灌肠通便方联合乳果糖治疗阿片类药物相关性便秘的临床疗效  

Clinical efficacy of enema laxative prescription combined with lactulose in the treatment of opioid-related constipation

作　　者：叶青槐 任立虹 YE Qinghuai;REN Lihong(Department of Pharmacy,Chun′an County Hospital of Traditional Chinese Medicine,Chun'an 311700,CHINA)

机构地区：[1]淳安县中医院药剂科,浙江311700 [2]淳安县第一人民医院药剂科

出　　处：《江苏医药》2025年第3期259-263,共5页Jiangsu Medical Journal

基　　金：杭州市医药卫生科技项目(B20231810)。

摘　　要：目的观察灌肠通便方联合乳果糖治疗阿片类药物相关性便秘的临床疗效。方法阿片类药物相关性便秘患者60例随机分为两组,每组30例。A组给予灌肠通便方150mL灌肠,每日1次,联合乳果糖15mL口服,每日2次;B组给予开塞露20mL灌肠,每日1次,联合乳果糖15mL口服,每日2次。两组均治疗1个月。使用便秘患者症状自评量表(PAC-SYM)、便秘患者生活质量自评量表(PAC-QOL)和便秘症状评分量表评估两组治疗前后便秘情况,比较两组肠鸣音恢复时间和排便恢复时间,观察两组不良反应和治疗后3个月内复发情况。结果两组治疗后PAC-SYM、PAC-QOL及便秘症状评分量表评分均低于治疗前(P<0.05),且A组治疗后PAC-SYM、PAC-QOL及便秘症状评分量表评分低于B组(P<0.05)。A组肠鸣音恢复时间和排便恢复时间短于B组(P<0.05)。A组复发率低于B组(P<0.05)。两组不良反应发生率相仿(P>0.05)。结论对于阿片类药物相关性便秘患者,灌肠通便方联合乳果糖较开塞露联合乳果糖治疗效果更好。Objective To observe the clinical efficacy of enema laxative prescription combined with lactulose in the treatment of opioid-related constipation.Methods Sixty patients with opioid-related constipation were randomly divided into two groups with 30 cases each.Group A was treated with enema laxative prescription 150 mL in enema way once per day,which was combined with lactulose 15 mL orally twice per day.Group B was treated with glycerin enema 20mL in enema way once per day,which was combined with lactulose 15 mL orally twice per day.The treatment lasted for one month.The constipation situation before and after treatment was evaluated by patient assessment of constipation symptom(PAC-SYM),patient assessment of constipation quality of life(PAC-QOL)and constipation symptom score scale.The recovery time of bowel sound and defecation of two groups were compared.The adverse reactions and recurrence within three months were observed.Results The scores of PAC-SYM,PAC-QOL and constipation symptom score scale in both groups were lower after treatment than those before treatment(P<0.05).The scores of PAC-SYM,PAC-QOL and constipation symptom score scale in group A were lower than those in group B after treatment(P<0.05).The recovery times of bowel sound and defecation in group A were shorter than those in group B(P<0.05).The recurrence rate of group A was lower than that of group B(P<0.05).The incidence of adverse reactions of two groups was similar(P>0.05).Conclusion In the patients with opioid-related constipation,the efficacy of enema laxative prescription combined with lactulose is better than glycerin enema combined with lactulose.

关 键 词：灌肠通便方 乳果糖 阿片类药物 便秘 

分 类 号：R256[医药卫生—中医内科学]