Study Of Shengjiang Decoction In Patients With Opioid-Induced Constipation And Cancer

Objective: To provide a basis for the treatment of OIC from the perspective of fire blocking Xuanfu,researchers aimed to study the efficacy and safety of Shengjiang decoction in patients with cancer and opioid-induced constipation(OIC).Material and methods: 84 subjects with cancer and opioid-induced constipation were collected at Hospital of Chengdu University of Traditional Chinese Medicine.According to the principle of randomization and control,84 OIC subjects who met the inclusion criteria were randomized to receive PEG alone(control group)or shengjiang decoction(study group).After enrollment,the previously used laxatives were discontinued,and the baseline was observed for 1 week.During the observation period,if there is no spontaneous bowel movement in 72 h,patients are allowed to use the rescue method(glycerine enema 60ml).After observation of baseline symptoms for 1 week,the control group took PEG 1 bag(10g)bid for 2weeks,while the study group took shengjiang decoction(turmeric 9g,rhubarb root and rhizome 9g,stiff silkworm 6g,cicada slough 6g)half a day during the same time.If there is no spontaneous bowel movement in 72 h,patients are allowed to use the rescue method(glycerine enema)at any time.Researchers record the general information of OIC subjects and access the number of spontaneous bowel movements,SBM response rates,Bristol stool form scales,constipation-related symptoms,upper gastrointestinal disorders-symptom severity index(PAGI-SYM)to evaluate effectiveness.Researchers also observe laboratory tests and vital signs before and after 2 weeks to access safety of the decoction.Results: During the study,2 subjects withdrew from the trial,and a total of 82 subjects were actually used for data analysis.(1)After 1 week and 2 weeks medication,frequency of SBM in study group increased more than that in control group(P<0.05);the response rates of SBM in the study group after 1 week of treatment was 64.3%,and the control group was 42.5%(P<0.05).Two weeks later,the SBM response rates of the study group was 59.5%,and that of the control group was 57.5%(P>0.05).(2)More subjects in the study group had Bristol stool scores changed from 1-2 to 3-5(P<0.05).(3)Compared with the control group,the study group can alleviate 3 symptoms including incomplete defecation,abdominal bloating,and defecation by manual maneuvers(P<0.05).(4)After 2-week medication,The total score of the severity of upper gastrointestinal symptoms in study group was significantly reduced(P<0.05).Conclusion:1.Shengjiang decoction have relatively effects on improvement of the number of spontaneous bowel movements,Bristol stool form scales,and constipation-related symptoms(incomplete defecation,abdominal bloating,and defecation by manual maneuvers).2.Shengjiang decoction can reduce the severity of upper gastrointestinal symptoms caused by opioids.3.Shengjiang decoction is safe but may cause adverse reactions of diarrhea.The clinical dosage can be reduced according to the actual situation.