中药保留灌肠结合西沙比利对虚证型慢传输型便秘患者肛门动力学的影响

Effects of herbal retention-enema and cisapride on anal kinetics in patients with slow transit constipation of deficiency syndrome

目的观察益气活血润肠灌肠剂结合西沙比利对虚证慢传输型便秘患者肛门动力学的影响。方法将60例患者随机分为两组,治疗组30例采用益气活血润肠灌肠剂保留灌肠结合口服西沙比利治疗,对照组30例仅口服西沙比利;两组疗程均为14天,观察临床疗效及结肠运输试验、肛管直肠测压变化情况。结果①治疗组、对照组总有效率分别为83.3%、80.0%,组间临床疗效差异无统计学意义(P>0.05)。②治疗组治疗后、停药14天时与本组治疗前比较,结肠运输试验阳性率、标志物排出数及排除率差异均有统计学意义(P<0.05);治疗后与本组停药14天时比较,各指标差异均无统计学意义(P>0.05)。对照组治疗后与本组治疗前比较,各指标差异有统计学意义(P<0.05);治疗后与本组停药14天时比较,各指标差异均有统计学意义(P<0.05)。组间停药14天时比较,各指标差异均有统计学意义(P<0.05)。③治疗组治疗后、停药14天时与本组治疗前比较,直肠初始感觉阈值、直肠排便感觉阈值、直肠最大耐受量、肛管舒张压差异有统计学意义(P<0.05),对照组差异均无统计学意义(P>0.05);组间治疗后、停药14天时比较,各指标差异均有统计学意义(P<0.05)。结论益气活血润肠灌肠剂结合西沙必利具有增强肠道动力的作用,可有效用于虚证型慢传输型便秘的临床治疗。

Objective To observe the effects of herbal retention-enema and cisapride on anal kinetics in patients with slow transit constipation.Methods Sixty subjects were randomized into two groups： treatment group in which 30 cases were treated with Supplementing Qi and activating blood circulation bowel enema retention enema combined with oral administration of cisapride,The control group of 30 cases was taking cisapride;Two groups were treated for 14 days,through the observation of the two groups before and after treatment of anal dynamics change,objective evaluation of Yiqi Huoxue bowel enema in the treatment of slow transit constipation of deficiency syndrome of effectiveness,safety.Results ①Colonic transit test positivity rate,number of markers and elimination rate of discharge：The two groups before and after treatment there was a significant difference in（P0.01）;After treatment in two groups have no significant difference in efficiency comparison（P0.05）;But the treatment group in 2 weeks after the results were better than the control group.②Anorectal manometry： Rectal sensory thresholds,initial bowel sensation threshold and the maximum tolerance,maximal anal systolic blood pressure and diastolic blood pressure and other indicators of anal canal,The initial feeling of rectum in the treatment group with significant difference before and after treatment（P0.01）;While the control group showed no significant difference before and after treatment（P0.05）;After two weeks,the treatment group was better than the control group the indexes.The treatment group,control group total effectiveness respectively is 83.3%,80%;Comparison of clinical efficacy between groups,the difference was not statistically significant.The two groups before treatment of colonic transit test positivity rate,discharge and the number of markers exclusion rate had no statistical significance（P0.05）.The two groups before and after treatment group,the index difference has statistics significance（P0.05）.Between group after treatment,there were no significant differences among the various indicators（P0.05）.Between group discontinued 14 days more,the index difference has statistics significance（P0.05）（table 2）.The two groups before treatment of anorectal manometry showed no significant difference（P0.05）.Before and after treatment group,treatment group rectal sensory thresholds,initial rectal sensory thresholds,defecation rectal MTD,anal diastolic pressure difference has statistics significance（P0.01）,The control group had no statistical significance between each index（P0.05）.Between group discontinued 14 days more,the index difference has statistics significance（P0.05）（table3）.Conclusion Benefiting qi for activating blood circulation and bowel enema combined with western medicine on patients with slow transit constipation anal dynamics have obvious effects on,and also can improve the curative effect in the near future,but traditional Chinese medicine retention enema anal systolic blood pressure and diastolic blood pressure effect and mechanism need further study.