疏肝降气润肠法治疗阿片类药物所致肠道气滞型便秘的疗效观察  

Clinical effect of soothing liver,lowering qi and moisturizing the intestines in the treatment of intestinal qi stag⁃nation constipation caused by opioids

作　　者：柳冬兵 刘加新[1] 黎钢[1] 夏国杰[1] LIU Dongbing;LIU Jiaxin;LI Gang(Department of Oncology and Gastroenterology,Huzhou Hospital of Traditional Chinese Medicine Affiliated to Zhejiang University of Traditional Chinese Medicine,Huzhou 313000,China)

机构地区：[1]浙江中医药大学附属湖州市中医院肿瘤消化科,浙江湖州313000

出　　处：《全科医学临床与教育》2022年第4期325-328,共4页Clinical Education of General Practice

基　　金：浙江省中医药科技计划项目(2020ZB245)。

摘　　要：目的观察疏肝降气润肠法治疗阿片类药物所致肠道气滞型便秘的临床疗效。方法选择60例因癌痛服用阿片类药物止痛后出现便秘的患者,按照随机数字表法分为治疗组和对照组,每组各30例。对照组予乳果糖口服,治疗组予四逆散合苏子降气汤加减方口服,两组疗程均为28 d。比较两组患者便秘症状、伴随症状及便秘患者生活质量量表(PAC-QOL)评分改善情况。结果治疗组总有效率90.00%,对照组总有效率76.67%,治疗组总有效率高于对照组,差异有统计学意义(χ^(2)=-2.71,P<0.05);治疗组在改善排便困难程度、腹胀、纳差、嗳气、烦躁或抑郁方面均优于对照组,差异均有统计学意义(t分别=-2.38、-2.16、-3.42、-3.03、-3.13,P均<0.05);治疗组在降低PAC-QOL量表总积分方面优于对照组,差异有统计学意义(t=-4.24,P<0.05)。结论疏肝降气润肠法,以四逆散合苏子降气汤加减方治疗阿片类药物所致肠道气滞型便秘临床效果显著,可有效改善便秘症状,减轻伴随症状,提高患者生活质量。Objective To observe the clinical effect of soothing liver,lowering qi and moisturizing the intestines in treating intestinal qi stagnation constipation caused by opioids.Methods A total of 60 patients with constipation after taking opioids for cancer pain were selected and divided into treatment group and control group according to the random number table,with 30 cases in each group.The control group was given oral lactulose,and the treatment group was given Sini San and Suzi Jiangqi decoction.Treatment course of both groups was 28 days.The constipation symptoms,accompanying symptoms and the improvement of the patient-assessment of constipation quality of life(PAC-QOL)score were compared between the two groups.Results The total effective rate of the treatment group was 90.00%,and the control group was 76.67%.The total effective rate of the treatment group was higher than that of the control group,the difference was statistically significant(χ^(2)=-2.71,P<0.05).The degree of defecation difficulty,abdominal distension,anorexia,belching,irritability or depression in the treatment group were better than the control group(t=-2.38,-2.16,-3.42,-3.03,-3.13,P<0.05).In reducing the total score of PAC-QOL scale,the treatment group was better than the control group,and the difference was statistically significant(t=-4.24,P<0.05).Conclusion The method of soothing liver,lowering qi and moisturizing the intestines has a significant clinical effect in the treatment of intestinal qi stagnation constipation caused by opioids,which can effectively improve the symptoms of constipation,alleviate the accompanying symptoms,and improve the life of patients quality.

关 键 词：疏肝降气润肠 阿片类药物 便秘 肠道气滞 临床疗效 

分 类 号：R256.35[医药卫生—中医内科学]