按中医体质饮食调护老年便秘平行对照研究

Diet Nursing of Senile Constipation based on TCM Constitution theory Paralleled Control Study

[目的]观察中医体质学说饮食调护老年便秘疗效。[方法]使用平行对照方法,将100例住院患者按中医体质分为五组。阴虚质组20例食性凉或寒、补阴津食物:早晚喝牛奶250m L或冲服蜂蜜水,忌辛辣、温热损耗阴津和助火生热之狗肉、羊肉、公鸡等,少用姜、葱、蒜、胡椒、辣椒之类;食物烹煮避免煎、烧、炒、烤,菜肴宜多清炖、清蒸为好。阳虚质组20例温阳通便:多食热性、温补性、补阳气食物,肉苁蓉15g入锅加水100m L,煮烂去渣备用,或羊肉100g切片加水500m L,煮烂入粳米50g,再加药汁煮粥,每日早晚空腹温服;忌苦寒耗气伤阳:苦瓜、冬瓜、白萝卜、白菜、绿豆芽、百合、蜂蜜等。气虚质组20例益气润肠:多食补气食物:黄芪15g加水500m L,煎至300m L,去渣留汁,入蜂蜜调匀,煮开代茶饮;少吃辛辣、刺激、耗气之荞麦、柚子、生萝卜、菊花、薄荷等,不宜饮茶、饮酒、抽烟。气郁质20例调肝理脾,通便导泻:多食行气、解郁、消食、醒神食物:小米60g煮粥服用,或取陈皮20g,郁李仁6g,煮后去渣,加适当蜂蜜调服;忌阻碍气机食物和中药:油腻、芋头、番薯等。连续护理14d为1疗程。观测临床症状、PAC-QOL、不良反应。护理1个疗程,判定疗效。[结果]PAC-QOL评分各组均有改善(P<0.05),体质组改善优于对照组(P<0.05,P<0.01)。[结论]按中医体质饮食调护老年便秘,疗效满意,无严重不良反应,值得推广。

[Objective]To observe the curative effect of diet nursing on senile constipation based on TCM constitution theory.[Method]The present research used a parallel control method.According to TCM constitution theory,a total of 100 hospitalized patients were divided into five groups with 20 cases in each.In yin-deficiencygroup,cool or cold foods for nourishing yin and body fluid were suggested： drinking milk 250 m L or honey in the morning and evening.It is prohibited to take dog meat,mutton,cock and other foods with pungent and spicy flavor,features of warming heat and consuming Yin and body fluid,and features of encouraging fire and generating heat.The use of ginger,onions,garlic,pepper,and hot pepper should be greatly reduced when cooking.Fried,burned,and roasting food should be prohibited as well.Steamed food are preferred.In yang-deficiency group,hot,warm,tonifying and yang foods were recommended for warming yang and relieving constipation.15 g cistanche was added into 100 m L water and boiled for decotion.100 g sliced mutton was added into 500 m L water.50 g polished round-grained rice was mixed when the mutton was boiled out.Then the decotion was put in for making porridge which was heated and taken on an empty stomach every morning and evening.Bitter gourd,wax gourd,green radish,cabbage,mungbean sprout,lily,honey,and other Qi-consuming or yang-consuming foods were prohibited.In Qi-deficiency group,Qi-tonifying foods for tonifying Qi and lubricatting the intestines were used.15 g astragalus was added into 500 m L water and boiled to 300 m L decotion.Then the decotion was mixed with honey and taken as tea.It is suggested to at less pungent,spicy,Qi-consuming foods（Buckwheat,gr apefruit,carrot,chrysanthemum,and mint）.Drinking tea and alcohol as well as smoking was inadvisable.In Qistagnation group,foods with features of promoting Qi,relieving depression,promoting digestion and inducing resuscitation were requested for regulating liver and spleen and reliving constipation： porridge made of 60 g millet and mixture of honey and herbal decotion（20g Tangerine peel and 6g bunge）.Foods and herbs blocking qi movement,namely greasy food,taro,and sweet potatoes,should be prohibited.14-days nursing was taken as a course.Clinical symptoms,PAC-QOL and adverse reactions were observed and curative effect were assessed after one-month nursing.[Results]PAC-QOL scores in all groups were improved（P0.05）,and the improvement of theconstitution group was superior to that of control group（P0.05,P0.01）.[Conclusion]TCM diet nursing hassatisfactory curative effect on senile constipation with no serious adverse reactions reported,which is worthy of promotion.