济川煎治疗老年功能性便秘临床研究  

Clinical Study on Jichuan Decoction(济川煎)for Functional Constipation in the Elderly

作　　者：高静[1] 李国荣 张本艳 许翠萍 GAO Jing;LI Guorong;ZHANG Benyan;XU Cuiping(Shandong University of Traditional Chinese Medicine,Jinan 250355,China;First Affiliated Hospital of Shandong First Medical University,Jinan 250014,China)

机构地区：[1]山东中医药大学,山东济南250355 [2]山东第一医科大学第一附属医院,山东济南250014

出　　处：《山东中医杂志》2023年第12期1266-1273,共8页Shandong Journal of Traditional Chinese Medicine

基　　金：山东省自然科学基金项目(编号:ZR202102280528);山东省中医药科技发展计划项目(编号:2021Z037)。

摘　　要：目的:探讨济川煎治疗老年功能性便秘的临床疗效。方法:选择153例65岁及以上的功能性便秘患者,分为两组,研究组78例服用济川煎治疗,对照组75例采用功能性便秘一般治疗法。治疗前1周开始,对患者排便频率、粪便质量、粪便含水量、粪便性状、SF-36健康量表进行评估,治疗4周后再持续观察4周,观察济川煎的临床疗效。采用qPCR TaqMan探针法定量检测双歧杆菌(Bifidobacterium)、乳酸杆菌(Lactobacillus)、拟杆菌(Bacteroides)、肠杆菌(Enterobacter)和肠球菌(Enterococcus)的含量,以探讨济川煎对老年功能性便秘患者肠道微生物的影响。结果:研究组治疗4周后排便频率由平均每周2.2次提高至4~5次;平均排便质量由平均每次75~80 g提高至105~110 g,Bristol粪便性状量表平均评分治疗前2.58分,大多数患者表现出粪便干燥、硬块且成条或成条但有裂纹,治疗后评分显著提高,达到4分;治疗前患者SF-36健康量表评分低于50分,济川煎治疗后,SF-36评分提高至50~60分。上述指标研究组治疗效果优于对照组。济川煎治疗前肠杆菌数量和肠球菌的数量多于双歧杆菌、拟杆菌和乳酸杆菌,治疗后拟杆菌、乳酸杆菌和双歧杆菌的丰度显著增加,而肠球菌和肠杆菌丰度显著减少,在这几种特定菌群中,济川煎治疗后,双歧杆菌数量最多。对照组治疗后,拟杆菌丰度增加,其他菌群变化无统计学意义(P<0.05)。结论:济川煎治疗可有效改善肠道菌群稳态,缓解老年人功能性便秘,提高老年人生活质量。Objective:To investigate the efficacy of Jichuan Decoction(济川煎)on functional constipation in the elderly.Methods:A total of 153 patients with functional constipation aged 65 and above were divided into two groups.The research group was treated with Jichuan Decoction(78 patients)and the control group was treated with conventional treatment for functional constipation(75 patients).The frequency of defecation,fecal weight,fecal water content,fecal characteristics and SF-36(the MOS item form health survey)of the patients were evaluated weekly starting from 1 week before treatment.After 4 weeks of treatment,the efficacy of Jichuan Decoction was observed continuously for 4 weeks.The contents of bifidobacterium,lactobacillus,bacteroides,enterobacter and enterococcus were quantitatively detected by qPCR TaqMan probe method.In order to investigate the effect of Jichuan Decoction on intestinal microflora in elderly patients with functional constipation.Results:After 4 weeks of treatment,the frequency of stool increased from 2.2 times per week to 4~5 times per week in the research group.The average defecation weight increased from 75~80 g to 105~110 g each time,and the average Bristol score was about 2.58 times compared before treatment.Most patients showed dry,lumpy stool in sausage shape with cracks,and the scores were significantly improved after treatment,reaching about 4.The SF-36 score before treatment was lower than 50 points,but after treated with Jichuan Decoction,SF-36 score increased to 50~60 points.The above indicators in the research group is better than those in the control group.The numbers of enterobacterium and enterococcus were higher than those of bifidobacterium,bacteroides and lactobacillus before treatment.After treatment,the number of bifidobacterium,bacteroides and lactobacillus increased significantly,while the numbers of enterobacterium and enterococcus decreased significantly.In these specific bacteria groups,the number of bifidobacterium was the highest after treated with Jichuan Decoction.

关 键 词：功能性便秘 济川煎 肠道菌群 排便频率 排便质量 Bristol粪便性状量表评分 SF-36健康量表 

分 类 号：R256.35[医药卫生—中医内科学] R289.5[医药卫生—中医学]