“寓通于补”论治食管癌术后吗啡制剂所致便秘  

Discussion on the treatment of constipation caused by morphine preparation after esophageal cancer surgery based on the theory of unobstructed flow is embodied in the act of nourishing

作　　者：刘新兰 吴乾 吴汶霖[1] 高天启 LIU Xinlan

机构地区：[1]山西中医药大学,山西太原030024 [2]山西省肿瘤医院,山西太原030013

出　　处：《中医临床研究》2025年第1期56-61,共6页Clinical Journal Of Chinese Medicine

基　　金：中成药治疗吗啡制剂所致便秘的临床研究(2012Y04)。

摘　　要：本研究聚焦于食管癌术后患者因使用吗啡类制剂镇痛而普遍面临的便秘问题。食管癌术后疼痛管理常需要依赖吗啡等强效镇痛药物,但其不良反应便秘严重影响患者的生活质量及康复进程。吗啡制剂所致便秘复杂程度远大于普通便秘,单纯依赖西医治疗的效果有限,而中医在个体化治疗便秘方面展现出显著疗效及低不良反应优势。本研究结合食管癌手术的中医化属性、深入分析术后长期使用吗啡制剂镇痛所致便秘的临床表现等,基于“寓通于补”理论探讨食管癌术后吗啡制剂所致便秘的病因、病机及治疗,通过中医调和气血、补益正气与通导大便并重的治疗方法验证“寓通于补”理念改善食管癌术后吗啡制剂所致便秘症状的有效性及安全性,以期为临床提供新的思路与实证依据,从而优化治疗方案,提升治疗效果。This study focuses on the common constipation problem faced by postoperative patients with esophageal cancer due to the use of morphine-based analgesics for analgesic treatment.Postoperative pain management for esophageal cancer often requires the use of strong analgesic drugs such as morphine as adjuvant therapy,but its adverse reactions such as constipation seriously affect the patient’s quality of life and rehabilitation process.Morphine induced constipation is much more complex than ordinary constipation,and the effectiveness of relying solely on Western laxatives for treatment is particularly limited.Traditional Chinese medicine has shown significant efficacy and fewer adverse reactions in individualized treatment of constipation.Therefore,this article combines the traditional Chinese medicine attributes of esophageal cancer surgery,deeply analyzes the clinical manifestations of constipation caused by long-term use of morphine preparations for pain relief after surgery,and explores the etiology,pathogenesis,and treatment of constipation caused by morphine preparations after esophageal cancer surgery based on the theory of unobstructed flow is embodied in the act of nourishing.This article also verifies the effectiveness and safety of the concept of unobstructed flow is embodied in the act of nourishing in ameliorating the symptoms of patients with morphine induced constipation after esophageal cancer surgery through the treatment method of harmonizing Qi(气)and blood,tonifying vital Qi and dredging defecation in traditional Chinese medicine,to provide new ideas and basis for clinical practice,so as to optimize the treatment plan and improve the treatment effect.

关 键 词：补益 食管癌手术 吗啡制剂 便秘 术后管理 

分 类 号：R735.1[医药卫生—肿瘤]