内科

目的分析益生菌联合穴位贴敷在阿片类药物相关性便秘的癌痛患者中的应用效果。方法选取92例阿片类药物相关性便秘的癌痛患者，采用随机数字表法将其分为对照组（46例，常规通便治疗）和研究组（46例，常规通便治疗+益生菌联合穴位贴敷治疗），两组均连续治疗4周。比较两组治疗总有效率，以及治疗前后便秘严重程度［采用便秘患者症状自评量表（PAC-SYM）进行评估］、生活质量［采用便秘患者生活质量量表（PAC-QOL）进行评估］及肠道菌群构成。结果研究组治疗总有效率高于对照组（91.30%比67.39%）（P<0.05）。治疗前，两组PAC-SYM粪便性状、直肠症状、腹部症状因子评分，PAC-QOL躯体不适、心理社会不适、担心与焦虑、满意度维度评分，以及大肠埃希菌、双歧杆菌、肠球菌、乳杆菌菌群计数差异均无统计学意义（均P>0.05）。治疗4周后，两组上述评分均降低，大肠埃希菌、肠球菌菌群计数均减少，双歧杆菌、乳杆菌菌群计数均增加；且研究组上述评分均低于对照组，大肠埃希菌、肠球菌菌群计数均少于对照组，双歧杆菌、乳杆菌菌群计数均多于对照组（均P<0.05）。结论应用益生菌联合穴位贴敷治疗阿片类药物相关性便秘的癌痛患者，有助于缓解其临床症状，改善肠道菌群失衡，促进生活质量提升，临床效果显著。

Objective To analyze the efficacy of probiotics combined with acupoint application in cancer pain patients with opioid-induced constipation. Methods A total of 92 cancer pain patients with opioid-induced constipation were selected and divided into a control group (n=46, receiving conventional laxative treatment) and a study group (n=46, receiving conventional laxative plus probiotics and acupoint application) using a random number table. Both groups were treated continuously for 4 weeks. The total effective rate, as well as constipation severity (assessed using the Patient Assessment of Constipation-Symptoms [PAC-SYM]), quality of life (assessed using the Patient Assessment of Constipation-Quality of Life [PAC-QOL]), and composition of intestinal microbiota before and after treatment, was compared between the two groups. Results The total effective rate in the study group was higher than that in the control group (91.30% vs 67.39%) (P<0.05). Before treatment, there was no statistically significant difference between the two groups in PAC-SYM factor score (stool consistency, rectal symptoms, or abdominal symptoms), PAC-QOL dimension score (physical discomfort, psychosocial discomfort, worries and concerns, or satisfaction), or counts of Escherichia coli, Bifidobacterium, Enterococcus, and Lactobacillus (all P>0.05). After 4 weeks of treatment, the above scores decreased in both groups, counts of Escherichia coli and Enterococcus decreased, and counts of Bifidobacterium and Lactobacillus increased; moreover, the study group had lower scores, fewer counts of Escherichia coli and Enterococcus, and more counts of Bifidobacterium and Lactobacillus than the control group (all P<0.05). Conclusions Probiotics combined with acupoint application helps alleviate clinical symptoms, improve intestinal microbiota imbalance, and promote quality of life in cancer pain patients with opioid-induced constipation, demonstrating significant clinical efficacy.

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