The Clinical Study Of HSM In Treating Opioid-Induced Constipation

Opioid-induced Constipation is one of the most common use of strong opioids after adverse reactions in patients analgesic effect, increase the patient painful emotions. Opioid-induced constipation oncologist has become an urgent problem. This article summarizes the TCM etiology and mechanism of Chinese and Western medicine that cancer patients causing constipation after use of opioid analgesic therapy. Put forward the new method of acupoints heat-sensitive moxibustion therapy (referred to as HSM) as a treatment for This paper system compiled TCM treatment of opioid-related constipation literature, found less adverse reactions to this type of constipation, and relative to the western medicine, traditional Chinese medicine has accumulated more rich experience in the treatment, and the clinical effect is more ideal. Moxibustion is commonly used in traditional Chinese medicine in clinical treatment, heat-sensitive moxibustion as a new type of moxibustion that constipation disease for its advantage,and patients can fell safety and comfort. In this study, heat-sensitive moxibustion therapy and oral phenolphthalein tablets as a control to observe the clinical effect of heat-sensitive moxibustion treatment of opioid-induced constipation.ObjectiveObserve the cancer patients that use heat-sensitive moxibustion therapy in the treatment of Opioid-induced Constipation effect and its influence on quality of life.MethodBy the method of randomized controlled trials and incorporate the guangzhou hospital of traditional Chinese medicine conforms to the standard of cases of 70 cases randomly divided into treatment group and control group, two groups of cases,35 cases each. Treatment group with thermal moxibustion therapy, the control group to give oral phenolphthalein tablet treatment. Observation time of 3 cycles (a total of 15 days), including 2 treatment cycle, stop treatment 1 cycle, after treatment, respectively, after 1 cycle,2 cycles and stop treatment 1 cycle, record the symptoms and to improve the quality of life of patients with constipation, and carries on the statistical processing, draw the conclusion.Result1. Longitudinal comparison:The two groups before and after treatment itself control study, by the repeated measurement anova to compare two groups of different measuring time difference, the results indicate:the treatment group:(T)compared with before treatment, the treatment group and the treatment after 1 cycle, after 2 cycles and stop treating constipation symptoms improved significantly after 1 cycle (P<0.05); ヽompared with before treatment, the treatment group to compare the quality of life improved after treatment 1 cycle is not obvious (P>0.05), treatment 2 and stop treatment after 1 cycle after cycle life quality improved significantly(P <0.05); Control group: ヽompared with before treatment, the control group after treatment 1, treatment 2 cycle after cycle and stop treating constipation symptoms improved significantly after 1 cycle (P<0.05); (2) compared with before treatment, the control group after treatment 1, treatment 2 cycle after cycle and stop treatment after 1 cycle to compare the quality of life were not significantly improved (P>0.05).2. Inter-group:each group by Bonferroni test showed that the effect of constipation score and quality of life scores were significantly different (P<0.05) between the treatment group and control groups. Different time points the treatment group and the control group constipation scores were compared, the treatment group showed no significant difference (P>0.05) results and the control group before treatment and one period after constipation score, but after 2 cycles of treatment and stop treating one cycle after constipation scores have significant difference (P<0.05), the treatment group than the control group; different time points the treatment group and the quality of life of the control group scores were compared, the results of the treatment group and the control group therapy and treatment There was no quality of life scores after one cycle of a significant difference (P>0.05), quality of life scores have significant difference (P< 0.05) in 2 cycles of treatment and after cessation of treatment 1 cycle, the treatment group than the control group.3. The comparison of constipation symptoms scale and quality of life individual:treatment group: ①Constipation scale single score, compared with before treatment, the treatment group treats in the back that the frequencey of bowel movements, feel not defecate row two aspects were no significant improvement (P>0.05), defecate fell difficult, abdominal pain, the time require for every time move bowels, the type of need to defecate, every day the number of bowel movements is not successful 5 aspects were significantly improved (P<0.05);②Single score of quality of life scale, compared with before treatment, stop treatment after 1 cycle individual daily life there was no significant difference (P>0.05), mental status, fatigue, loss of appetite, sleep score four were improved significantly{P <0.05); Single score in the control group:①Feel not defecate row, abdominal pain, the time require for every time move bowels, every day the number of bowel movements is not successful four aspects were not significantly improved (P>0.05), Frequenceyof bowel movements, defecate fell difficult, the type of need to defecate two aspcets were improved significantly (P<0.05). ②Single score of quality of life scale, compared with before treatment, the control group to stop treatment after 1 cycle individual daily life, mental status, fatigue, loss of appetite, sleep score 5 no obviously improved(P<0.05). Above, results show that thermal moxibustion therapy on patients with feel not defecate row, abdominal pain, the time require for every time move bowels, the type of need to defecate, every day the number of bowel movements is not successful that can improve these five aspects, the mental state, fatigue, loss of appetite,sleep four aspect were improve;Oral phenolphthalein tablet could improve the frequenceyof bowel movements, defecate fell difficult, the type of need to defecate three aspcets, the five aspects of individual symptoms of the quality of life for patients were not significantly improved.4. Efficient treatment:the treatment group 35 cases, control group 35 cases. Stop after 1 cycle of treatment, the treatment group recovered in 7 cases,15 cases were markedly effective,8 cases effectively, invalid in 5 cases, total effective rate was 85.8%; The control group 35 cases,2 cases cured,10 cases had marked effect,13 cases effectively,10 cases of invalid, total effective rate was 71.4%.Conclusion1. The heat-sensitive moxibustion treatment can effectively improve the patients because of opioid-induced constipation.2. Both Heat-sensitive moxibustion and phenolphthalein tablet and can improve the symptoms of constipation, but the Heat-sensitive moxibustion is more efficient than the later.3. Heat-sensitive moxibustion treatment can significantly improve the life quality of cancer patients.