化浊解毒润肠方治疗热积型功能性便秘患者36例随机对照临床研究  

Functional Constipation of 36 Cases with Heat Accumulation Pattern Treated by Huazhuo Jiedu Runchang Formula(化浊解毒润肠方):A Randomized Controlled Trial

作　　者：朱叶珊 陆庆革 李凤红 李小海 胡泽 陈彤君 白国民 王清贤 ZHU Yeshan;LU Qingge;LI Fenghong;LI Xiaohai;HU Ze;CHEN Tongjun;BAI Guomin;WANG Qingxian(Hospital of Traditional Chinese Medicine of Tangshan City,Hebei Province,063000)

机构地区：[1]唐山市中医医院,河北省唐山市063000

出　　处：《中医杂志》2022年第9期845-850,共6页Journal of Traditional Chinese Medicine

基　　金：河北省中医药管理局科研计划(2020381)。

摘　　要：目的观察化浊解毒润肠方治疗热积型功能性便秘的临床疗效,并探讨其可能作用机制。方法将72例热积型功能性便秘患者按照随机数字表法分为治疗组和对照组各36例,对照组给予复方聚乙二醇电解质散(Ⅳ)治疗,服用方法:A剂、B剂各1包,同溶于125 ml温水中,每日2次口服;治疗组给予化浊解毒润肠方,每日1剂,水煎分2次口服。两组疗程均为4周。观察两组治疗前后每周完全自发排便次数、首次排便时间、便秘症状评分量表(KESS)评分、中医证候总积分、72 h结肠排出率;检测治疗前后两组患者血清5-羟色胺(5-HT)、胃动素(MOT)、血管活性肠肽(VIP)水平及肠道菌群(乳杆菌、双歧杆菌和大肠埃希菌)数量。结果治疗后两组每周完全自发排便次数均较治疗前明显增加(P<0.05),且治疗组明显高于对照组(P<0.05)。治疗后治疗组首次排便时间为(5.08±1.54)h,对照组为(9.08±1.38)h,治疗组明显短于对照组(P<0.05)。两组患者KESS评分、中医症状总积分、72 h结肠残留率及血清VIP水平均较治疗前明显降低(P<0.05),且治疗组明显低于对照组(P<0.05)。两组患者血清5-HT、MOT水平及肠道双歧杆菌、乳杆菌数量均较治疗前明显升高(P<0.05),且治疗组明显高于对照组(P<0.05)。结论化浊解毒润肠方可以增加热积型功能性便秘患者每周完全自发排便次数,改善便秘症状,缩短首次排便时间,其机制可能与调节血清5-HT、MOT、VIP水平及肠道菌群有关。Objective To explore the clinical effect and possible mechanism of Huazhuo Jiedu Runchang formula(化浊解毒润肠方)in the treatment of functional constipation(FC)with heat accumulation pattern.Methods Seventytwo FC patients with heat accumulation pattern were randomly divided into treatment group and control group,with 36 cases in each group.The control group was treated with polyethylene glycol electrolyte powder,by taking one package of agent A and agent B each dissolved in 125 ml of warm water,orally administered twice daily.The treatment group was given Huazhuo Jiedu Ruuchang formula orally,200 ml each time,twice daily.Both groups were treated for 4 weeks.The complete spontaneous defecation weekly frequency,time to first defecation,the Knowles Eccersley Scott Symptom Score(KESS),total traditional Chinese medicine(TCM)symptom score,and 72 h colonic excretion rate were assessed before and after treatment.Moreover,the levels of 5-hydroxytryptamine(5-HT),motilin(MOT)and vasoactive intestinal peptide(VIP)in the serum were determined,and the number of intestinal flora(Lactobacillus,Bifidobacterium,and Escherichia coli)was analyzed before and after treatment.Results After treatment,the complete spontaneous defecation weekly frequency significantly increased in both groups(P<0.05),and it was higher in the treatment group than in the control group(P<0.05).The time to first defecation in the treatment group was5.08±1.54 hours,significantly shorter than 9.08±1.38 hours in the control group(P<0.05).The KESS,total TCM symptom score,72 h colon residual rate and serum VIP level significantly decreased in both groups after treatment(P<0.05),and were significantly lower in the treatment group than in the control group(P<0.05).The levels of serum 5-HT and MOT,as well as the number of Bifidobacteria and Lactobacillus significantly increased after treatment in both groups(P<0.05),and were significantly higher in the treatment group than the control group(P<0.05).Conclusion Huazhuo Jiedu Runchang Formula can increase the c

关 键 词：功能性便秘 热积型 化浊解毒润肠方 肠道菌群 首次排便时间 72 h结肠残留率 

分 类 号：R256.35[医药卫生—中医内科学]