参芪举陷汤联合套扎术治疗气虚下陷型便秘患者的疗效观察  

Observation on Efficacy of Shenqi Juxian Decoction Combined with Ligation Surgery in Treating Patients with Qi Deficiency Depression Type Constipation

作　　者：周锡晨 王芳芳[1] 李勇骑 王晓雯 牛明了[1] 张龙江[1] ZHOU Xi-chen;WANG Fang-fang;LI Yong-qi;WANG Xiao-wen;NIU Ming-liao;ZHANG Long-jiang(Second Clinical Medical College of Henan University of Chinese Medicine,The Second District of Anorectal Department,Henan Province Hospital of TCM,Zhengzhou Henan 450000)

机构地区：[1]河南中医药大学第二临床医学院/河南省中医院肛肠科二区,河南郑州450000

出　　处：《世界中西医结合杂志》2024年第9期1812-1817,共6页World Journal of Integrated Traditional and Western Medicine

基　　金：河南省中医药科学研究专项课题(20-21ZY2064)。

摘　　要：目的探究参芪举陷汤联合套扎术对气虚下陷型便秘患者的治疗疗效。方法选取2022年1月—2023年2月期间河南中医药大学附属医院收治的便秘(气虚下陷型直肠黏膜内脱垂所致便秘)患者127例,采用随机数字表法分为对照组66例和观察组61例。对照组采用套扎术治疗,观察组在对照组基础上联合参芪举陷汤。持续治疗4周后,观察比较两组患者临床疗效、不良反应情况,治疗前后中医证候评分、肛管直肠压力、黏膜5-羟色胺(5-hydroxytryptamine,5-HT)、时受体电位通道V1(Transient receptor potentialchannel vanilloid subfamily member l,TRPVl)、血清D-乳酸、抑郁自评量表(Self-rating depression scale,SDS)、焦虑自评量表(Self-rating anxiety scale,SAS)、简明健康状况调查表(Short form 36 health survey questionnaire,sF-36)评分。结果治疗后观察组临床总有效率93.44%(57/61)明显高于对照组80.30%(53/66),差异有统计学意义(P<0.05)。治疗后两组患者各中医证候评分均较治疗前降低,差异有统计学意义(P<0.05);且观察组中医证候评分明显低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者舒张压、最大收缩压均较治疗前升高,静息压均较治疗前降低,差异有统计学意义(P<0.05);且观察组舒张压、最大收缩压均明显高于对照组,静息压明显低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者TRPVl、5-HT表达及血清D-乳酸浓度均较治疗前降低,差异有统计学意义(P<0.05);且观察组TRPVl、5-HT阳性表达均明显低于对照组,差异有统计学意义(P<0.05),两组间血清D-乳酸水平比较,差异无统计学意义(P>0.05)。治疗后两组患者SAS、SDS评分较治疗前降低,sF-36评分较治疗前升高,差异有统计学意义(P<0.05);且观察组SDS、SAS评分低于对照组、sF-36评分高于对照组,差异有统计学意义(P<0.05)。治疗期间,两组患者不良反应发生率比较,差异无统计学意义无差异(χ2Objective To explore the efficacy of Shenqi Juxian decoction combined with ligation surgery in treating patients with Qi-deficiency depression type constipation.Methods 127 patients with constipation(caused by rectal mucosal prolapse with Qi-deficiency depression type)were selected from the Affiliated Hospital of Henan University of Chinese Medicine between January 2022 and February 2023.They were randomly divided into a control group(66 patients)and an observation group(61 patients)using the random number table method.The control group received ligation surgery,while the observation group received Shenqi Juxian decoction in addition to the ligation surgery.After four weeks of continuous treatment,clinical efficacy,adverse reactions,TCM syndrome scores,anorectal pressure,mucosal 5-hydroxytryptamine(5-HT),transient receptor potential channel vanilloid subfamily member l(TRPVl),serum D-lactic acid,Self-Rating Depression Scale(SDS),Self-Rating Anxiety Scale(SAS),and short form-36 health survey questionnaire(SF-36)scores were observed and compared between the two groups before and after treatment.Results After treatment,the overall clinical effectiveness rate in the observation group was 93.44%(57/61),significantly higher than the 80.30%(53/66)in the control group,with a statistically significant difference(P<0.05).TCM syndrome scores in both groups were significantly lower after treatment compared to before treatment,with statistically significant differences(P<0.05);the observation group showed significantly lower scores than the control group,with statistically significant differences(P<0.05).After treatment,diastolic blood pressure and maximum systolic blood pressure in both groups were significantly higher,while resting pressure was significantly lower compared to pre-treatment values,with statistically significant differences(P<0.05);the observation group had significantly higher diastolic and maximum systolic pressures and lower resting pressure than the control group,with statistically significant differences

关 键 词：参芪举陷汤 套扎术 便秘 肛管直肠压力 5-羟色胺 焦虑 抑郁 

分 类 号：R256.35[医药卫生—中医内科学]