Constipation Thiab GI Diagnoses nyob rau hauv cov me nyuam uas muaj cov qog nqaij hlav: Prevalence thiab Management Ⅰ

TSAB NTAWV

Lub Hom Phiaj Txawm hais tias muaj kev txhim kho txuas ntxiv ntawm cov phiaj xwm kev kho mob rau cov menyuam yaus uas muaj mob qog noj ntshav, cov neeg mob tseem muaj kev cuam tshuam ntau yam tsis xav tau. Cov menyuam yaus uas muaj cov qog nqaij hlav tuaj yeem ua rau cem quav vim yog kev kho mob vinca alkaloid, kev ntxhov siab ntawm lub hlwb, lub sijhawm tsis ua haujlwm thiab siv opioid. Peb lub hom phiaj yog txhawm rau tshawb xyuas qhov nthuav dav thiab kev kho mob cem quav hauv cov menyuam yaus hauv tsev kho mob nrog cov qog nqaij hlav kho nrog tshuaj kho mob.

Cov Txheej Txheem Peb tau txheeb xyuas cov ntaub ntawv rov qab los ntawm 48 lub tsev kho mob menyuam yaus hauv Pediatric Health Information System, tshem tawm cov neeg mob 0-21 xyoo uas muaj cov qog nqaij hlav hauv tsev kho mob txij lub Kaum Hli 2015 txog Lub Kaum Ob Hlis 2019.

Cov txiaj ntsig Peb tau txheeb xyuas 13375 cov neeg mob tshwj xeeb uas kuaj mob qog nqaij hlav tau txais tshuaj kho mob. Kev cem quav yog qhov kev tsis txaus siab ntawm plab hnyuv loj tshaj plaws nrog 8658 (64.7%; 95% Cl: 63.9% mus rau 65.5%) muaj kev kuaj mob cem quav lossis tau txais tsawg kawg ob lub laxatives thaum nkag. Cov qog nqaij hlav pob txha muaj qhov feem pua ​​​​siab tshaj (69.9%) ntawm cov neeg mob cem quav, thaum Hodgkin's lymphoma muaj qhov qis tshaj, txawm tias 52.1% ntawm cov neeg mob tau cuam tshuam. Tag nrho ntawm 44% (n{14}}) ntawm kev ntsib tau txais ib qho tshuaj opioid ntawm qee lub sijhawm thaum nkag. Ntawm cov neeg mob tau txais cov tshuaj cem quav, feem ntau yog cov tshuaj yog polyethyl glycol (n=25175, 31.7%), ua raws li docusate (n=11297, 14.2%), senna (n{21}}, 13 .0%) thiab lactulose (n=5501, 6.9%).

Nyem rau natural laxatives

Cov ntsiab lus Kev cem quav yog qhov teeb meem ntawm plab hnyuv loj tshaj plaws uas cov menyuam yaus muaj cov qog nqaij hlav thaum tau txais kev kho mob hauv tsev kho mob. Kev saib xyuas ntxiv yuav tsum tau muab rau cem quav prophylaxis thiab kev kho mob hauv cov menyuam yaus uas muaj cov qog nqaij hlav uas tau txais kev kho mob, tshwj xeeb yog cov uas pom tias muaj kev pheej hmoo siab.

Taw qhia

Kev mob qog noj ntshav thaum yau tseem yog qhov thib ob ua rau tuag rau cov menyuam yaus hnub nyoog 5 txog 14 xyoo.1 Cov kev kuaj mob ntau tshaj plaws hauv Tebchaws Meskas muaj xws li leukemias, central nervous system (CNS) qog thiab lymphomas nrog rau ntau yam ntawm lwm cov qog nqaij hlav.2 Cov menyuam yaus uas mob qog noj ntshav. kev kho mob raug kev txom nyem litany ntawm cov kev mob tshwm sim tsis xav tau thaum thiab tom qab lawv txoj kev kho. Thaum cov kev ciaj sia nyob txuas ntxiv txhim kho nrog kev koom ua ke ntawm kev siv tshuaj tiv thaiv kab mob thiab cov phiaj xwm kho mob, ntau CNS thiab tsis-CNS cov kev kho mob qog nqaij hlav txuas ntxiv vam khom cov tshuaj cytotoxic thiab radiotherapy-raws li kev kho mob.

