFS score,constipation symptom TCM score,PAC-QOL score,MTL and VIP levels between the 2 groups of opioid constipation patients(P>0.05);after treatment,the CCS score,BSFS score,constipation symptom TCM score,PAC-QOL score,MTL and VIP level improved in each group,and the observation group was better than the control group(P<0.05);the satisfaction rate of the observation group(96.67%)was higher than that of the control group(85.00%),P<0.05.Conclusion Qirong Tongbian Decoction combined with auricular acupressure can effectively prevent opioid constipation,and the treatment effect is remarkable with patients′symptoms improving and recovering.