摘要
现今,阿片类药物是中度及重度非癌性疼痛治疗中使用频率最高的药物,它在有效控制疼痛的同时,也给患者带来便秘、恶心呕吐、肌肉痉挛、耐药等不良反应,其中最主要的不良反应为便秘,临床上将此类型的便秘称为阿片类药物相关性便秘(opioidinduced constipation,OIC)。OIC给患者带来的抑郁情绪比疼痛本身更难以忍受,严重影响患者的生存质量,有些患者宁愿遭受疼痛,也不接受长期使用阿片类药物带来的便秘,给临床医师的工作带来了新的挑战。本文将就阿片类药物对消化道的作用及不同消化器官对阿片类药物的耐药机制,OIC临床表现、诊断及诊断障碍,OIC治疗新进展,临床指导作一概述。
Recently, opioids come to be the most frequently used analgesic for moderate to severe noncancer pain. While opioids can control pain effectively, they had adverse reactions such as constipaton, nausea, vomiting, muscle spasm, drug resistance and so on. The most common adverse reaction is constipation which is called opioid-induced constipation （ OIC）. OIC often takes patients more depression than pain, and a serious impact on quality of life. Some pa- tients prefer to pain rather than suffering from OIC. With the widespread availability of opioids, OIC takes physicians more challenges. This review addressed the effects of opioids for gastrointestinal tract and the resistance mechanism of opioids for different digestive organs, the clinical manifestation, diagnosis, barriers to diagnosis of OIC, and the development and clinical guidance for the treatment of OIC.
出处
《胃肠病学和肝病学杂志》
CAS
2017年第3期352-355,共4页
Chinese Journal of Gastroenterology and Hepatology
关键词
阿片类药物
便秘
阿片受体拮抗剂
耐药机制
Opioid
Constipation
Opioid receptor antagonist
Resistance mechanism
