中医药治疗抗精神病药物不良反应验案举隅
代谢综合征,便秘
虞芳 杨蒋伟 邢葆平 祝红燕[摘要] 抗精神病药物易引起便秘,便秘容易导致肛周疾病(甚至肠癌)、胃肠功能紊乱,增加心脑血管意外风险,严重影响患者生活质量及生存时间。临床多通过加用通便药、灌肠等方式处理,有时便秘仍持续存在,甚至导致肠梗阻,危及患者生命。代谢综合征是使用抗精神病药物的常见不良反应,导致肥胖、糖脂代谢异常、增加罹患心血管疾病的风险。无论通过改变生活方式,亦或是换药、减少药量,都不能完全解决这一问题。本文介绍了两则中医药治疗抗精神病药物不良反应的验案。抗精神病药物不良反应起初容易化火,进而耗气伤阴,同时损伤脾胃,运化失常,酝酿痰湿成代谢综合征,或致肠腑传导失常而致便秘。结合患者实际辨证论治,可采用清热养阴、健脾益气、燥湿化痰、润肠通便等治法,具有一定疗效。
[关键词] 抗精神病药物;不良反应;代谢综合征;便秘;中医药
[中图分类号] R277.7? ? ? ? ? [文献标识码] B? ? ? ? ? [文章编号] 1673-9701(2021)34-0140-04
[Abstract] Antipsychotics can easily cause constipation, which can easily lead to perianal diseases (even intestinal cancer), gastrointestinal dysfunction, increase the risk of cardiovascular and cerebrovascular events, and seriously affect the quality of life and survival time of patients. Clinically, it is usually treated by laxative and enema. Sometimes constipation persists and even leads to intestinal obstruction, which is life-threatening. Metabolic syndrome is a common adverse reaction of antipsychotics,which leads to obesity,abnormal glucose and lipid metabolism and increases the risk of cardiovascular disease. Lifestyle changes ......
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