Chemotherapy-induced cem quav (CIC) tau kawm zoo nyob rau hauv cov neeg laus cov ntaub ntawv oncology thiab yog qhov thib peb feem ntau cov kev mob tshwm sim tsis zoo nyob rau hauv cov neeg mob uas tau txais cytotoxic chemotherapy, nrog rau 50% -87% ntawm cov neeg mob uas muaj CIC.3 Vinca alkaloids yog ib qho tshwm sim ntawm cem quav, nrog 80% -90% ntawm cov neeg laus oncology tau txais lawv qhia CIC.4 Thaumcov ntaub ntawv muaj tshwm sim rau cem quav nyob rau hauv cov menyuam yaus cov pej xeem, tsis muaj kev tshawb fawb tau tshawb nrhiav cem quav lossis sequela hauv cov menyuam yaus uas muaj cov qog nqaij hlav. Tsis tas li ntawd, cov ntaub ntawv tsis tau tshawb fawb txog kev siv tshuaj tiv thaiv cem quav thaum kho cov menyuam yaus uas tau txais tshuaj kho mob. Constipation suav rau 3% ntawm kev mus ntsib kws kho mob sab nraud thiab 25% ntawm cov kws kho mob plab hnyuv siab raum (GI) tshwj xeeb mus ntsib hauv Asmeskas.5 Cov menyuam yaus uas cem quav raug kev txom nyem los ntawm cov tsos mob ntawm lub cev xws li mob plab, cramping, faecal incontinence, qhov quav fissures, enuresis thiab urinary tract infections.6 Hauv cov menyuam yaus uas tsis muaj kabmob kheesxaws, kev ua haujlwm cem quav muaj kev noj qab haus huv ntau dua piv rau cov menyuam yaus uas tsis cem quav.

Kev kho mob tuaj yeem nyuaj rau cov menyuam yaus noj qab haus huv tab sis tsim teeb meem tshwj xeeb rau tus menyuam uas tab tom kho mob qog noj ntshav. Kev tswj cem quav siv cov tshuaj pharmacological thiab non-pharmacological kev cuam tshuam los txhim kho cov tsos mob.4 Cov kev cuam tshuam tsis yog tshuaj kho mob, xws li kev ua kom muaj zog thiab dej, tej zaum yuav nyuaj rau cov menyuam yaus uas mob qog noj ntshav ua raws li xeev siab, mucositis, anorexia, qaug zog lossis lwm yam kev kho mob. . Tsis tas li ntawd, qee qhov kev txhawb nqa kev saib xyuas, suav nrog tag nrho cov khoom noj khoom haus parenteral (TPN), tau pom tias muaj kev pheej hmoo ntau ntxiv ntawm kev cem quav.7 Txawm hais tias muaj kev vam meej nyob rau hauv cov menyuam yaus oncology, tseem tsis muaj kev taw qhia rau pab pawg oncology hais txog kev tswj cem quav.

Cov ntaub ntawv yog tsis muaj kev tshawb fawb tshawb nrhiav qhov tshwm sim thiab kev tswj hwm cem quav hauv cov neeg mob oncology. Ib daim ntawv nug yav tom ntej los ntawm 2011 kwv yees tias 57% -77% ntawm cov menyuam yaus xav tau kev khomob rau kev kuaj mob oncology ntsib cem quav, raws li tau hais los ntawm North American Society of Pediatric Gastroenterology, Hepatology, thiab Nutrition Criteria.8 cem quav yog feem ntau GI kuaj mob thaum lub sij hawm. mob lymphoblastic leukemia (TAG NRHO) induction therapy cuam tshuam rau 34% ntawm cov menyuam yaus, thiab pom tias muaj ntau dua ntawm cov poj niam, cov neeg nyob hauv tsev kho mob ntev thiab cov neeg mob tau txais opioids. Tsis tas li ntawd, ntau yam tshuaj cem quav tau raug txheeb xyuas, nrog rau 81% ntawm cov neeg mob tau txais tsawg kawg yog ib lub laxative thaum lub sij hawm induction.9

Cov menyuam yaus feem ntau tau txais kev kho mob rau kev kuaj mob qog nqaij hlav tau txais ntau lub tsev kho mob txuas ntxiv, yuav xav tau kev phais phais kom tsis txhob txav mus los thiab feem ntau tau txais kev kho hluav taws xob ntxiv. Tsis tas li ntawd, kev phiv xws li mucositis ua rau lub cev qhuav dej thiab kev tswj xyuas qhov mob tuaj yeem ua rau cov neeg mob cem quav. Txawm hais tias kev nce qib tsis tu ncua hauv kev kho menyuam yaus oncology, tseem tsis muaj kev taw qhia txog kev tswj cem quav. Lub hom phiaj ntawm peb txoj kev tshawb fawb yog siv lub teb chaws cov ntaub ntawv tswj hwm los piav qhia txog qhov tshwm sim ntawm cem quav, GI kuaj mob thiab kev hloov pauv ntawm kev tswj tus neeg mob hauv tsev kho mob, thiab tshawb xyuas qhov muaj feem cuam tshuam nrog cem quav thaum mus pw hauv tsev kho mob rau cov neeg mob qog nqaij hlav hauv Tebchaws Meskas.

