强化细则罗马Ⅲ标准的一般疗法辅助普芦卡必利对老年功能性便秘的临床疗效观察

Clinical observation of intensive physical training combined with prucalopride on the treatment of functional constipation in the elderly

[目的]观察强化细则罗马Ⅲ标准的一般疗法辅助普芦卡必利治疗老年功能性便秘的临床综合疗效。[方法]选择老年功能性便秘134例,按照序数分为观察组、对照组,各67例,观察组给予强化细则罗马Ⅲ标准的一般疗法辅助普芦卡必利,对照组给予一般疗法辅助普芦卡必利,观察2组患者治疗前、治疗3个月后的症状积分变化,指标包括:排便困难、过度用力排便;粪便性状;排便时间;不尽、坠胀感;频率;腹胀;总积分等量化项目,问卷调查2组治疗前后SF-36健康量表变化。[结果]观察组与对照组治疗后便秘各症状积分以及生理功能、总体健康、活力、情感职能等9个维度的生活质量评分均较治疗前有明显改善。治疗后观察组的总有效率95.52%(64/67)明显高于对照组的53.73%(36/67),P<0.01;观察组、对照组在治疗后便秘总积分平均疗效指数分别为64.13%、33.03%,2组比较差异有统计学意义(P<0.05);治疗后观察组粪便性状、每次排便时间及每周排便次数积分改善幅度均好于对照组,生理功能、情感职能2个维度评分明显高于对照组(均P<0.01)。[结论]强化细则的罗马Ⅲ标准的一般疗法辅助普芦卡必利治疗老年功能性便秘,具有良好的疗效,易被老年患者接受,能显著改善功能性便秘的临床症状及其生命质量。

[Objective]To observe the clinical effect of of intensive physical training defined by Rome III criteria combined with prucalopride on the treatment in elderly patients with functional constipation. [Methods]Total 134 elderly patients with functional constipation were involved,and were divided into ob servation group（A）,control group（B） according to the visit sequence with 67 cases in each group. Patients in A group were given intensive physical training described in Rome Ⅲ standard general therapy. Patients in B group were given simple universal advice. The symptoms were scored in the two groups before and 3 months after the treatment. The observation indexes included： the difficulty of defecation, excessive exertion of defecation, stool traits, defecation time, the sensation of tenesmus, anal pendant expansion, the fre- quency of abdominal distension,the total score and other quantitative items. The SF36 health scale ques- tionnaire was used to evaluated the life quality before and 3 months after the treatment. I-Results]The total effective rate in A group was 95.52%（64/67）,which was significantly higher than that of B group（36/67） 53.73%（P〈0.05）. The total score of A and B were 50.27% and 33.03% ,respectively,which was signifi- cantly different（P〈0.05）. The improvement of the quality of life in A groups was significantly higher than that in B group（P〈0. 01）. [Conclusion]Intensive physical training treatment shows well effect in elderly patients with functional constipation,which is easy to be accepted by the patients. It can significantly im- prove the clinical symptoms and quality of life indicators of functional constipation.