四磨汤加减治疗功能性便秘的作用机制研究

Research on the mechanism of modified Simo decoction in the treatment of functional constipation

目的探讨四磨汤加减治疗功能性便秘(FC)的临床效果及其作用机制。方法收集暨南大学附属广州红十字会医院消化内科2018年1月1日~2020年4月30日接诊的80例中重度FC患者临床资料,随机分成对照组及四磨汤组各40例。对照组接受合理膳食、饮水及建立良好的排便习惯指导2周,四磨汤组在对照组接受的指导基础上给予口服四磨汤加减治疗2周,比较两组治疗前后Wexner便秘评分(WCS)、血清及尿钠、钾、钙及镁离子浓度。结果四磨汤加减液中钠、钾、钙、镁元素含量分别是22.0、676.0、130.0、95.3mg/kg。治疗后,四磨汤组WCS比对照组低,四磨汤组血清钾离子浓度比对照组高,差异均有统计学意义(P <0.05),两组血清钠、钙及镁离子浓度及尿钠、钾、钙及镁离子浓度比较,差异无统计学意义(P> 0.05)。结论四磨汤加减液可有效改善患者便秘,它富含钾元素,提高患者的血钾离子浓度水平可能是其中一个作用机制。

Objective To investigate the clinical efficacy and mechanism of Simo decoction in the treatment of functional constipation(FC). Methods The clinical data of 80 patients with moderate to severe FC admitted to the department of gastroenterology of Guangzhou Red Cross Hospital affiliated to Jinan University from January 1, 2018 to April 30, 2020 were collected and randomly divided into the control group(n=40) and the Simo decoction group(n=40). The control group was given reasonable diet, drinking water and establishing good defecation habits for 2 weeks, while the Simo decoction group was given oral modified Simo decoction for 2 weeks on the basis of the guidance received by the control group. Wexner constipation score(WCS), levels of serum and urine sodium, potassium, calcium and magnesium concentrations were compared between the two groups before and after treatment. Results The contents of sodium, potassium, calcium and magnesium in modified Simo decoction were 22.0, 676.0, 130.0 and 95.3 mg/kg respectively. After treatment, WCS in the Simo decoction group was lower than that in the control group, the level of serum potassium concentration in the Simo decoction group was higher than that in the control group, and the differences were both statistically significant(P < 0.05). There was no statistically significant difference in the levels of serum sodium, calcium and magnesium concentrations and urine sodium, potassium, calcium and magnesium concentrations between the two groups(P > 0.05). Conclusion Simo decoction can effectively decrease constipation of patients, which is rich in potassium, and raising the level of serum potassium concentration of patients may be one of the mechanisms.