补肾健脾和胃法联合西药治疗老年顽固性便秘效果及对Wexner便秘评分、肠道菌群的影响  

Clinical Efficacy of Bushen Jianpi Hewei Therapy Combined with Western Medicine in Treatment of Elderly Patients with Intractable Constipation and Its Effects on Wexner Constipation Score and Intestinal Flora

作　　者：王海峰[1] 董秋安[2] 李健[1] 罗帮镇[1] 邓冰[1] 刘阳[1] 黄俊玲[1] 李宇航 马文林[1] WANG Hai-feng;DONG Qiu-an;LI Jian;LUO Bang-zhen;DENG Bing;LIU Yang;HUANG Jun-ling;LI Yu-hang;MA Wen-lin(Department of Geriatrics,Tongji Hospital Affiliated to Tongji University,Shanghai 200065,China;Department of Traditional Chinese Medicine,Tongji Hospital Affiliated to Tongji University,Shanghai 200065,China)

机构地区：[1]同济大学附属同济医院老年医学科,上海200065 [2]同济大学附属同济医院中医科,上海200065

出　　处：《解放军医药杂志》2022年第2期104-107,共4页Medical & Pharmaceutical Journal of Chinese People’s Liberation Army

基　　金：上海市卫健委科研项目(2019SY026)。

摘　　要：目的探究补肾健脾和胃法联合西药治疗老年顽固性便秘效果及对Wexner便秘评分、肠道菌群的影响。方法选取2019年6月—2021年1月收治的老年顽固性便秘76例,按照治疗方法分为观察组和对照组各38例,对照组给予聚乙二醇治疗,观察组在对照组基础上予以补肾健脾和胃法治疗。比较治疗4周后2组中医证候疗效差异,比较治疗前及治疗4周后2组中医症状积分、便秘严重程度(Wexner便秘评分)、肠道菌群状态、血清学指标[P物质(SP)、血管活性肠肽(VIP)、神经肽Y(NPY)、胃动素(MOT)]变化。结果观察组总有效率高于对照组(P<0.05)。2组治疗4周后中医症状积分、Wexner便秘评分、VIP、NPY水平均较治疗前降低,且观察组低于对照组(P<0.05)。2组治疗4周后SP、MOT水平均较治疗前升高,且观察组高于对照组(P<0.05);治疗4周后,观察组双歧杆菌、乳酸杆菌水平高于治疗前和对照组,大肠埃希菌、肠球菌水平低于治疗前和对照组(P<0.05)。结论补肾健脾和胃法联合西药治疗老年顽固性便秘效果较好,可降低Wexner便秘评分,有利于肠道菌群及胃肠道激素水平调节。Objective To explore clinical efficacy of Bushen Jianpi Hewei therapy combined with western medicine in treatment of elderly patients with intractable constipation and its effects on Wexner constipation score and intestinal flora.Methods A total of 76 elderly patients with intractable constipation admitted between June 2019 and January 2021 were selected and divided into observation group(n=38)and control group(n=38)according to different therapeutic methods.Control group was treated with Polyethylene Glycol,while observation group was given Bushen Jianpi Hewei therapy on the basis of treatment for control group.In two groups,difference in clinical efficacy of TCM syndromes after treatment for 4 week was compared;scores of TCM symptoms,severity of constipation(Wexner constipation score),intestinal flora status and changes of serological indicators[substance P(SP),vasoactive intestinal peptide(VIP),neuropeptide Y(NPY),motilin(MOT)]before and after treatment for 4 weeks were compared.Results The total effective rate in observation group was significantly higher than that in control group(P<0.05).After treatment for 4 weeks,TCM symptom score,Wexner constipation score,VIP and NPY levels were significantly lower than those before treatment in two groups,and the above indexes in observation group were significantly lower than those in control group(P<0.05).After treatment for 4 weeks,SP and MOT levels were significantly higher than those before treatment in two groups,and the levels in observation group were significantly higher than those in control group(P<0.05).After treatment for 4 weeks in observation group,levels of bifidobacterium and lactobacillus were significantly higher,while escherichia coli and enterococcus were significantly lower than those before treatment in the same group and in control group(P<0.05).Conclusion Bushen Jianpi Hewei therapy combined with western medicine may achieve significant efficacy and reduce Wexner constipation score in treatment of elderly patients with intractable constipation,a

关 键 词：老年顽固性便秘 补肾健脾和胃法 聚乙二醇 Wexner便秘评分 P物质 神经肽Y 肠道菌群 

分 类 号：R442.2[医药卫生—诊断学]