补气增液汤加减联合针刺治疗气阴两虚型慢传输型便秘临床研究

Clinical Study on Modified Buqi Zengye Decoction Combined with Acupuncture for Slow Transit Constipation of Dual Deficiency of Qi and Yin Type

目的:观察补气增液汤加减联合针刺治疗气阴两虚型慢传输型便秘(STC)的临床疗效。方法:选取90例气阴两虚型STC患者,按随机数字表法分为试验组、对照1组及对照2组,每组30例。对照1组剔除2例,对照2组剔除1例,最终纳入试验组30例、对照1组28例、对照2组29例。对照1组给予补气增液汤加减治疗,对照2组给予针刺治疗,试验组给予补气增液汤加减联合针刺治疗,3组均治疗30 d。比较3组临床疗效、便秘症状积分、标记物排出结果及胃肠激素[P物质(SP)及血管活性肠肽(VIP)]水平,评估治疗安全性。结果:治疗后,试验组总有效率96.67%,高于对照1组75.00%、对照2组68.97%(P<0.05)。3组粪便性状,腹胀,排便困难,排便时间,下坠、不尽、胀感,排便频率积分均较治疗前下降(P<0.05),试验组上述6项便秘症状积分均低于对照1组、对照2组(P<0.05)。3组运输异常数均较治疗前减少(P<0.05),试验组运输异常数少于对照1组、对照2组(P<0.05);3组48 h标记物排出数、72 h标记物排出数、72 h标记物排出率均较治疗前提高(P<0.05),试验组上述3项指标值均高于对照1组、对照2组(P<0.05)。3组血清SP水平均较治疗前升高(P<0.05),血清VIP水平均较治疗前下降(P<0.05);试验组血清SP水平均高于对照1组、对照2组(P<0.05),血清VIP水平均低于对照1组、对照2组(P<0.05)。对照1组、对照2组上述各项指标治疗后比较,差异均无统计学意义(P>0.05)。治疗期间,3组均未出现不良反应。结论:补气增液汤加减联合针刺治疗气阴两虚型STC疗效确切,可有效改善临床症状,提高结肠传输功能,调节胃肠激素水平,安全性高。

Objective:To observe the clinical effect of the combination use of modified Buqi Zengye Decoction and acupuncture on slow transit constipation(STC)of dual deficiency of qi and yin type.Methods:A total of 90 cases of STC patients of dual deficiency of qi and yin type were selected and assigned to the trial group,the control group 1 and the control group 2 according to the random number table method,with 30 cases in each group.Two cases were culled in the control group 1 and one case was culled in the control group 2,and finally 30,28 and 29 cases were included in the trial group,the control group 1 and the control group 2 respectively.The control group 1 was treated with modified Buqi Zengye Decoction,the control group 2 was treated with acupuncture and the trial group was combination use of modified Buqi Zengye Decoction and acupuncture.The three groups were treated for 30 days.The clinical effects,scores of constipation-related symptoms,results of discharged marker,and levels of gastrointestinal hormones[substance P(SP)and vasoactive intestinal peptide(VIP)]were compared between the three groups;the treatment safety was evaluated.Results:After treatment,the total effective rate was 96.67%in the trial group,higher than that of 75.00%in the control group 1 and 68.97%in the control group 2(P<0.05).The scores of stools characters,abdominal distention,difficulty in defecation,defecation time,straining,endless defecation and defecation frequency in the three groups were down-regulated when compared with those before treatment(P<0.05),and the above six scores in the trial group were lower than those in the control group 1 and the control group 2(P<0.05).The number of transit abnormalities in the three groups were reduced when compared with those before treatment(P<0.05),and the number of transit abnormalities in the trial group was less than that in the control group 1 and the control group 2(P<0.05);the number of discharged 48 h marker and 72 h marker,and the rate of discharged 72 h marker in the three groups were elevated when compared with those before treatment(P<0.05),and the above three indexes in the trial group were higher than those in the control group 1 and the control group 2(P<0.05).The serum SP levels in the three groups were increased when compared with those before treatment(P<0.05),and the serum VIP levels were dwindled when compared with those before treatment(P<0.05);the serum SP level in the trial group was higher than that in the control group 1 and the control group 2(P<0.05),and the serum VIP level was lower than that in the control group 1 and the control group 2(P<0.05).There was no significant difference being found in the comparisons of above indexes between the control group 1 and the control group 2(P>0.05).There was no adverse reaction in the three groups during the treatment.Conclusion:The combination use of modified Buqi Zengye Decoction and acupuncture has a definite curative effect on STC of dual deficiency of qi and yin type,which can effectively improve the clinical symptoms and the colonic transit activity,and regulate the levels of gastrointestinal hormones with great safety.