大黄附子汤加减治疗老年脾气虚弱型便秘的临床研究

Clinical Study of Dahuang Fuzi Decoction in Treatment of Spleen-qi Deficiency Senile Constipation

目的探讨大黄附子汤加减治疗老年脾气虚弱型便秘的临床研究。方法 2016年3月—2018年4月将该院辨证为脾气虚弱型便秘老年患者104例,随机分两组,各52例,对照组采用莫沙必利15 mg口服;在此基础上,观察组采用大黄附子汤加减治疗,每日1剂,治疗2周为1个疗程。比较两组患者临床疗效、Wexner便秘系统、便秘患者生活质量量表(constipation quality of life scale,PAC-QOL)及中医证候积分,记录不良反应。结果对照组有效率80. 77%低于观察组94. 23%,差异具有统计学意义(P <0. 05)。两组患者治疗前Wexner便秘评分、PAC-QOL量表及中医证候积分比较,差异无统计学意义(P> 0. 05)。治疗后对照组和观察组Wexner便秘评分为11. 07±3. 64、7. 12±3. 27,PAC-QOL量表为46. 83±9. 57、35. 38±9. 20,排便困难为2. 05±1. 34、1. 14±0. 78,神疲乏力为2. 74±1. 23、0. 89±0. 57,胃脘痞满为2. 41±1. 12、0. 95±0. 64,恶心呕吐为2. 23±1. 03、0. 84±0. 73,对照组和观察组上述指标比较,差异具有统计学意义(P <0. 05)。对照组不良率11. 54%(6/52)与观察组不良率13. 46%(7/52)比较,差异无统计学意义(P> 0. 05)。结论大黄附子汤加减治疗老年脾气虚弱型便秘的疗效显著,有助于改善中医证候积分,提高生活质量,且患者安全性高,是一种安全有效的治疗方案。

Objective To explore the clinical study of Dahuang Fuzi Decoction in treating spleen-Qi deficiency senile constipation.Methods Totally 104 elderly patients with spleen-Qi deficiencyconstipation from March 2016 to April 2018 were divided into two groups randomly,52 cases in each group.The control group received Mosapride 15 mg orally and the observation group received Dahuang Fuzi Decoction,one dose per day,two weeks as a course of treatment.The clinical efficacy,Wexner constipation system,constipation quality of life scale(PAC-QOL)and TCM syndrome scores were compared between the two groups,and adverse reactions were recorded.Results The effective rate of the control group(80.77%)was lower than that(94.23%)of the observation group(P<0.05).There was no significant difference in Wexner constipation score,PAC-QOL scale or TCM syndrome score between the two groups before treatment(P>0.05).After treatment,Wexner constipation scores of Wexner in control group and observation group after treatment were 11.07±3.64 and 7.12±3.27,scores of PAC-QOL were 46.83±9.57 and 35.38±9.20,scores of difficult defecation were 2.05±1.34 and 1.14±0.78,scores of fatigued spirit and lack of strength were 2.74±1.23 and 0.89±0.57,scores of fullness or distension or pain in the stomach were 2.41±1.12 and 0.95±0.64,scores of nausea and vomiting were 2.23±1.03 and 0.84±0.73.All indexes above had statistically significant difference(P<0.05).There was no significant difference in the adverse rate between the control group and the observation group[11.54%(6/52)vs 13.46%(7/52),P>0.05].Conclusion Dahuang Fuzi Decoction is a safe and effective treatment for spleen-Qi deficiency senile constipation,which is helpful to improve the integral of TCM syndromes,the quality of life,and has high safety.