温阳通下法在癌痛患者阿片类药物相关性便秘治疗中的应用  

Effects of Method of Warming Yang and Dredging Intestines on Opioid-Related Constipation of Patients with Cancer Pain

作　　者：马永剑[1] 姜玥[1] 侯莉娟[1] 

机构地区：[1]宁夏回族自治区人民医院,宁夏银川750002

出　　处：《河南中医》2017年第8期1491-1496,共6页Henan Traditional Chinese Medicine

摘　　要：阿片类药物相关性便秘以本虚标实为显著特点,表现为阴阳失调,虚实夹杂,寒热错杂,燥湿相混,脏气亏虚与痰浊、水湿、饮、瘀、六淫之邪相互胶结并存等正虚(毒)邪结的复杂情形。泻下通便法是中医药治疗OIC的主要方法之一,临床报道采用寒下及润下法较多,而温下法常被忽视,然而结合癌症、癌痛基本病因病机,从内因与外因关系,对OIC中医病因病机进行辨证分析,阳虚寒凝,阴结便秘亦是其常见证型,采用温阳通下法治疗此型OIC,得到理论与临床实践支持,同时应用温阳通下方,进行恰当的药物配伍,对于缓解癌痛等癌症相关症状亦有很好疗效,有益于控制甚至减少阿片类药物用量。Opioid-related constipation （OIC） is marked by deficient root and excess superficialities, manifesting as imbalance between yin and yang, intermingling of deficiency and excess, cold and heat, dampness and dryness as well as the complicated conditions of visceral qi deficiency intermingling with phlegm turbidity, water dampness, water retention, blood stasis, six climatic exogenous pathogens. Method of purging and promoting defecation is one of the main methods to treat OIC in TCM. It is reported that methods of cold purging and moist purging are commonly applied in clinic, but the method of warm purging is always neglected. Combined with the basic etiology and pathogenesis of cancer and cancer pain and from the relation between internal causes and external causes, the syndrome differentiation was made and the etiology and pathogenesis of OIC was analyzed, which showed that the syndromes of yang deficiency and cold co,agulation, constipation due to yin stagnation are the commonly-seen syndromes. The method of warming yang and dredging intestines has theoretical and clinical support for the treatment of OIC. Simultaneously, Yang-Warming and Intestine-Dredging Prescription with proper drug compatibility has excellent therapeutic effects on relieving cancer pain or other relevant symptoms of cancer. It also helps control the dosage of opioid.

关 键 词：便秘 癌痛患者 阿片类 温阳通下法 

分 类 号：R256.35[医药卫生—中医内科学]