唐远山名中医治疗功能性便秘的临床经验研究  

Clinical experience research of Tang Yuanshan famous traditional Chinese medicine in the treatment of functional constipation

作　　者：王昆 唐远山 李朝阳 魏妮 杨丽丽 沙静涛 李媛媛 孙兴伟 WANG Kun;TANG Yuanshan;LI Chaoyang;WEI Ni;YANG Lili;SHA Jingtao;LI Yuanyuan;SUN Xingwei(Xi'an Hospital of Traditional Chinese Medicine,Xi'an 710021;the First Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710061,China)

机构地区：[1]西安市中医医院,陕西西安710021 [2]西安交通大学第一附属医院,陕西西安710061

出　　处：《临床医学研究与实践》2022年第36期152-156,共5页Clinical Research and Practice

基　　金：西安市卫生健康委员会中医药科研项目(No.SZL202020)。

摘　　要：目的通过随机对照研究分析唐远山名中医治疗功能性便秘的临床经验。方法选择2020年7月至2021年7月于西安市中医医院就诊的120例功能性便秘患者作为研究对象,按随机数字表法将其分为治疗组和对照组,各60例。治疗组脱落4例,最终纳入56例,对照组脱落3例,最终纳入57例。治疗组根据不同辨证分型采用唐远山主任相应的经验方治疗,对照组采用乳果糖口服溶液治疗。比较两组的临床疗效及复发率、肛门直肠测压指标、生活质量评分、治疗安全性。结果治疗2周后,治疗组的治疗总有效率高于对照组(P<0.05)。治疗后4周,治疗组的复发率为8.70%,对照组的复发率为83.36%,治疗组的复发率显著低于对照组(P<0.05)。治疗2周后,两组的肛管静息压、肛门松弛率、直肠最大耐受容量比较,差异无统计学意义(P>0.05);治疗2周后,治疗组的肛管最大收缩压、直肠排便压力大于对照组,直肠初始感觉阈值、直肠初始排便阈值小于对照组,差异具有统计学意义(P<0.05)。治疗2周后,两组的生活质量评分均降低,且治疗组低于对照组,差异具有统计学意义(P<0.05)。两组患者在治疗过程中均无明显不良反应发生。结论唐远山名中医在临床中发现气滞导致的便秘较多,并将功能性便秘分为气滞、阴虚、阳虚三型,临证中以和法为指导思想,重视四诊合参,用药时随证加减,疗效显著。中医药治疗功能性便秘与乳果糖相比较,疗效确切,复发率低,不仅能改善临床症状,而且能提高患者的生活质量,且无明显不良反应,安全性高。Objective Through randomized controlled study to analyze the clinical experience of Tang Yuanshan famous traditional Chinese medicine in the treatment of functional constipation.Methods A total of 120 patients with functional constipation who were treated in Xi'an Hospital of Traditional Chinese Medicine from July 2020 to July 2021 were selected as the research objects.The patients were divided into treatment group and control group according to the random number table method,with 60 cases in each group.There were 4 cases dropped out in the treatment group and 56 cases were finally included.There were 3 cases dropped out in the control group and 57 cases were finally included.The treatment group according to different syndrome differentiation using director Tang Yuanshan corresponding experience treatment,the control group was treated with lactulose oral solution.The clinical efficacy and recurrence rate,anorectal manometry indexes,quality of life score and treatment safety of the two groups were compared.Results After 2 weeks of treatment,the total effective rate of treatment in the treatment group was higher than that in the control group(P<0.05).At 4 weeks after treatment,the recurrence rate of the treatment group was 8.70%,and the control group was 83.36%,the recurrence rate of the treatment group was significantly lower than that of the control group(P<0.05).After 2 weeks of treatment,there were no significant differences in anal resting pressure,anal relaxation rate and rectal maximum tolerable volume between the two groups(P>0.05);after 2 weeks of treatment,the maximum anal canal systolic pressure and rectal defecation pressure in the treatment group were higher than those in the control group,and the rectal initial sensory threshold and rectal initial defecation threshold were lower than those in the control group,and the differences were statistically significant(P<0.05).After 2 weeks of treatment,the quality of life score of the two groups decreased,and that of the treatment group was lower than the con

关 键 词：功能性便秘 名中医经验 生活质量 肛门直肠测压指标 

分 类 号：R256.35[医药卫生—中医内科学]