戒毒人员便秘处方专家共识(2021年)  

Expert consensus on constipation prescription for drug abusers(2021)

作　　者：中华医学会消化病学分会胃肠功能性疾病协作组 国家卫生健康委员会毒品依赖和戒治重点实验室 云南省消化病研究所 王昆华[2] 侯晓华[3] 缪应雷[4] 缪佳蓉[4] 张弢[4] 张伦嘉 朱云珍 唐君瑞[4] 石梦琳 Study Group of Functional Gastrointestinal Disorders,Chinese Society of Gastroenterology,Chinese Medical Association;Key Laboratory of Drug Dependence and Treatment of National Health Commission;Yunnan Institute of Digestive Diseases;Wang Kunhua;Hou Xiaohua(不详;Key Laboratory of Drug Dependence and Treatment of National Health Commission,Office of The First Affiliated Hospital of Kunming Medical University 650032;Department of Gastroenterology,Union Hospital Affiliated to Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430022)

机构地区：[1]不详 [2]国家卫生健康委员会毒品依赖和戒治重点实验室,昆明医科大学第一附属医院院办,650032 [3]华中科技大学同济医学院附属协和医院消化内科,武汉430022 [4]昆明医科大学第一附属医院消化内科

出　　处：《中华消化杂志》2021年第7期446-453,共8页Chinese Journal of Digestion

摘　　要：海洛因、鸦片等毒品和美沙酮等脱毒药物属于阿片类,可抑制中枢神经系统,阻止排便反射的下传和肠道平滑肌的运动,使肠管蠕动不协调而导致便秘,加之吸毒者普遍存在焦虑、抑郁、睡眠障碍等不良精神因素,且生活习惯不规律,蔬菜、水果类补充不足等促使便秘发生。因此,吸毒者便秘的发生率远高于普通人群。很多戒毒人员在戒毒期间存在严重的戒断反应和心理依赖,同时,他们还要承受便秘带来的痛苦。为此,必须对戒毒人员的便秘进行综合治疗。国内相关专家坚持先进性、科学性、实用性和循证医学证据的原则,经多次研讨后,就戒毒人员便秘的流行病学、病因、发病机制、诊断和治疗达成共识,并针对戒毒人员的便秘提出治疗建议,包括非药物治疗如调整生活方式、精神心理治疗等,药物治疗如促胃肠动力药、各类泻剂、微生态制剂的应用等,以规范戒毒人员便秘的诊治,供戒毒相关管理人员、医师等在戒毒工作中参考应用。Drugs such as heroin,opium and detoxification drugs such as methadone are classified as opioids,which can inhibit the central nervous system,prevent the downward transmission of defecation reflex and the movement of intestinal smooth muscle cause uncoordinated peristalsis of intestine and finally lead to constipation.In addition,drug abusers generally have unhealthy mental factors such as anxiety,depression,sleep disorders and poor lifestyles as well as insufficient supplementation of vegetables and fruits,which contribute to constipation.Therefore,the incidence of constipation among drug addicts is much higher than that of the general population.Many drug addicts have severe withdrawal reaction and psychological dependence during detoxification and constipation is even worse.So,the constipation of drug addicts must be comprehensively treated.Domestic experts adhered to the principles of advanced,scientific,practical,and evidence-based medicine and have reached a consensus on the epidemiology,etiology and pathogenesis,diagnosis and treatment of constipation in drug addicts after many discussions.And formulate treatment prescriptions for constipation of drug addicts including non-drug treatment such as lifestyle adjustment,psychotherapy,drug treatment including gastrointestinal motility drugs,laxatives,microbial ecological agents,and so on.In order to standardize the diagnosis and treatment of drug addicts'constipation.This expert consensus can provide reference for drug addicts'management and doctors.

关 键 词：戒毒人员 便秘处方 共识 治疗 

分 类 号：R574.62[医药卫生—消化系统] R749.64[医药卫生—内科学]