加味枳实白术汤治疗功能性便秘气阴两虚证临床研究

Clinical Study on Modified Zhishi Baizhu Decoction for Functional Constipation with Deficiency of Both Qi and Yin Syndrome

目的:观察加味枳实白术汤治疗功能性便秘气阴两虚证的临床疗效。方法:采用随机数字表法将96例功能性便秘气阴两虚证患者分为对照组、试验组各48例。对照组口服滋阴润肠口服液治疗,试验组给予加味枳实白术汤治疗。比较2组治疗前后便秘症状评分、便秘患者生活质量自评量表(PAC-QOL)评分、周自发排便次数及血清胃动素(MTL)、血管活性肠肽(VIP)、胃泌素(GAS)水平,并评估2组临床疗效及不良反应发生情况。结果:试验组总有效率93.75%,高于对照组79.17%(P<0.05)。2组治疗后便秘症状评分、PAC-QOL维度(生理、社会心理、担忧、满意度)评分、血清VIP水平较治疗前降低(P<0.05),周自发排便次数增多(P<0.05),血清MTL、GAS水平升高(P<0.05);试验组治疗后便秘症状评分、PAC-QOL评分及血清VIP水平低于对照组(P<0.05),周自发排便次数多于对照组(P<0.05),血清MTL、GAS水平高于对照组(P<0.05)。2组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:加味枳实白术汤治疗功能性便秘气阴两虚证疗效确切,能有效改善患者胃肠功能,提高生活质量,安全性较高。

Objective:To observe the clinical effect of modified Zhishi Baizhu Decoction for functional constipation with deficiency of both qi and yin syndrome.Methods:A total of 96 cases of patients with functional constipation with deficiency of both qi and yin syndrome were divided into the control group and the trial group according to the random number table method,with 48 cases in each group.The control group was given oral administration of Ziyin Runchang Oral Liquid,and the trial group was treated with modified Zhishi Baizhu Decoction.Before and after treatment,symptom scores of constipation,scores of Patient Assessment of Constipation Quality of Life(PAC-QOL),number of spontaneous defecation per week,and levels of motilin(MTL),vasoactive intestinal peptide(VIP)and gastrin(GAS)were compared between the two groups.The clinical effects and incidence of adverse reactions were evaluated between the two groups.Results:The total effective rate was 93.75%in the trial group,higher than that of 79.17%in the control group.After treatment,the symptom scores of constipation,the PAC-QOL scores including physiological,social psychology,concern,and satisfaction degree,and VIP levels in serum in the two groups were decreased when compared with those before treatment(P<0.05),the number of spontaneous defecation per week was increased(P<0.05),and the levels of MTL and GAS in serum were increased(P<0.05).After treatment,the symptom scores of constipation,PAC-QOL scores,and VIP levels in serum were lower than those in the control group(P<0.05),and number of spontaneous defecation per week was more than that in the control group(P<0.05),and levels of MTL and GAS in serum were higher than those in the control group(P<0.05).There was no significant difference being found in the comparison of the incidence of adverse reactions between the two groups(P>0.05).Conclusion:Modified Zhishi Baizhu Decoction has a definite curative effect in functional constipation of deficiency of both qi and yin syndrome type,which can effectively improve the gastrointestinal function and quality of life,with high safety.