World J Gastroenterol. 2012 Aug 7;18(29):3921-2. doi: 10.3748/wjg.v18.i29.3921.
I read with great interest the recent article by Chen et al in a recent issue of your esteemed journal. The article is highly thought provoking. One emerging therapeutic alternative for opioid induced constipation is the emergence of opioid/naloxone prolonged release combinations. For instance, naloxone when administered in a 1:2 ratio with oxycodone reverses the inhibitory effect of oxycodone on the gastrointestinal tract. The advantage of oxycodone/naloxone prolonged release (OXN) is that while its anti-nociceptive efficacy is equivalent to that of oxycodone prolonged release (OXC), it significantly decreases the "Bowel Function Index" thereby ameliorating symptoms of opioid induced constipation to a large extent. Schutter et al in a recent study have reported a decrease in the bowel function index from 38.2 to 15.1. Similarly, Löwenstein et al in another recent study have reported that following a month of therapy, complete spontaneous bowel movements per week is increased from one in OXC therapy to three in OXN therapy.
我饶有兴致地阅读了陈等人近期在贵刊发表的文章。该文章发人深省。对于阿片类药物引起的便秘，一种新兴的治疗选择是阿片类药物/纳洛酮缓释组合的出现。例如，纳洛酮与羟考酮以 1:2 的比例给药，可逆转羟考酮对胃肠道的抑制作用。羟考酮/纳洛酮缓释（OXN）的优势在于，尽管其镇痛效果与羟考酮缓释（OXC）相当，但它显著降低了“肠道功能指数”，从而在很大程度上改善了阿片类药物引起的便秘症状。Schutter 等人在最近的一项研究中报告称，肠道功能指数从 38.2 降至 15.1。同样， Löwenstein 等人在另一项最近的研究中报告称，治疗一个月后，每周完全自发的肠蠕动从 OXC 治疗的一次增加到 OXN 治疗的三次。
