阿片类药物引起的便秘：进展与临床指南
Opioid-induced constipation: advances and clinical guidance.
作者信息
Nelson Alfred D, Camilleri Michael
机构信息
Clinical Enteric Neuroscience Translational and Epidemiological Research (CENTER), Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA.
Clinical Enteric Neuroscience Translational and Epidemiological Research (CENTER), Division of Gastroenterology and Hepatology, Mayo Clinic, Charlton Building, Room 8-110, 200 First Street SW, Rochester, MN 55905, USA.
出版信息
Ther Adv Chronic Dis. 2016 Mar;7(2):121-34. doi: 10.1177/2040622315627801. Epub 2016 Jan 25.
Abstract
Currently opioids are the most frequently used medications for chronic noncancer pain. Opioid-induced constipation is the most common adverse effect associated with prolonged use of opioids, having a major impact on quality of life. There is an increasing need to treat opioid-induced constipation. With the recent approval of medications for the treatment of opioid-induced constipation, there are several therapeutic approaches. This review addresses the clinical presentation and diagnosis of opioid-induced constipation, barriers to its diagnosis, effects of opioids in the gastrointestinal tract, differential tolerance to opiates in different gastrointestinal organs, medications approved and in development for the treatment of opioid-induced constipation, and a proposed clinical management algorithm for treating opioid-induced constipation in patients with noncancer pain.
摘要
目前，阿片类药物是治疗慢性非癌性疼痛最常用的药物。阿片类药物引起的便秘是长期使用阿片类药物最常见的不良反应，对生活质量有重大影响。治疗阿片类药物引起的便秘的需求日益增加。随着治疗阿片类药物引起的便秘的药物最近获得批准，有几种治疗方法。本文综述了阿片类药物引起的便秘的临床表现和诊断、诊断的障碍、阿片类药物在胃肠道的作用、不同胃肠道器官对阿片类药物的差异耐受性、已批准和正在研发的治疗阿片类药物引起的便秘的药物，以及针对非癌性疼痛患者治疗阿片类药物引起的便秘的临床管理算法建议。
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