升降散对癌痛患者阿片类药物相关性便秘的预防作用  

Clinical Study on The Preventive Effect of Shengjiang Powder on Opioid-induced Constipation in Patients with Cancer Pain

作　　者：何生奇[1] 金金 林南星[1] 芦殿荣[1] HE Sheng-qi;JIN Jin;LIN Nan-xing;LU Dian-rong(Wangjing Hospital,China Academy of Chinese Medical Sciences,Beijing 100102,China;Graduate School,Chinese Academy of Chinese Medieal Sciences,Beijing 100700,China)

机构地区：[1]中国中医科学院望京医院肿瘤科,北京100102 [2]中国中医科学院研究生院,北京100700

出　　处：《中国中医基础医学杂志》2020年第5期648-650,700,共4页JOURNAL OF BASIC CHINESE MEDICINE

基　　金：中国中医科学院望京医院院级科研课题(WJYY2016-ZD-010)-经方升降散缓解癌痛患者阿片相关性便秘-恶心的临床评价。

摘　　要：目的:观察升降散对癌痛患者阿片类药物相关性便秘的预防作用。方法:筛选重度癌痛患者66例,采用随机数字表法分为2组各33例,2组均给予强阿片类药物奥施康定止痛,试验组同时给予中药升降散颗粒剂(僵蚕6g,蝉蜕6g,姜黄9g,大黄9g)预防便秘,连续观察2周。比较2组患者轻度、中度、重度便秘发生次数,以及2组患者大便PAC-QOL评分、排便间隔时间和生活质量KPS评分,并检测受试患者肝肾功能。结果:试验组在排便间隔时间、大便PAC-QOL评分等指标方面明显优于对照组,在轻中重度便秘发生次数上,经2个独立样本比较的Wilcoxon秩和检验,试验组与对照组比较差异有统计学意义。2组患者生活质量KPS评分比较,试验组也优于对照组,试验组治疗后肝肾功能未见明显异常。结论:中药升降散可以预防癌痛患者阿片类药物相关性便秘,可减轻癌症患者镇痛药引起的不良反应,有助于提高患者的生活质量。Objective:The objective of the present investigation was to explore the preventive effect of Shengjiang powder on opioid-induced constipation(OIC)in patients with cancer pain.Methods:Sixty-six patients with severe cancer pain were randomly divided into two groups by using the random number table method with 33 cases in each group.The patients in both of the two groups were given strong opioid OxyContin to relieve pain.The Traditional Chinese Medicine Shengjiang Powder granule(6 g of Bombyx Batryticatus,6 g of Cicada Slough,9 g of Turmeric and 9 g of Rhubarb)was also employed in the experimental group to prevent constipation at the same time for continuous observation for 2 weeks.The frequency of mild,moderate and severe constipation,Patient Assessment of Constipation-Quality of Life(PAC-QOL)score of patient defecation,defecation interval and quality of life score of Karnofsky(KPS)were compared between the two groups,and liver and renal functions of the subjects were measured.Results:The defecation interval,defecation PAC-QOL score and other indexes in the experimental group were better than that of the control group.In the frequency of mild,moderate and severe constipations,the Wilcoxon rank sum test of two independent samples demonstrated that there was significant difference between the experimental group and the control group.The quality of life of KPS score of the experimental group was better than that of the control group.No significant abnormality was found in the liver and renal functions after the treatment of the experimental group.Conclusion:The traditional Chinese Medicine Shengjiang Powder can prevent the OIC of the patients with cancer pain,relieve the adverse reaction caused by the analgesics of the cancer patients,and can help to improve the quality of life of the patients.

关 键 词：升降散 癌痛 阿片类药物相关性便秘 临床研究 

分 类 号：R256.35[医药卫生—中医内科学]