温肾缩泉柔肝方对阳虚型便秘患者粪便性状及生活质量的影响

Effect of Wenshen Suoquan Rougan Decoction on Stool Characteristics and Quality of Life foRPatients with Yangdeficiency Constipation

目的:观察温肾缩泉柔肝方治疗对阳虚型便秘患者粪便性状及生活质量的影响。方法:选择86例阳虚型便秘患者随机分为对照组和观察组,每组43例,对照组给予基础治疗+乳果糖口服溶液治疗,观察组基于以上加予温肾缩泉柔肝方治疗,对比两组治疗前及治疗7d后的中医主次症症状体征积分、治疗7d后的中医证候疗效、治疗7d后的胃肠相关指标(腹内压、肠鸣音及胃肠残留量)治疗前及治疗7d后的血清胃肠激素水平[血清胃动素(MTL)、血管活性肠肽(VIP)、胃肠激素P物质(SP)、生长抑制素(SS)]及治疗前及治疗7d后的生活质量[便秘患者生活质量评价表(PAC-QOL)]。结果:治疗后,两组关于排便次数、粪便性状、排便用力程度、排便时间共4项主症积分、关于腹中冷痛喜暖、面色㿠光、四肢不温、小便清长共4项次症积分和总积分较治疗前显著降低(P<0.05),观察组显著低于对照组(P<0.05);观察组的中医证候总有效率显著高于对照组(93.02%vs 74.42%,P<0.05);观察组的腹内压显著小于对照组(P<0.05),肠鸣音显著多于对照组(P<0.05),胃肠残留量显著少于对照组(P<0.05);治疗后,两组血清MTL、VIP、SP水平较治疗前显著性升高(P<0.05),两组血清SS水平较治疗前显著性降低(P<0.05),两组PAC-OQL量表中关于躯体不适、心理社会不适、担心和焦虑、满意度共4项评分和总均分较治疗前显著性降低(P<0.05),观察组变化幅度显著大于对照组(P<0.05)。结论:温肾缩泉柔肝方治疗阳虚型便秘患者疗效显著,能改善粪便性状和相关症状体征,降低腹内压,改善肠鸣音和胃肠残留量,并纠正血清胃肠激素紊乱,以改善胃肠功能,利于患者生活质量提高。

Objective:To explore the effect of Wenshen Suoquan Rougan Decoction on stool characteristics and quality of life foRpatients with Yang-deficiency constipation.Methods:Eighty-six patients with Yang-deficiency constipation were randomly divided into a controlled group and an observation group,with 43 cases in each group.The controlled group was given basic treatment+Lactulose Oral Solution,and the observation group was treated with Wenshen Suoquan Rougan Decoction based on the above.The scores of TCM primary and secondary symptoms and signs before treatment and afteR7d of treatment,efficacy of TCM syndromes afteR7d of treatment,gastrointestinal related indicators(intra-abdominal pressure,bowel sounds and gastrointestinal residual)afteR7d of treatment,levels of serum gastrointestinal hormones[serum motilin(MTL),vasoactive intestinal peptide(VIP),gastrointestinal hormone substance P(SP),somatostatin(SS)]before treatment and afteR7d of treatment and quality of life[Patient Assessment of Constipation Quality of Life(PAC-QOL)]before treatment and afteR7d of treatment were compared between the two groups.Results:AfteRtreatment,the scores of fouRprimary symptoms of frequency of defecation,stool characteristics,degree of defecation straining and defecation time,scores of fouRsecondary symptoms of cold pain in the abdomen and liking foRwarmth,pale complexion,cold limbs and cleaRabundant urine and total score in the two groups were significantly loweRthan those before treatment(P<0.05),and the scores of the observation group were significantly loweRthan those of the controlled group(P<0.05).The total effective rate of TCM syndromes in the observation group was significantly higheRthan that in the controlled group(93.02%vs 74.42%,P<0.05).The intra-abdominal pressure of observation group was significantly loweRthan that of the controlled group(P<0.05),and the bowel sounds were significantly more than those of the controlled group(P<0.05),and the gastrointestinal residual was significantly less than that of the controlled group(P<0.05).After treatment,the levels of serum MTL,VIP and SP in the two groups were significantly higheRthan those before treatment(P<0.05)while the level of serum SS in the two groups was significantly loweRthan that before treatment(P<0.05).The scores of fouRitems of physical discomfort,psychosocial discomfort,worry and anxiety and satisfaction and total average score of PAC-OQL scale in the two groups were significantly lower than those before treatment(P<0.05),and the changes of the observation group were significantly greater than those of the controlled group(P<0.05).Conclusion:Wenshen Suoquan Rougan Decoction has a significant efficacy in treating patients with Yang-deficiency constipation.And it can improve stool characteristics and related symptoms and signs,lower intra-abdominal pressure,improve bowel sounds and gastrointestinal residual,correct serum gastrointestinal hormone disorders,improve gastrointestinal function,and help improve the quality of life of patients.