针刺结合增液承气汤对老年慢性功能性便秘患者临床症状及胃肠功能的影响  

Effect of Acupuncture Combined with Zengye Chengqi Decoction on Clinical Symptoms and Gastrointestinal Function of Elderly Patients with Chronic Functional Constipation

作　　者：陈瑶 祁正亮[2] 王青 徐艺 王玉 胡小军 CHEN Yao;QI Zheng-liang;WANG Qing;XU Yi;WANG Yu;HU Xiao-jun(Department of Acupuncture and Moxibustion,Wuhan Puren Hospital,Wuhan 430081,China;Department of Geriatrics,Hubei Hospital of Traditional Chinese Medicine,Wuhan 430061,China)

机构地区：[1]武汉市普仁医院中医针灸科,武汉430081 [2]湖北省中医院老年病科,武汉430061

出　　处：《微循环学杂志》2024年第2期25-30,共6页Chinese Journal of Microcirculation

基　　金：武汉市中医药科研项目(WZ22C31)。

摘　　要：目的:观察针刺结合增液承气汤对老年慢性功能性便秘患者临床症状及胃肠功能的影响。方法:选取老年慢性功能性便秘患者90例,采用简单随机法分为乳果糖组(45例)和针药结合组(45例)。乳果糖组给予乳果糖口服溶液治疗,针药结合组在其基础上给予针刺结合增液承气汤治疗,连续治疗3个疗程。比较两组疗效及治疗前后肠神经递质、肠道菌群、结肠传输时间、Wexner便秘评分、中医证候积分差异。结果:针药结合组总有效率明显高于乳果糖组(93.33%vs 75.56%,P<0.01)。两组生长抑素(SS)及双歧杆菌、乳杆菌较治疗前显著升高,针药结合组较乳果糖组更高(P<0.01)。治疗后两组一氧化氮合酶(nNOS)、血管活性肠肽(VIP)、肠杆菌、酵母菌、左结肠传输时间(LCTT)、直肠乙状结肠传输时间(RSTT)、全结肠传输时间(TCTT)及Wexner便秘评分、中医证候积分较同组治疗前显著降低,针药结合组较乳果糖组更低(P<0.01)。结论:乳果糖口服溶液辅以针刺结合增液承气汤可缩短老年慢性功能性便秘患者结肠传输时间,调节肠道菌群,改善胃肠功能。Objective:To observe the effect of acupuncture combined with Zengye Chengqi Decoction on clinical symptoms and gastrointestinal function of elderly patients with chronic functional constipation.Method:Ninety cases of elderly patients with chronic functional constipation were selected and divided into lactulose group(45 cases)and needle-medicine combination group(45 cases)by simple random method.The lactulose group was treated with lactulose oral solution,and the needle and medicine combination group was treated with acupuncture combined with fluid-enhancing Cheng Qi Tang on its basis for 3 consecutive courses of treatment.Compare the efficacy of the two groups and the differences in enteric neurotransmitters,intestinal flora,colonic transit time,Wexner constipation score,and TCM evidence points before and after treatment.Results:The total effective rate was significantly higher in the needle-medicine combination group than in the lactulose group(93.33%vs 75.56%,P<0.01).Growth inhibitin(SS)and Bifidobacterium and Lactobacillus were significantly higher in both groups compared to pre-treatment,and were higher in the needle-medicine combination group compared to the lactulose group(P<0.01).After treatment,nitric oxide synthase(nNOS),vasoactive intestinal peptide(VIP),Enterobacteriaceae,yeast,left colonic transit time(LCTT),rectosigmoid transit time(RSTT),total colonic transit time(TCTT),and Wexner constipation scores and Chinese medicine evidence points were significantly lower in the two groups compared with those in the same group before treatment,while the combination of acupuncture and medication group was lower than the lactulose group(P<0.01).Conclusion:Lactulose oral solution supplemented with acupuncture combined with fluid-enhancing Chengqi Tang can shorten colonic transit time,regulate intestinal flora,and improve gastrointestinal function in elderly patients with chronic functional constipation.

关 键 词：针刺 增液承气汤 慢性功能性便秘 肠道菌群 胃肠功能 

分 类 号：R574.62[医药卫生—消化系统]