General Internal Medicine, Center for Palliative Medicine, Mayo Clinic, Rochester, Minnesota.
General Internal Medicine, Center for Palliative Medicine, Mayo Clinic, Rochester, Minnesota.
J Pain Symptom Manage. 2021 Oct;62(4):876-880. doi: 10.1016/j.jpainsymman.2021.01.135. Epub 2021 Feb 5.
Use of acupuncture for treatment of functional constipation is well studied; however, studies examining use of acupuncture for opioid-induced constipation are limited.
A 70-year-old woman with newly diagnosed multiple myeloma discovered after presentation to the emergency room with severe back pain. Pain management required use of opioids, escalating to effect. Hospital course was complicated by opioid-induced constipation causing abdominal pain, nausea, and ileus despite aggressive titration of stimulant and osmotic laxatives as well as administration of suppositories and enemas on multiple occasions. Prior to nasogastric tube placement for the ileus, the patient requested acupuncture treatment in attempt to relieve constipation. Shortly after acupuncture session, patient passed multiple stools with improvement in abdominal pain and nausea and avoidance of nasogastric tube.
Acupuncture for opioid-induced constipation may provide symptom relief through use of nonpharmacologic interventions; however, further studies are needed to determine the optimal therapeutic approach.
针灸治疗功能性便秘已有大量研究；然而，关于针灸治疗阿片类药物引起的便秘的研究有限。
一位 70 岁女性，因严重腰痛就诊于急诊室，被诊断为多发性骨髓瘤。疼痛管理需要使用阿片类药物，剂量逐渐增加。尽管积极滴定刺激性和渗透性泻药，以及多次使用栓剂和灌肠剂，医院治疗过程仍因阿片类药物引起的便秘导致腹痛、恶心和肠梗阻而复杂化。在因肠梗阻而放置鼻胃管之前，患者要求进行针灸治疗以缓解便秘。针灸治疗后不久，患者多次排便，腹痛和恶心减轻，避免了放置鼻胃管。
针灸治疗阿片类药物引起的便秘可能通过非药物干预提供症状缓解；然而，需要进一步研究以确定最佳治疗方法。
