济川煎合必通汤加减治疗脾肾两虚型老年功能性便秘临床研究  

Clinical Study on Modified Jichuan Jian and Bitong Tang for Senile Functional Constipation of Spleen-Kidney Deficiency Type

作　　者：盛新民 孔伟 吴相坤 SHENG Xinmin;KONG Wei;WU Xiangkun

机构地区：[1]驻马店市第二中医院中医内科,河南驻马店463000 [2]驻马店市第二中医院肛肠科,河南驻马店463000

出　　处：《新中医》2022年第17期51-55,共5页New Chinese Medicine

摘　　要：目的:观察济川煎合必通汤加减治疗脾肾两虚型老年功能性便秘的临床疗效。方法:采用随机数字表法将142例脾肾两虚型老年功能性便秘患者随机分为观察组与对照组各71例。对照组给予常规西药治疗,观察组在对照组的基础上加用济川煎合必通汤加减治疗,2组持续治疗60 d。比较2组治疗前后中医证候积分、血清肠神经递质[一氧化氮(NO)、一氧化氮合酶(NOS)、生长抑素(SS)、P物质(SP)、血管活性肠肽(VIP)]、直肠感觉功能参数[初始阈值(FRS)、排便阈值(CRS)、最大耐受阈值(MRTS)]及中文版患者便秘状况评估量表(PAC-QOL)评分,并评价2组临床疗效及不良反应发生情况。结果:观察组与对照组总有效率分别为94.37%、83.10%,2组比较,差异有统计学意义(P<0.05)。治疗后,2组中医证候积分、NO、NOS、SS、VIP、FRS、CRS、MRTS、PAC-QOL各维度评分及总分均较治疗前降低(P<0.05),SP水平升高(P<0.05),且观察组上述指标改善优于对照组(P<0.05)。2组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:济川煎合必通汤加减治疗脾肾两虚型老年功能性便秘,可调节血清肠神经递质水平,提高直肠敏感性,改善患者生活质量,临床疗效确切。Objective:To observe the clinical effect of modified Jichuan jian and Bitong tang for senile functional constipation of spleen-kidney deficiency type.Methods:A total of 142 cases of senile patients with functional constipation of spleen-kidney deficiency type were divided into the observation group and the control group according to the random number table method,with 71 cases in each group.The control group was treated with routine western medicine,and the observation group was additionally treated with modified Jichuan jian and Bitong tang based on the treatment of the control group.Both groups were treated for 60 days.Before and after treatment,the Chinese medicine syndrome scores,serum intestinal neurotransmitters including nitric oxide(NO),nitric oxide synthase(NOS),somatostatin(SS),substance P(SP)and vasoactive intestinal peptide(VIP),rectal sensory function parameters including first-rectal sensation(FRS),constant rectal sensation(CRS)and maximum rectal tolerable sensation(MRTS),and scores of Chinese version of Patient Assessment of Constipation Quality of Life(PAC-QOL)questionnaire in the two groups were compared.The clinical effects and the incidence of adverse reactions in the two groups were evaluated.Results:The total effective rate was 94.37%in the observation group and 83.10%in the control group,the difference being significant(P<0.05).After treatment,Chinese medicine syndrome scores,NO,NOS,SS,VIP,FRS,CRS,MRTS,and scores of all dimensions and total scores of PAC-QOL in the two groups were decreased when compared with those before treatment(P<0.05),SP levels were increased(P<0.05),and the improvement in the above indexes in the observation group was better than that in the control group(P<0.05).There was no significant difference being found in the comparison of incidence of adverse reactions between the two groups(P>0.05).Conclusion:Modified Jichuan jian and Bitong tang for senile functional constipation of spleen-kidney deficiency type can regulate levels of serum intestinal neurotransmitters,and i

关 键 词：功能性便秘 老年 脾肾两虚证 济川煎 必通汤 一氧化氮 P物质 

分 类 号：R256.35[医药卫生—中医内科学]