枳实消痞丸化裁方联合穴位贴敷治疗脾虚气滞型阿片类药物相关性便秘的临床效果  

Clinical effect of Zhishi Xiaopi Pills Huacai Prescription combined with acupoint application in the treatment of opioid-induced constipation of spleen deficiency and qi stagnation type

作　　者：毕俊芳[1] 王永欣 王冠军[1] 吕军辉 杨杰[1] 赵扬[1] BI Junfang;WANG Yongxin;WANG Guanjun;LYU Junhui;YANG Jie;ZHAO Yang(Department of Integrated Chinese and Western Medicine,Shijiazhuang Hospital of Traditional Chinese Medicine,Hebei Province,Shijiazhuang 050051,China;Department of Pharmacy,Beijing Tongrentang Shijiazhuang Hospital of Traditional Chinese Medicine,Hebei Province,Shijiazhuang 050051,China;Department of Nephrology,Jingxing County Hospital,Hebei Province,Jingxing 050300,China)

机构地区：[1]石家庄市中医院中西医结合科,河北石家庄050051 [2]北京同仁堂石家庄中医医院药剂科,河北石家庄050051 [3]河北省井陉县医院肾内科,河北井陉050300

出　　处：《中国医药导报》2024年第17期1-4,12,共5页China Medical Herald

基　　金：河北省中医药管理局科研计划项目(2021262)。

摘　　要：目的 探讨枳实消痞丸化裁方联合穴位贴敷治疗脾虚气滞型阿片类药物相关性便秘(OIC)的临床效果。方法 选取2022年2月至2023年2月石家庄市中医院住院的70例脾虚气滞型OIC患者,按照随机数字表法分为治疗组和对照组,各35例。治疗组予枳实消痞丸化裁方联合穴位贴敷治疗,对照组予乳果糖治疗。连续治疗2周。比较两组治疗前后便秘主要症状积分、中文版便秘患者生存质量自评量表(PAC-QOL)评分及血清胃肠激素[P物质(SP)、胃动素(MTL)、血管活性肠肽(VIP)]水平,评价其临床疗效。结果 治疗前,两组排便频率,排便费力,排便时间,腹胀,下坠、不尽及胀感,粪便性状积分比较,差异无统计学意义(P>0.05);治疗后,两组排便频率,排便费力,排便时间,腹胀,下坠、不尽及胀感,粪便性状积分低于治疗前,且治疗组低于对照组,差异有统计学意义(P<0.05)。治疗前,两组PAC-QOL量表中的生理、社会心理、担忧焦虑及满意度各项评分比较,差异无统计学意义(P>0.05);治疗后,两组PAC-QOL量表中的生理、社会心理、担忧焦虑及满意度各项评分均低于治疗前,且治疗组低于对照组,差异有统计学意义(P<0.05)。治疗前,两组VIP、MTL、SP水平比较,差异无统计学意义(P>0.05);治疗后,两组VIP水平低于治疗前,MTL、SP水平高于治疗前,且治疗组VIP水平低于对照组,MTL、SP水平高于对照组,差异有统计学意义(P<0.05)。治疗组临床疗效优于对照组,差异有统计学意义(P<0.05)。结论 枳实消痞丸化裁方联合穴位贴敷能降低脾虚气滞型癌痛患者OIC的严重程度,提高生活质量,具有良好的临床疗效,考虑与其能调整胃肠激素水平具有相关性。Objective To investigate the clinical effect of Zhishi Xiaopi Pills Huacai Prescription combined with acupoint application in the treatment of opioid-induced constipation(OIC)of spleen deficiency and qi stagnation type.Methods Seventy patients with spleen deficiency and qi stagnation OIC hospitalized in Shijiazhuang Hospital of Traditional Chinese Medicine from February 2022 to February 2023 were selected and they were divided into treatment group and control group according to random number table method,with 35 cases in each group.The treatment group was treated with Zhishi Xiaopi Pills Huacai Prescription combined with acupoint application,and the control group was treated with Lactulose.Continuous treatment for two weeks.The scores of major constipation symptoms,the Chinese version of patient assessment of constipation quality of life(PAC-QOL)scores and the levels of serum gastrointestinal hormones(substance P[SP],motilin[MTL],vasoactive intestinal peptide[VIP])before and after treatment were compared between the two groups,and the clinical efficacy was evaluated.Results Before treatment,there were no significant differences in the frequency of defecation,defecation effort,defecation time,abdominal distension,fall,fullness and feeling of distension,and fecal traits scores between the two groups(P>0.05).After treatment,the scores of defecation frequency,defecation effort,defecation time,abdominal distension,fall,fullness and feeling of distension,and fecal traits of the two groups were lower than before treatment,and those in the treatment group were lower than those in the control group,and the differences were statistically significant(P<0.05).Before treatment,there were no statistical significances in the scores of physiological,social psychological,worry and anxiety and satisfaction in PAC-QOL scale between the two groups(P>0.05).After treatment,the scores of physiological,social psychological,worry and anxiety and satisfaction in PAC-QOL scale of two groups were lower than before treatment,and those in the

关 键 词：枳实消痞丸 穴位贴敷 癌痛 阿片类药物相关性便秘 

分 类 号：R574.4[医药卫生—消化系统]