摘要
目的观察益气养阴法治疗阿片类药物相关性便秘的疗效,并探索其可能的作用机制。方法选择2018年1-12月作者所在医院治疗的Ⅲa期、Ⅲb期肝癌患者60例,均合并阿片类药物相关性便秘(OIC)。采用分层随机抽样方法将患者分为观察组与对照组各30例,另设30例无便秘患者为空白组。2组均给予肝动脉化疗栓术+羟考酮缓释片止痛作为基础治疗。对照组除基础治疗外加乳果糖口服液10 mL/次口服,每日3次。观察组除基础治疗外加口服益气养阴中药治疗。2组疗程均为4周。比较2组疗效,治疗前后肠功能指数(BFI)评分、盆底肌电参数及血清β抑制蛋白2(β-arrestin2)及水通道蛋白(AQPs)水平,统计2组治疗期间发生的不良反应。结果观察组总有效率73.3%,对照组为46.7%,差异有统计学意义(P<0.05)。观察组治疗后快速收缩最大波幅升高,持续收缩变异系数及耐久收缩变异系数均下降(均P<0.05);前基线波幅及后基线波幅比较,差异无统计学意义(P>0.05)。治疗前与空白组比较,观察组、对照组血清β-arrestin2、AQP3、AQP4、AQP8表达均升高(P<0.05),AQP2表达下降(P<0.05);治疗后,观察组血清β-arrestin2、AQP3、AQP4、AQP8表达均下降(P<0.05),AQP2表达升高(P<0.05),而对照组差异均无统计学意义(P>0.05)。结论益气养阴法能改善OIC患者临床症状、增强盆底肌肌力,提高盆底肌群的运动协调性,其作用机制可能与调节β-arrestin2及AQPs的表达有关。
Objective To observe the curative effect of opioid-induced-constipation(OIC)with the method of tonifying Qi and nourishing Yin,and explore its possible mechanism.Methods 60 cases of patients with stage Ⅲ a and Ⅲbliver cancer treated from January to December 2018 who were all complicated with OIC were divided into observation group and control group of 30 cases in each group with stratified random sampling method.Both groups were given transcatheter arterial chemoembolization and oxycodone for pain relief as the basic treatment.The control group was also given lactulose oral liquid 10 mL/time and 3 times a day.While the observation group was also treated with Chinese herbal medicines for tonifying Qi and Yin.The course of treatment were both 4 weeks.The improvement of clinical symptoms,BFI,pelvic floor electromyography and the expression of serum β-arrestin2 and related AQPs were observed and the the adverse reactions during the treatment were collected.Results 1.The effective rate of the observation group and the control group were 73. 3% 和 46. 7% respectively,BFI was lowered in both groups,the observation group improved more significantly(all P<0. 05);2. After treatment,the maximum amplitude of rapid contraction in the observation group was increased,while the coefficient of variation of sustained contraction and the coefficient of variation of durable contraction decreased(all P<0.05). There was no significant difference between the amplitude of the front baseline and the amplitude of the rear baseline(P>0.05). 3. Compared with the blank group before treatment,β-arrestin2 and serum AQP3,AQP4 and AQP8 in the patient ’s serum were significantly improved,and AQP2 reduced in the observation group(P<0. 05). After treatment,the expressions of serumβ-arrestin2,AQP3,AQP4 and AQP8 of the observation group decreased(P<0. 05),and the expression of AQP2 increased(P<0. 05),while there was no significant difference in the indexes in the control group(P>0. 05). Conclusion The method of tonifying Qi and nourishing Y
作者
叶旭星
马双双
方燕妮
YE Xu-xing;MA Shuang-shuang;FANG Yan-ni(Traditional Chinese Medicine Center of Jinhua Central Hospital,Jinhua 321000,China)
出处
《北京中医药》
2020年第4期316-320,共5页
Beijing Journal of Traditional Chinese Medicine
基金
金华市中医药科技项目(2017jzk04)。
关键词
便秘
益气养阴
阿片类药物
Constipation
tonifying Qi and nourishing Yin
opioid drugs
