白术和胃方治疗阿片相关性便秘的疗效观察及对IL-6、TRPV1的影响  

Clinical Observation on Effect of Baizhu Hewei Decoction(白术和胃方)in Treatment of Opioid Induced Constipation and Effects on TRPV1 and IL-6

作　　者：陶智会[1] 仝欣[1] 徐蔚杰[2] 周之毅[2] 靳永杰 李敏[1] 于小伟[1] TAO Zhihui;TONG Xin;XU Weijie;ZHOU Zhiyi;JIN Yongjie;LI Min;YU Xiaowei(Department of Oncology,Jiading District Hospital of Chinese Medicine,Shanghai 201899;Department of Oncology,Longhua Hospital Affiliated to Shanghai University of Chinese Medicine,Shanghai 20003)

机构地区：[1]上海市嘉定区中医医院肿瘤科,上海201899 [2]上海中医药大学附属龙华医院肿瘤科,上海200003

出　　处：《中国中医药科技》2021年第2期187-191,共5页Chinese Journal of Traditional Medical Science and Technology

基　　金：上海市杏林新星培养计划[ZY(2018-2020)-RCPY-3026];上海市嘉定区卫生和计划生育委员会中医药科研项目(2017-QN-ZYY-001);上海市卫生和计划生育委员会上海市中医药发展办公室中医优势病种培育项目(zybz-2017054)。

摘　　要：目的:观察白术和胃方治疗阿片类相关性便秘的临床疗效及对TRPV1(辣椒素受体)、IL-6(白介素-6)细胞因子的影响。方法:将72例阿片相关性便秘患者根据随机数字表分成两组,每组各36例,治疗组给予白术和胃方口服,对照组给予杜密克口服,治疗14 d后评价疗效;治疗前后观察患者的卡氏评分(KPS)、肠功能指数(BFI)、Bristol粪便性状评分(BSFS)、中医证候评分变化,并比较两组患者治疗前后血清TRPV1、IL-6水平。结果:治疗组总有效率为88.2%,显著高于对照组65.7%(P<0.05)。治疗后两组患者BFI评分较治疗前降低,Bristol粪便性状评分升高,生活质量KPS评分有一定程度的改善,治疗组上述变化更明显(P<0.05);治疗后,两组症状均有改善,治疗组症状及中医证候总积分减少较对照组更明显(P<0.05);治疗后,两组患者血清TRPV1、IL6水平上均有下降,治疗组下降更显著(P<0.05)。结论:白术和胃方治疗阿片相关性便秘疗效显著,并能改善患者脾虚津亏证的临床症状,降低相关血清细胞因子水平,显著提高生存质量。Objective:To evaluate the clinical efficacy of Baizhu Hewei Decoction in the treatment of opioid induced constipation and its effects on TRPV1(capsaicin receptor),and IL-6(interleukin-6).Methods:72 patients with opioid induced constipation were divided into two groups according to the random number table,36 cases in each group.The treatment group was given Baizhu Hewei Decoction,the control group was given dumike.After 14 days of treatment,the curative effect was evaluated,the changes of KPS,BFI,BSFS and TCM syndrome score were observed before and after treatment,serumTRPV1and IL-6 were determined before and after treatment.Results:The total effective rate of treatment group was 88.2%,that was better than that of control group,that was 65.7%(P<0.05).After treatment,BFI of the two groups was lowered,BSFS and KPS score were raised significantly,all changes in the treatment group were much more significant than those in control group(P<0.05).The serum TRPV1and IL-6 levels were decreased in the two groups after treatment,they were lower in the treatment group than those of control group(P<0.05).Conclusion:Baizhu Hewei Decoction can effectively treated opioid induced constipation,improve the clinical symptoms of spleen deficiency and fluid impairment syndrome,reduce the level of serum cytokines,and improve the quality of life of patients.

关 键 词：阿片相关性便秘 白术和胃方 脾虚津亏 辣椒素受体 白介素-6 

分 类 号：R256.35[医药卫生—中医内科学]