温阳通便推拿法治疗老年功能性便秘合并失眠临床研究

Clinical Study on Wenyang Tongbian Tuina Method for Senile Functional Constipation Complicated with Insomnia

目的:观察温阳通便推拿法治疗老年功能性便秘合并失眠的临床疗效。方法:选取100例老年功能性便秘合并失眠患者为研究对象,随机分为观察组和对照组各50例。对照组给予枸橼酸莫沙必利胶囊和艾司唑仑片口服,观察组在对照组基础上采用温阳通便推拿法治疗,2组均治疗4周。对比2组治疗前后便秘症状评分、匹兹堡睡眠质量指数(PSQI)评分,以及便秘和失眠治疗总有效率,记录2组不良反应发生情况。结果:治疗后,2组各项便秘症状评分及便秘症状总分均较治疗前降低,观察组排便困难、排便时间、排便频度及便秘症状总分均低于对照组,差异均有统计学意义(P<0.05)。治疗后,2组PSQI评分均较治疗前降低(P<0.05),观察组PSQI评分低于对照组(P<0.05)。观察组便秘及失眠治疗总有效率分别为92.00%、94.00%,对照组分别为76.00%、80.00%,观察组便秘及失眠治疗总有效率均高于对照组(P<0.05)。治疗期间,观察组有3例患者因推拿手法不当导致腰背部疼痛,调整手法力度后未再出现该情况,对照组有2例患者出现腹泻,减少用药剂量后不良反应消失。结论:温阳通便推拿法可改善老年功能性便秘合并失眠患者的便秘和失眠症状。

Objective:To observe the clinical effect of Wenyang Tongbian tuina method for senile functional constipation complicated with insomnia. Methods:A total of 100 cases of senile patients with functional constipation complicated with insomnia were selected as the study objects, and randomly divided into the observation group and the control group,50 cases in each group. The control group was given the oral administration of mosapride citrate capsules and estazolam tablets,and the observation group was additionally given Wenyang Tongbian tuina method based on the treatment of the control group. Both groups were treated for four weeks. Symptom scores of constipation and scores of Pittsburgh Sleep Quality Index(PSQI) before and after treatment,as well as the total effective rates of treating constipation and insomnia after treatment were compared between the two groups. The incidences of adverse reactions were recorded in the two groups.Results:After treatment,each symptom score of constipation along with the total score in the two groups was decreased when compared with that before treatment;symptom scores of constipation including difficult defecation, the time and frequency of defecation, as well as the total score in the observation group were lower than those in the control group,differences being significant(P<0.05). After treatment,the PSQI scores in the two groups were decreased when compared with those before treatment(P<0.05),and the score in the observation group was lower than that in the control group(P<0.05). The total effective rates of treating constipation and insomnia were 92.00% and 94.00% respectively in the observation group,and 76.00% and 80.00% respectively in the control group;the two rates in the observation group were higher than those in the control group(P<0.05). During treatment,three cases of sensation of lumbodorsal pain due to inappropriate tuina manipulation occurred in the observation group;after regulation of strength of manipulation,the pain disappeared. During treatment,two cases of diarrhea occurred in the control group;the adverse reaction disappeared after medication dosage was reduced. Conclusion:Wenyang Tongbian tuina method can improve symptoms of constipation and insomnia of senile patients with functional constipation complicated with insomnia.