中药穴位贴敷联合新斯的明穴位注射预防阿片类药物相关性便秘的疗效观察

摘要

目的 观察大黄穴位贴敷神阙穴联合新斯的明足三里穴位注射治疗阿片类药物相关性便秘的临床疗效.方法 2015年11月至2016年12月口服盐酸羟考酮缓释片控制疼痛的肿瘤患者95例,随机分为2组,观察组48例,对照组47例.两组均常规治疗,对照组采用大黄外敷神阙穴;观察组采用大黄外敷神阙穴配合足三里穴位注射新斯的明1mg,连续治疗2周.两组患者均参照中药新药治疗便秘的临床研究指导原则的疗效评价标准评价,比较两组患者治疗便秘的有效率.结果 对照组治愈15例、显效10例、有效5例、无效17例,临床有效率63.83％.观察组治愈30例、显效8例、有效5例、无效5例,临床有效率89.58％.两组比较差异有统计学意义(P<0.05).治疗期间观察组2例患者发生腹泻,予以停用及调整剂量后好转;无皮肤过敏反应.结论 大黄贴敷神阙穴配合足三里穴位注射新斯的明治疗阿片类止痛药物相关性便秘优于单纯大黄穴位贴敷,能更有效缩短患者促排便时间,缓解腹胀.%Objectives The objective of this study was to determineTo observe the clinical effect of rhubarb acupoint Shenque acupoint combined with neostigmine Zusanli acupoint injection for the treatment of opioid dependence constipation if patients suffered from Opioid correlation constipation could relieve by Shenque acupoint application with rhubarb combined and tsusanli acupuncture point injection with neostigmine. Methods All 95 patients treated with oral hydroxyketone hydrochloride tablets to relieve cancer pain were selected between November 2015 and December 2016,and then divided into two groups randomly: observation group (48 patients) and control group (47 patients). The control group received Shenque acupoint application with rhubarb,and the observation group received Shenque acupoint application with rhubarb and zusanli tsusanli acupuncture point injection with neostigmine 1 mg at the same time. The both groups had a course of two weeks. The principal of clinical research on the treatment of constipation of Chinese traditional medicine was used to evaluate all patients and compare the efficiency between two groups were compared. Results In the control group,15 patients cured,10 patients relieved obviously,5 patients relieved a little and 17 patients had no improvement,and the clinical efficiency was 63.88％. In the observation group,30 patients cured,8 patients relieved obviously,5 patients relieved a little and 5 patients had no improvement,and the clinical efficiency was 89.58％. The P value between two groups was <0.05. During the treatment,2 patients from observation group occurred diarrhea, then the treatment stopped. No cutaneous anaphylaxis occurred. Conclusion Compared with only Shenque acupoint application with rhubarb,combination Shenque acupoint application with rhubarb and tsusanli point injection with neostigmine has had better clinical efficiency in terms of opioid correlation constipation,and has had a shorter time to defecation defacation so that relieves relieved abdominal distension.