润肠丸合黄芪汤联合常规疗法治疗老年重度功能性便秘临床研究  

Clinical Study on Runchang Pills and Huangqi Tang Combined with Routine Therapy for Senile Severe Functional Constipation

作　　者：王小华 王钧 李莉 张铮森 WANG Xiaohua;WANG Jun;LI Li;ZHANG Zhengsen

机构地区：[1]绍兴文理学院附属医院老年科,浙江绍兴312000

出　　处：《新中医》2020年第19期50-54,共5页New Chinese Medicine

摘　　要：目的:观察润肠丸合黄芪汤联合常规疗法治疗老年重度功能性便秘(FC)的临床疗效。方法:将90例气阴(血)不足型患者随机分为对照组和观察组各45例。2组均给予调整生活方式,服用枸橼酸莫沙必利片、双歧杆菌三联活菌肠溶胶囊和乳果糖口服溶液,观察组加用润肠丸合黄芪汤加减内服,2组均治疗6周。治疗前后评定便秘主要症状评分、便秘患者生活质量自评量表(PAC-QOL)评分、气阴(血)不足证评分,记录治疗前1周、治疗结束后1周的每周完全自发排便(CSBM)次数,并进行肛门直肠测压,记录肛管静息压(ARP)、最大缩榨压(MSP)、MSP持续时间及排便压。比较2组的疗效。结果:治疗后,2组粪便性状、排便费力、排便时间、排便频率、腹胀及下坠、不尽、胀感等便秘主要症状评分均较治疗前下降(P<0.01),观察组上述6项便秘主要症状评分均低于对照组(P<0.01)。2组气阴(血)不足证积分均较治疗前下降(P<0.01),治疗结束后1周的CSBM次数均较治疗前增加(P<0.01)。观察组气阴(血)不足证积分低于对照组(P<0.01),CSBM次数多于对照组(P<0.01)。2组ARP、MSP和排便压均较治疗前升高(P<0.01),MSP持续时间较治疗前延长(P<0.01)。观察组ARP、MSP及排便压均高于对照组(P<0.01),MSP持续时间长于对照组(P<0.01)。2组PAC-QOL生理、心理、担忧度、满意度4个维度的评分及总分均较治疗前下降(P<0.01),观察组各维度评分及总分均低于对照组(P<0.01)。观察组中医证候疗效优于对照组(P<0.05)。结论:在常规治疗的基础上加用润肠丸合黄芪汤加减内服治疗气阴(血)不足型老年重度FC患者,可进一步缓解便秘症状,增加CSBM次数,促进正常肠道动力的恢复,提高患者的生活质量,改善中医证候疗效显著。Objective:To observe the clinical effect of Runchang pills and Huangqi tang combined with routine therapy for senile severe functional constipation(FC). Methods: A total of 90 cases of patients of qi-yin(blood) deficiency type were randomly divided into the control group and the observation group,45 cases in each group. In both groups,their life styles were regulated;they were given oral administration of mosapride citrate tablets, bifidobacterium triple viable capsules dissolving at intestines, and lactulose oral solution. The observation group was additionally given oral administration of modified Runchang pills and Huangqi tang. Both groups were treated for six weeks. Before and after treatment,scores of the main symptoms of constipation,score of Patient Assessment of Constipation Quality of Life Scale(PAC-QOL),and score of qi-yin(blood) deficiency syndrome were evaluated. The weekly frequency of complete spontaneous bowel movements(CSBM) at the 1 stweek before treatment and one week after treatment was recorded, and anorectal manometry was conducted. Anal resting pressure(ARP), maximum squeeze pressure(MSP), MSP duration and defecation pressure were recorded. The curative effect was compared between the two groups. Results: After treatment, the scores of the main symptoms of constipation in the two groups, such as fecal character, difficult defecation, defecation time, defecation frequency,abdominal distension and straining sensation,incomplete defecation and distending sensation,were decreased when compared with those before treatment(P<0.01);the above six scores in the observation group were lower than those in the control group(P<0.01). The scores of qi-yin(blood) deficiency syndrome in the two groups were decreased when compared with those before treatment(P<0.01),and the weekly frequency of CSBM was increased(P<0.01). The score of qi-yin(blood) deficiency syndrome in the observation group was lower than that in the control group(P<0.01),and the weekly frequency of CSBM was higher(P<0.01). In the two grou

关 键 词：功能性便秘 气阴(血)不足型 润肠丸 黄芪汤 直肠测压 生活质量 

分 类 号：R574.62[医药卫生—消化系统]