Ntuj Herbal Tshuaj Rau Relieving cem quav-Cistanche

Cistanche yog ib tug genus ntawm parasitic nroj tsuag uas belongs rau tsev neeg Orobanchaceae. Cov nroj tsuag no paub txog lawv cov khoom siv tshuaj thiab tau siv hauv Cov Tshuaj Suav Tshuaj (TCM) rau ntau pua xyoo. Cov hom Cistanche feem ntau pom muaj nyob hauv thaj av qhuav thiab suab puam ntawm Tuam Tshoj, Mongolia, thiab lwm qhov chaw ntawm Central Asia. Cistanche nroj tsuag yog tus cwj pwm los ntawm lawv cov nqaij tawv, yellowish stems thiab muaj nuj nqis heev rau lawv cov txiaj ntsig kev noj qab haus huv. Hauv TCM, Cistanche ntseeg tau tias muaj cov khoom siv tonic thiab feem ntau yog siv los kho lub raum, txhim kho qhov tseem ceeb, thiab txhawb kev ua haujlwm ntawm kev sib deev. Nws kuj yog siv los daws cov teeb meem ntsig txog kev laus, qaug zog, thiab kev noj qab haus huv tag nrho. Thaum Cistanche muaj keeb kwm ntev ntawm kev siv tshuaj ib txwm siv, kev tshawb fawb tshawb fawb txog nws txoj kev ua tau zoo thiab kev nyab xeeb yog tsis tu ncua thiab txwv. Txawm li cas los xij, nws paub tias muaj ntau yam bioactive tebchaw xws li phenylethanoid glycosides, iridoids, lignans, thiab polysaccharides, uas tuaj yeem ua rau nws cov teebmeem tshuaj.

Wecistanche covcistanche hmoov, cistanche ntsiav tshuaj, cistanche capsules, thiab lwm yam khoom tsim los sivsuab puamcistancheraws li cov khoom siv raw, txhua yam muaj txiaj ntsig zoo rau kev tshem tawm cem quav. Cov txheej txheem tshwj xeeb yog raws li hauv qab no: Cistanche ntseeg tau tias muaj cov txiaj ntsig zoo rau kev tshem tawm cem quav raws li nws cov kev siv ib txwm siv thiab qee cov tshuaj uas nws muaj. Txawm hais tias kev tshawb fawb tshawb fawb tshwj xeeb ntawm Cistanche qhov cuam tshuam rau cem quav yog txwv, nws tau xav tias muaj ntau lub tswv yim uas yuav ua rau nws muaj peev xwm txo tau cem quav. Laxative nyhuv: Cistanche tau ntev tau siv nyob rau hauv Tsoos Suav Tshuaj raws li ib tug tshuaj rau cem quav. Nws ntseeg tau tias muaj cov nyhuv laxative me me, uas tuaj yeem pab txhawb kev zom zaub mov thiab ua rau cem quav. Cov nyhuv no tej zaum yuav raug ntaus nqi rau ntau cov tebchaw nyob hauvCistanche, xws li phenylethanoid glycosides thiab polysaccharides. Moistening cov hnyuv: Raws li kev siv ib txwm siv, Cistanche suav hais tias muaj cov khoom siv moisturizing, tshwj xeeb yog tsom rau cov hnyuv. Txhawb nqa dej thiab lubrication ntawm txoj hnyuv, nws yuav pab tau cov cuab yeej soften thiab yooj yim dua, yog li no relieving cem quav. Anti-inflammatory Effect: cem quav tej zaum yuav txuam nrog o nyob rau hauv lub plab zom mov. Cistanche muaj qee qhov sib txuas, suav nrog phenylethanoid glycosides thiab lignans, uas ntseeg tau tias muaj cov tshuaj tiv thaiv kab mob. Los ntawm kev txo cov kab mob hauv cov hnyuv, nws tuaj yeem pab txhim kho kev zom zaub mov tsis tu ncua thiab txo qhov cem quav.