增液承气汤联合定时直肠刺激法治疗上运动神经源性脊髓损伤后便秘的临床效果

Clinical effect of Zengye Chengqi Decoction combined with regular digital rectal stimulation in the treatment of the upper motor neurogenic constipation after spinal cord injury

目的探讨增液承气汤联合定时直肠刺激法治疗上运动神经源性脊髓损伤后便秘的疗效。方法选取2017年1月~2018年12月广东省工伤康复医院收治的48例脊髓损伤后便秘患者作为研究对象,依据随机数字表法分为治疗组和对照组,每组各24例。对照组给予直肠刺激定时排便管理,治疗组在对照组基础上口服增液承气汤,疗程均为3周。记录并比较治疗前后患者排便周期、排便速度、Bristol粪便性状评分、不良反应,并统计两组患者的临床疗效。结果治疗后,治疗组患者的排便周期、排便所需时间评分均低于对照组,大便性状正常比例高于对照组,差异有统计学意义(P<0.05);且两组患者治疗后的排便周期、排便所需时间评分均低于本组治疗前,大便性状正常比例均高于本组治疗前,差异有统计学意义(P<0.05)。结论增液承气汤联合定时直肠刺激排便法可有效改善上运动神经源性脊髓损伤后便秘,其疗效优于单独使用定时直肠刺激排便法。

Objective To investigate the effect of Zengye Chengqi Decoction combined with regular digital rectal stimulation(DRS)in the treatment of the upper motor neurogenic constipation after spinal cord injury(SCI).Methods A total of 48 patients with constipation post SCI admitted to Guangdong Work Injury Rehabilitation Hospital from January 2017 to December 2018 were selected as research subjects.They were divided into treatment group and control group by the random number table method,24 cases in each group.The control group was given the regular defecation management with DRS,while the treatment group was given oral Zengye Chengqi Decoction,and the regular DRS.The treatment course of two groups were all 3 weeks.The patients′defecation frequency,defecation speed,Bristol stool character score before and after treatment and the adverse reactions were recorded and compared,and the clinical effect of the two groups were analyzed with statistics.Results After treatment,the defecation period and defecation time score of the patients in the treatment group were lower than those in the control group,and the normal proportion of fecal characteristics was higher than that in the control group,with statistically significant differences(P<0.05).In addition,the defecation period and defecation time of the two groups after treatment were shorter than those before treatment,and the normal proportion of defecation characteristics was higher than that before treatment,with statistically significant differences(P<0.05).Conclusion The treatment of the upper motor neurogenic constipation after SCI with Zengye Chengqi Decoction combined with regular DRS is effective,and the curative effect is better than that of the simple regular DRS.