运脾润肠法对慢传输型功能性便秘结肠动力的影响  

Effect of therapeutic method of activating spleen and moistening intestine on motivity of colon in slow-transit constipation

作　　者：姜国平[1] 何凌[1] 霍岭霞[2] 胡珂[1] 徐友妹[3] 邵继满[4] 

机构地区：[1]江西中医学院附属医院消化内科,江西南昌330006 [2]江西中医学院 [3]江西中医学院附属医院检验科,江西南昌330006 [4]江西中医学院附属医院放射科,江西南昌330006

出　　处：《中国中西医结合消化杂志》2006年第6期377-379,382,共4页Chinese Journal of Integrated Traditional and Western Medicine on Digestion

基　　金：江西省卫生厅中医药科研基金资助项目(04A22)

摘　　要：[目的]观察中医运脾润肠法治疗慢传输型便秘(STC)的临床疗效及对血清一氧化氮(NO)、血浆P物质(SP)水平、结肠动力的影响。[方法]选择确诊为STC患者90例按2∶1比例随机分为2组,治疗组(应用秘通治疗)60例,对照组(莫沙必利治疗)30例,并设正常对照(正常)组30例。采用放射免疫法(RIA)测定2组治疗前、后空腹血清NO和血浆SP水平,并与正常组测得值对比。并比较2组治疗前、后的结肠通过时间(GITT)。[结果]治疗组临床症状总有效率为93.3%,对照组为73.3%(P<0.05)。治疗前,2组血浆SP水平比正常组显著降低,血清NO水平比正常组显著增高;治疗后2组NO及SP水平均有显著改善,与治疗前比较差异有统计学意义(P<0.05)。但治疗组治疗后NO及SP与正常组比较P>0.05,而对照组治疗后NO及SP与正常组比较P<0.05。结果表明秘通、莫沙必利均可明显降低血清NO及升高血浆SP水平,而治疗组的效果优于对照组。治疗前2组GITT示48 h后停留在右半结肠或横结肠的标志物超过80%,用药后标志物显著减少并接近正常,但治疗组减少情况优于对照组。[结论]中医运脾润肠法治疗STC患者疗效显著,能缩短GITT、调节血清NO和血浆SP水平,推动肠道蠕动,促进肠道排空,达到改善患者临床症状的目的。[Objective]To assess the therapeulic effect of activating spleen and moistening intestine in the treatment of slow-transit constipation （STC） and explore the relationship of TCM syndromes, the gastrointestinal transit time （GITT）, and the gastrointestinal neurotic mediators such as nitrie oxide （NO） and substance P （SP）. [Methods]Ninety cases of STC patients were di vided into two groups randomly： treatment group （n=60, treated with Chinese herbs of activating spleen and moistening intestine） and control group （n=30, treated with west medicine）. Meanwhile, twenty healthy volunteers served as normal controls. The serum NO, plasma SP, GITT were measured by means of radioimmunoassay preand post treatment. [Results]Efficacy rate in the treatment group was 93.3 %, and 73.3% in the control group. Before the treatment, the serum NO in the treatment group was higher and the plasma SP was lower than that in nor-mal control group respectively （P〈0. 05）. There was significant difference between preand post-treatment of serum NO and plasma SP in the treatment group. After the treatment with Chinese herbs, the serum NO and plasma SP were near to normal, which has no significant difference with those of normal control group （P〉0. 05）. In the group with west medicine, though the serum NO and plasma SP were decreased significantly, there was difference from normal control （P〈0. 05）. The same results were found on GITT. [Conclusion] The therapy of activating spleen and moistening intestine can treat STC via lowing the high level of NO, lifting the low level of SP and improving the movement of colon.

关 键 词：便秘.慢传输型功能性 运脾润肠 一氧化氮 P物质 结肠通过时间 

分 类 号：R442.2[医药卫生—诊断学] R574.62[医药卫生—临床医学]