济川煎加味联合持续规范化健康教育干预用于老年功能性便秘患者的效果观察

Jichuan decoction addition combining continuous standardized health education intervention for elderly patients with functional constipation

目的探讨济川煎加味联合持续规范化健康教育干预用于老年功能性便秘患者的价值。方法将160例符合罗马Ⅲ诊断标准的脾肾阳虚型老年功能性便秘患者随机分为观察组和对照组，各80例。对照组口服西沙比利片，常规健康教育。观察组采用加味济川煎治疗，并进行持续规范化健康教育干预。连续服药3个疗程后观察临床疗效，利用PAC—QOL量表评价生活质量。结果治疗后7d，观察组排便费力、粪便性状、排便不尽感、排便次数症状积分分别为（0．49±0．37）、（0．34±0．22）、（0．63±0．16）、（0．44±0．13），降低幅度较对照组[（1．43±0．25）、（1．36±0．29）、（1．17±0．53）、（1．09±0．52）]更明显；对照组痊愈1例，显效6例，有效10例，无效63例，总有效率21．2％；观察组痊愈33例，显效42例，有效5例，无效0例，总有效率100．0％。观察组总有效率明显高于对照组（x2=19．02，P〈0．05）；治疗后2年，观察组对便秘的焦虑与关注、生理功能的紊乱、心理障碍、满意度、总体评价等维度的评分依次为（0．98±0．17）、（0．78±0．23）、（0．56±0．11）、（0．62±0．24）、（0．95±0．15），均显著低于对照组[（1．58±1．01）、（1．04±0．68）、（1．13±0．31）、（1．87±1．12）、（1．17±0．73）]，生活质量更具优势（均P〈0．05）。结论济川煎加味联合全程持续规范化健康教育治疗老年功能性便秘，疗效持续确切，大便畅而不泻，泻下而不伤正，标本兼治，排便功能和心理情绪改善明显，复发率低，提高生活质量，促进全面康复，值得推广。

Objective To investigate the value of Jichuan decoction addition combining continuous standardized health education intervention for elderly patients with functional constipation. Methods 160 patients diagnosed with functional constipation of spleen and kidney Yang deficiency type by Roman Ⅲ diagnosis standard were randomly divided into an observation group and a control group, 80 cases for each group. The control group orally took cisapride tablets and received routine health education. The observation group were treated with Jichuan decoction addition and intervened by continuous standardized health education. After 3 continuous treatment courses, the clinical efficacies were observed and the life quality was evaluated by PAC-QOL scale. Results 7 days after treatment, the integral scores of defecation, stool property, endless defecation, and stool frequency were （0.49±0.37）, （0.34±0.22）, （0.63±0.16）, and （0.44±0.13） in the observation group and were （1.43±0.25）, （1.36±0.29）, （1.17±0.53）, and （1.09±0.52） in the control group. 1 case recovered, 6 cases had marked effect, 10 cases were effective, and 63 had no effect in the control group and the total effective rate was 21.2%; 33 cases recovered, 42 cases had marked effective, and 5 cases were effective in the observation group and the total effective rate was 100.0%; the total effective rate was obviously higher in the observation group than in the control group （X2= 19.02, P 〈 0.05）. Two years after the treatment, the scores of anxiety and concern of constipation, physiological function disorder, mental disorder, satisfaction, and overall evaluation were （0.98±0.17）, （0.78±0.23） , （0.56±0.11）, （0.62±0.24）, and （0.95±0.15） in the observation group and were （1.58±1.01）, （1.04±0.68）, （1.13±0.31）, （1.87±1.12）, （1.17±0.73） in the control group （all P 〈 0.05）. Conclusions Jichuan decoction addition combining continuous standardized health education intervention for elderly patients with functional constipation is effective; the patients have continuous and smooth defecation without diarrhea and harm; the symptoms and the disease can be cured; the defecation function and psychological mood will be obviously improved; the recurrence rate is low; the patients＇ life quality will improved; the comprehensive rehabilitation will be promoted; so it is worth being generalized.