摘要
目的:观察瓜蒌通便汤联合脐疗治疗气秘型功能性便秘的临床疗效。方法:将68例气秘型功能性便秘患者按照随机数字表法分为观察组和对照组,每组各34例。对照组给予四磨汤口服、保留灌肠联合脐疗,观察组给予瓜蒌通便汤口服、保留灌肠联合脐疗。比较两组患者的临床疗效及治疗前后便秘症状[Cleveland便秘评分(Cleveland constipation score,CCS)、Bristol粪便性状评分(Bristol stool form scale,BSFS)]、便秘患者生活质量量表(patient assessment of constipation-quality of life,PAC-QOL)评分、汉密尔顿焦虑量表(Hamilton anxiety scale,HAMA)评分、脑肠肽指标[5-羟色胺(5-hydroxy tryptamin,5-HT)、血管活性肠肽(vasoactive intestinal peptide,VIP)]及肠道微生态(双歧杆菌水平、大肠埃希菌水平)的变化情况。结果:观察组有效率为91.18%,对照组有效率为70.59%,两组有效率比较,差异具有统计学意义(P<0.05)。两组患者治疗后CCS评分低于本组治疗前,BSFS评分均高于本组治疗前,治疗后组间比较,差异均有统计学意义(P<0.05)。观察组治疗后PAC-QOL评分为(37.02±6.14)分,HAMA评分为(7.23±0.99)分,均低于本组治疗前及对照组治疗后,差异具有统计学意义(P<0.05)。两组患者治疗后5-HT高于本组治疗前,VIP水平低于本组治疗前,且治疗后组间比较,差异具有统计学意义(P<0.05)。两组患者治疗后双歧杆菌水平高于本组治疗前,大肠埃希菌水平低于本组治疗前,且治疗后组间比较,差异具有统计学意义(P<0.05)。结论:瓜蒌通便汤联合脐疗治疗气秘型功能性便秘,可明显提高临床疗效及患者生活质量,改善患者焦虑状态,还能通过调节血清脑钠肽5-HT、VIP水平和肠道微生态双歧杆菌、大肠埃希菌数量,促进胃肠蠕动。
Objective:To observe the clinical efficacy of Trichosanthes Laxative Decoction combined with umbilical therapy on functional constipation of qi-stagnation type.Methods:A total of 68 patients with functional constipation of qi-stagnation type were randomly divided into the observation group and the control group,with 34 cases in each group.The control group received Four Milled Ingredients Decoction orally,retention enema combined with umbilical therapy,while the observation group received Trichosanthes Laxative Decoction orally,retention enema combined with umbilical therapy.The clinical efficacy,the changes in TCM syndrome scores,constipation symptoms[such as Cleveland Constipation Score(CCS),Bristol stool form scale(BSFS)],patient assessment of constipation-quality of life(PAC-QOL)score,Hamilton anxiety scale(HAMA)score,brain-gut peptides[5-hydroxytryptamine(5-HT),vasoactive intestinal peptide(VIP)],and intestinal microecology(including bifidobacterium and escherichia coli levels)before and after treatment were compared.Results:The effective rate was 91.18%in the observation group and 70.59%in the control group respectively,with a statistically significant difference(P<0.05).After treatment,CCS scores decreased and BSFS scores increased in both groups compared to pre-treatment,with significant intergroup differences(P<0.05).The CCS scores of both groups were after treatment lower than those before treatment in their respective groups,and the Bristol scores were higher after treatment than those before treatment in their respective groups.There were statistically significant differences between the two groups after treatment(P<0.05).After treatment,the PAC-QOL score of the observation group was(37.02±6.14)points,and the HAMA score was(7.23±0.99)points,both of which were lower than those before treatment in the observation group and after treatment in the control group,and all the differences were statistically significant(P<0.05).The levels of 5-HT in both groups were higher than those before treatment in the same group,while the levels of VIP were lower than those before treatment in the same group,and all the differences between the two groups were statistically significant(P<0.05).The levels of Bifidobacterium in both groups were higher than those before treatment in the same group,while the levels of Escherichia coli were lower than those before treatment in the same group,and all the differences between the two groups were statistically significant(P<0.05).Conclusion:Trichosanthes Laxative Decoction combined with umbilical therapy in the treatment of functional constipation of qi stagnation type can not only significantly improve clinical efficacy,enhance patients′quality of life and alleviate psychological disorders,but also promote gastrointestinal peristalsis by regulating the levels of serum brain natriuretic peptide,5-HT,VIP and the quantities of bifidobacterium and escherichia coli in the intestinal microecology.
作者
罗林山
张威
刘全林
巩跃生
LUO Linshan;ZHANG Wei;LIU Quanlin;GONG Yuesheng(Zhengzhou Colorectal and Anal Disease Hospital,Henan Provincial Hospital of Traditional Chinese Medicine for Digestive Diseases,Zhengzhou,Henan,China,450004)
出处
《河南中医》
2025年第6期866-872,共7页
Henan Traditional Chinese Medicine
基金
2019年中国民族医药学会科研项目(2019KYXM-Z1131-118)
河南省中医药第二批青苗人才培养项目{豫卫中医函〔2021〕16号}。
关键词
功能性便秘
气秘证
瓜蒌通便汤
脐疗
四磨汤
保留灌肠
functional constipation
qi-stagnation syndrome
Trichosanthes Laxative Decoction
umbilical therapy
Four Milled Ingredients Decoction
retention enema
作者简介
罗林山(1989-),男,河南驻马店人,硕士研究生;通信作者:张威,E-mail:zw8405@163.com。
