四逆汤加味联合普芦卡必利治疗阳虚型慢性便秘患者

Additional Sini Tang Combined with Prucalopride in Treatment of Patients with Yang Deficiency Type Chronic Constipation

目的:探讨四逆汤加味联合普芦卡必利治疗阳虚型慢性便秘患者的临床疗效,为进一步提高阳虚型慢性便秘的治疗效果,减少药物不良反应提供新的治疗方案。方法:以本院2012年10月—2014年11月收治的278例阳虚型便秘患者作为研究对象,随机分为西药组和中西药结合组,每组各139例。西药组患者采用口服普芦卡必利治疗,中西药结合组采用口服普芦卡必利联合中药汤剂四逆汤加味治疗,两组均持续治疗12周。观察两组患者治疗前后临床症状积分、中医证候积分和结肠传输试验积分变化,并对治疗过程中的不良反应进行比较分析。结果:治疗后两组患者各项症状积分均较治疗前明显降低(P<0.05),组间比较中西药结合组患者各项临床症状积分及中医临床证候积分均明显低于西药组(P<0.05);结肠传输试验中西药结合组相比西药组其正常患者明显增加,中度患者明显减少(P<0.05);治疗后中西药结合组在肛管静息压、肛管最大收缩压、肛门括约肌长度以及持续挤压时间方面的改善均明显优于西药组(P<0.05);治疗后与西药组相比,中西药结合组患者痊愈率明显增加,无效率明显降低(P<0.05);治疗过程中中西药结合组患者不良反应发生率明显低于对照组(P<0.05),差异均具有统计学意义。结论:联合四逆汤加味治疗阳虚型慢性便秘能有效提高普芦卡必利对患者临床症状的改善作用,提高临床疗效,并显著减少患者不良反应的发生。

Objective： To study the curative effect of additional Sini Tang combined with prucalopride in treating patients with Yang deficiency type chronic constipation, in order to offer a new therapeutic schedule for improving the clinical curative effect and reduce adverse drug reactions. Method： Totally 278 cases of patients with Yang deficiency type chronic constipation treated in our hospital from October 2012 to November 2014 were taken as the research objects, and randomly divided into western medicine group and Chinese combined with western medicine group, each group was 139 cases. The western medicine group were treated by oral prucalopride, the Chinese combined with western medicine group were treated by oral prucalopride and additional Sini Tang, both groups were treated for 12 weeks. The changes of clinical symptoms, Chinese medicine symptom score and colon transmission test score of two groups before and after treatment were observed, and the adverse reactions in the process of treatment were compared and analyzed. Result： Various symptom scores of two groups after treatment were significantly lower than that before the treatment （P 〈 0.05）, and the comparison between the groups showed that the clinical symptoms and clinical symptom scores of Chinese combined with western medicine group were significantly lower than that of western medicine group （P 〈 0.05）. The colon transmission test showed that the number of normal patients of Chinese combined with western medicine group was significantly higher than that of western medicine group, with significantly fewer moderate patients （P 〈 0.05 ）. After the treatment, the improvement of anal canal resting pressure, anal canal maximum systolic blood pressure, the length of the anal sphincter and the continuous extrusion time of patients in Chinese combined with western medicine group were moresignificant than that of the western medicine group （P 〈 0.05 ）. After the treatment, compared with western medicine group, the cure rate of patients in Chinese combined with western medicine group was obviously increase and no efficiency patients were significantly decreased （P 〈 0.05）. During the treatment, the incidence of adverse reactions of Chinese combined with western medicine group was obviously lower than that of the control group （P 〈 0.05） , the differences were statistically significant. Conclusion： Combined therapy with additional Sini Tang in treating Yang deficiency type chronic constipation can effectively increase prucalopride＇s effect in relieving clinical symptoms, improve the clinical curative effect, and significantly reduce the occurrence of adverse reactions.