升督平木汤联合琥珀酸普芦卡必利治疗腰骶神经源性便秘的临床研究

Clinical Study of Shengdu Pingmu Decoction Combined with Prucalopride Succinate for Treatment of Lumbosacral Neurogenic Constipation

【目的】观察升督平木汤联合琥珀酸普芦卡必利治疗腰骶神经源性便秘的临床疗效。【方法】将100例腰骶神经源性便秘患者随机分为治疗组和对照组,每组各50例。治疗组给予升督平木汤联合琥珀酸普芦卡必利治疗,对照组给予单纯口服琥珀酸普芦卡必利治疗,观察2组患者的中医证候疗效、便秘症状改善疗效、随访疗效和疗程结束后6个月的复发情况。【结果】(1)中医证候疗效:治疗组的愈显率和总有效率分别为92.0%(46/50)和98.0%(49/50),对照组分别为24.0%(12/50)和64.0%(32/50),治疗组的愈显率和总有效率均明显优于对照组(P<0.05)。(2)便秘症状改善疗效:治疗组的显效率和总有效率分别为90.0%(45/50)和100.0%(50/50),对照组分别为46.0%(23/50)和72.0%(36/50),治疗组的显效率和总有效率均明显优于对照组(P<0.05)。(3)治疗后,2组患者Wexner便秘评分均较治疗前明显降低(P<0.01),且治疗组的降低作用明显优于对照组(P<0.05)。(4)随访疗效:治疗期内每周完全自发排便≥3次的患者比例,治疗组为88.0%(44/50),对照组为54.0%(27/50),治疗组的随访疗效明显优于对照组(P<0.05)。(5)复发情况:疗程结束后6个月随访,治疗组的复发率为4.0%(2/50),明显低于对照组的20.0%(10/50),差异有统计学意义(P<0.05)。【结论】中药升督平木汤联合琥珀酸普芦卡必利治疗腰骶神经源性便秘疗效确切,既能有效改善患者的便秘情况,又能降低复发率。

Objective To observe the effect of Shengdu Pingmu Decoction combined with prucalopride succinate for the treatment of lumbosacral neurogenic constipation.Methods One hundred cases of lumbosacral neurogenic constipation patients were randomly divided into trial group and control group,50 cases in each group.The trial group was treated with Shengdu Pingmu Decoction combined with prucalopride succinate orally,and the control group was given oral use of prucalopride succinate alone.The clinical efficacy for traditional Chinese medicine(TCM)syndrome,efficacy for improving constipation symptoms,follow-up efficacy,and the recurrence of constipation 6 months after the course of treatment in the two groups were compared.Results(1)In respect of the TCM syndrome efficacy,the cure and markedly effective rate and the total effective rate of the trial group were 92.0%(46/50),98.0%(49/50)respectively,and those of the control group were 24.0%(12/50),64.0%(32/50)respectively.The trial group had higher cure and markedly effective rate and higher total effective rate than the control group(P<0.05).(2)In respect of the efficacy for improving constipation symptoms,the cure and markedly effective rate and the total effective rate of the trial group were 90.0%(45/50),100.0%(50/50)respectively,and those of the control group were 46.0%(23/50),72.0%(36/50)respectively.The trial group had higher cure and markedly effective rate and higher total effective rate than the control group(P<0.05).(3)After treatment,the Wexner constipation scores in the two groups were much decreased in comparison with thosebefore treatment(P<0.01),and the decrease in the trial group was superior to that in the control group(P<0.05).(4)In respect of the follow-up efficacy,the percentage of the patients having spontaneous defecation beingor over 3 times per week in the trial group was 88.0%(44/50),and that in the control group was 54.0%(27/50).The trial group had stronger follow-up efficacy than the control group(P<0.05).(5)Six months after the course oftreatment,the recurrence rate in the trial group was 4.0%(2/50),obviously lower than that in the control group(20.0%;10/50),and the difference was significant(P<0.05).Conclusion Shengdu Pingmu Decoction combinedwith prucalopride succinate is effective for the treatment of lumbosacral neurogenic constipation by relievingconstipation symptoms and decreasing the recurrence rate.