通便汤治疗老年慢传输型便秘多中心、双盲、随机对照临床研究  

Multicenter randomized controlled trial of Tongbian Decoction in treating elderly patients with slow transit constipation

作　　者：颜帅[1,2] 董宏利[1] 乐音子[1] 徐天舒[3] 刘佃温[4] 陈淑君[5] 钱海华[6] 王晓鹏[1] 

机构地区：[1]苏州市中医医院,苏州215009 [2]南京中医药大学,南京210023 [3]南京市鼓楼医院,南京210008 [4]河南中医药大学第三附属医院,郑州450008 [5]河南中医药大学第一附属医院,郑州450000 [6]南京中医药大学附属医院,南京210029

出　　处：《中华中医药杂志》2018年第3期1171-1174,共4页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：中国博士后基金(No.2017M620220);国家自然科学基金项目(No.81573979);江苏省中医药科技项目(No.YB2017061);苏州市产业技术创新专项(民生科技)项目(No.SYS201775)~~

摘　　要：目的:观察通便汤对老年慢传输型便秘(STC)的临床疗效,探讨其可能机制。方法:采用多中心、随机对照、双盲的研究方法,将92例老年STC患者随机分为治疗组(通便汤)和对照组(酪酸梭菌活菌散剂),其中治疗组47例,对照组45例,分别药物干预4周。观察两组治疗前后便秘临床症状积分、粪便性状评分、患者生活质量问卷(PCA-QOL评分)、临床疗效、粪便短链脂肪酸(SCFA)和酪酸含量,并观察停药后4周和8周复发情况及不良反应。结果:通便汤可显著提升SCFA和酪酸的含量(P<0.01),改善粪便性状积分、每次排便时间积分、排便间隔时间积分、排便困难程度积分以及PAC-QOL评分(P<0.01),且临床总有效率达91.4%。停药4周和8周时治疗组患者的复发率均显著低于对照组,且无明显不良反应发生。结论:通便汤对老年STC临床疗效显著,值得临床推广应用。Objective： To observe the clinical effect and safety of Tongbian Decoction in treating elderly patients with slow transit constipation. Methods： A multicenter, large sample, randomized controlled clinical trial was designed. Ninetytwo cases of elderly patients with slow transit constipation were randomly divided into treatment group（47 cases, Tongbian Decoction） and control group（45 cases, clostridium butyricum powder）, the treatment course of each group was 30 days. The clinical effect of each group were evaluated by the index of fecal character, time for defecation and intervals, difficulty of defecate. PCA-QOL score, clinical efficacy, fecal short chain fatty acids and acid casein as well as the recurrence rate were also observed. Results： Tongbian Decoction could increase the content of SCFA and butyric acid（P0.01）, improve the scores of fecal character, defecating time, time interval of defecation, difficulty integral of defecation and PCA-QOL score（P0.01）, the clinical efficacy rate was 91.4%. Discontinuous drugs for 4 weeks and 8 weeks, the recurrence rate of treatment group was significantly lower than that of control group with no obvious adverse effect. Conclusion： Tongbian Decoction can decrease the recurrence incidence of slow transit constipation and take significant role in clinical effect.

关 键 词：慢传输型便秘 通便汤 PCA-QOL评分 短链脂肪酸 

分 类 号：R256.35[医药卫生—中医内科学]