五脏同调法治疗胸腰段骨折早期便秘临床研究

A clinical study on“Five-Zang-organs Simultaneous Regulation”in the treatment of thoracolumbar fractures with early constipation

目的探讨五脏同调法治疗胸腰段骨折早期便秘102例的临床疗效。方法我院102例胸腰段骨折早期便秘患者,按照随机数字表法分为观察组与对照组各51例。两组均给予基础饮食指导,对照组在此基础上予以聚乙二醇4000散治疗,观察组在此基础上根据五脏同调法给予自拟调腑舒秘方治疗。比较两组短期内(1个月)临床疗效及围手术期指标,治疗前及治疗1个月后康复情况、血清肠道功能指标,并记录两组治疗前、随访3个月后的生活质量变化及随访过程中的不良反应。结果观察组短期临床总有效率及疗效均高于对照组,排气时间、排便时间、腹痛缓解时间、肠鸣音恢复时间均低于对照组(P<0.05);治疗1个月后,两组CSS量表评分及一氧化氮(NO)、生长抑素水平、Bristol粪便性状分级(BSFS)、P物质、胃动素、神经降压素水平与治疗前比较差异有统计学意义,且组间比较差异有统计学意义(P<0.05);随访3个月后,两组中文版患者便秘状况评估量表(PACQOL)各维度评分及总分均低于治疗前,且观察组低于对照组(P<0.05);两组不良反应总发生率比较,差异无统计学意义(P>0.05)。结论根据五脏同调法给予自拟调腑舒秘方治疗有利于胸腰段骨折早期便秘患者临床症状的改善,促进胃肠道功能恢复的同时改善其生活质量,综合提高其临床疗效.

Objective To explore the clinical efficacy of“Five-Zang-organ Simultaneous Regulation”in the treatment of 102 cases of thoracolumbar fractures with early constipation.Methods One hundred and two patients with thoracolumbar fractures and early constipation in our hospital were randomly divided into observation group and control group according to the random number table method,51 in each group.Both groups were given basic dietary guidance.The control group was treated with polyethylene glycol 4000 powder and the observation group was given self-made Tiao-fu-tong-bian decoction based on“Five Zang-organ Simultaneous Regulation”theoryin addition to basic dietary guidance.The short-term(1 month)clinical efficacy and perioperative indicators,rehabilitation status and serum intestinal function indicators before treatment and after 1 month of treatment were compared between the two groups.The changes in quality of life estimated with Chinese Version of Patient Assessment of Constipation Quality of Life scale(PACQOL)before treatment and after 3 months of follow-up and adverse reactions during follow-up were recorded in the two groups.Results After treatment,the total short-term clinical effective rate and curative effect in the observation group was significantly higher than that in the control group,and the exhaust time,defecation time,abdominal pain relief and bowel sound recovery in the observation group were significantly lower or shorter than those in the control group(P<0.05).After 1 month of treatment,there were significant differences in the CSS scale score,levels of NO and SS,BSFS grade score and levels of SP,MTL and NT when compared to before treatment in both groups and there were significant differences between the groups(P<0.05).After 3 months of follow-up,total scores and scores of all dimensions of PACQOL were lower than before treatment in both groups and the scores in the observation group was lower than that in the control group(P<0.05).There was no significant difference in incidence of adverse reaction(P>0.05).Conclusion According to“Five-Zang-organ Simultaneous Regulation”,our self-made decoction can improve the clinical symptoms of the patients.It can also effectively promote the recovery of gastrointestinal function and the quality of life.Thus,it comprehensively promotes the clinical efficacy.