健脾理气润肠法治疗STC对患者临床症状及肠神经递质水平的影响  

Effects of invigorating spleen,regulating Qi,and moistening intestine therapy on clinical symptoms and intestinal neurotransmitter levels in patients with slow transit constipation

作　　者：梁榕钰 邓蓓蕾 LIANG Rong-yu;DENG Bei-lei(Department of Proctology,Shanghai Jing'an District Traditional Chinese Medicine Hospital,Shanghai 200040,CHINA)

机构地区：[1]上海市静安区中医医院肛肠科,上海200040

出　　处：《海南医学》2024年第4期486-491,共6页Hainan Medical Journal

基　　金：上海市静安区卫生科研课题-青年项目(编号:2021QN05)。

摘　　要：目的研究健脾理气润肠法应用于慢传输型便秘(STC)患者中的临床效果。方法选取2021年8月至2022年12月上海市静安区中医医院肛肠科收治的120例STC患者作为研究对象,采用随机数表法将所有患者分为两组各60例,跟踪随访1个月后,脱落5例,最终115例患者完成研究。其中58例接受乳果糖口服液治疗者设为对照组,57例接受健脾理气润肠汤联合乳果糖口服液治疗者设为观察组。比较两组患者治疗1个月后的治疗效果,以及入院时、治疗7 d、治疗1个月后的便秘主要性状评分、便秘患者症状自评量表(PAC-SYM)评分、Bristol评分、肠神经递质水平[生长抑素(SS)、血管活性肠肽(VIP)、P物质(SP)]和治疗24 h、48 h、72 h的结肠传输试验标志物残留率。结果观察组患者的治疗总有效率为98.25%,明显高于对照组的86.21%,差异有统计学意义(P<0.05);两组患者入院时的便秘主要症状评分比较差异均无统计学意义(P>0.05);治疗7 d、1个月后,观察组患者的各项便秘主要症状评分明显低于对照组,差异均有统计学意义(P<0.05);治疗7 d和1个月后,观察组患者的Bristol评分分别为(21.35±5.69)分、(15.63±3.88)分,明显低于对照组的(28.96±4.19)分、(20.20±4.52)分,PAC-SYM评分分别为(5.96±0.88)分、(6.33±0.76)分,明显高于对照组的(4.55±0.87)分、(5.69±0.74)分,差异均有统计学意义(P<0.05);治疗7 d、1个月后,观察组患者的SS水平分别为(18.52±3.44)ng/mL、(14.20±3.52)ng/mL,明显低于对照组的(21.20±3.69)ng/mL、(18.41±3.66)ng/mL,VIP水平分别为(36.52±5.58)ng/mL、(25.63±7.41)ng/mL,明显低于对照组的(40.10±5.20)ng/mL、(31.20±6.85)ng/mL,SP水平分别为(40.52±6.88)ng/mL、(55.52±7.41)ng/mL,明显高于对照组的(35.63±4.20)ng/mL、(44.52±8.52)ng/mL,差异均有统计学意义(P<0.05);治疗24 h、48 h、72 h后观察组患者的肠传输实验标志物残留率分别为(60.00±4.20)%、(30.00±5.10)%、(15.00±2.21)%,明显低�Objective To study the clinical effect of Jianpi Liqi Runchang decoction(invigorating spleen,regulating Qi,and moistening intestine)in patients with slow transit constipation(STC).Methods A total of 120 STC patients admitted to Department of Proctology,Shanghai Jing'an District Traditional Chinese Medicine Hospital from August 2021 to December 2022 were selected as the study objects.All patients were divided into two groups by random number table method,with 60 cases in each group.After 1 month of follow-up,5 cases were lost,and 115 patients finally completed the study.Among them,58 patients receiving lactulose oral liquid treatment were set as control group,and 57 patients receiving Jianpi Liqi Runchang decoction combined with lactulose oral liquid treatment were set as observation group.The treatment effect of the two groups was compared after 1 month of treatment.At admission,7 days after treatment,and 1 month after treatment,main symptoms score of constipation,Patient Assessment of Constipation Symptoms(PAC-SYM)score,Bristol score,intestinal neurotransmitter levels[somatostatin(SS),vasoactive intestinal peptide(VIP),substance P(SP)],and residual rate of colon transport test markers at 24 h,48 h,and 72 h after treatment were also compared.Results The total effective rate of observation group was 98.25%,which was significantly higher than 86.21%of the control group(P<0.05).There was no significant difference in the scores of major symptoms of constipation between the two groups at admission(P>0.05).After 7 days and 1 month of treatment,the scores of major symptoms of constipation in the observation group were significantly lower than those in the control group,with statistically significant differences(P<0.05).After 7 days and 1 month of treatment,the Bristol scores of the observation group were(21.35±5.69)points and(15.63±3.88)points,respectively,which were significantly lower than(28.96±4.19)points and(20.20±4.52)points of the control group;the PAC-SYM scores were(5.96±0.88)points and(6.33±0.76)points,r

关 键 词：慢传输型便秘 健脾理气润肠法 乳果糖 疗效 

分 类 号：R574.4[医药卫生—消化系统]