补气温阳法治疗老年性胸腰椎骨折中后期便秘临床研究

Clinical effects of the method of invigorating qi and warming yang in the treatment of senile thoracolumbar fracture with constipation in middle and late stages

目的:探析补气温阳法在老年性胸腰椎骨折中后期便秘中的治疗效果。方法:选取老年性胸腰椎骨折中后期便秘患者230例,采用随机数字表法将其分为对照组(114例)与治疗组(116例)。对照组予以口服聚乙二醇4000散治疗,治疗组则接受补气温阳法其方药(配方颗粒)治疗,两组均以连续治疗1周为1个疗程,均行2个疗程的治疗。采用Cleveland便秘评分系统(CCS)评价患者治疗前后的便秘严重程度,Bristol大便性状分型法评价大便性状,并对患者的中医证候积分进行统计。评价两组的治疗效果,患者治疗前后胃肠功能以及肠道菌群数量的差异性,评价用药安全性。结果:治疗组治疗有效率为93.10%,明显高于对照组的84.21%(P<0.05)。两组治疗后CCS、Bristol评分以及中医证候积分均较治疗前下降(P<0.05),且治疗组治疗后上述指标评分均低于对照组(P<0.05)。治疗组患者治疗后胃泌素、生长抑素水平均低于对照组,其胃动素水平高于对照组(P<0.05)。治疗后两组乳酸杆菌/双歧杆菌数量高于治疗前,球杆菌、肠杆菌数量低于治疗前(P<0.05),且治疗组变化程度大于对照组(P<0.05)。两组患者面红、皮疹及恶心呕吐等不良反应发生率分别为8.62%和6.14%,两组比较,差异无统计学意义(P>0.05)。结论:补气温阳法在老年性胸腰椎骨折中后期便秘中的治疗效果显著,其能够明显改善患者的便秘症状和胃肠道功能,纠正肠道菌群失调。

Objective:To explore the therapeutic effect of method of invigorating qi and warming yang on senile thoracolumbar fracture with constipation in middle and late stages.Methods:230 elderly patients with thoracolumbar fracture and constipation in middle and late stages were selected.Using random number table method,the patients were divided into control group(114 cases)and treatment group(116 cases).The control group was treated by oral administration of polyethylene glycol 4000 powder,and the treatment group was treated by method of invigorating qi and warming yang.1 week was a course of treatment,and both groups received 2 courses of treatment.The CCS was used to evaluate the severity of constipation before and after treatment,and the Bristol stool form scale was used to evaluate stool traits.The patients’TCM syndrome scores were counted.Gastrointestinal function and the number of intestinal flora were compared before and after treatment.Results:The effective rate of treatment in the treatment group was 93.10%,significantly higher than 84.21%in the control group(P<0.05).After treatment,the CCS scores,Bristol scores and TCM syndrome scores of the two groups were reduced(P<0.05),and the above scores of the treatment group were lower than those of the control group(P<0.05).After treatment,the levels of gastrin and somatostatin in the treatment group were lower than those in the control group,and the motilin level was higher than that in the control group(P<0.05).After treatment,the quantity of lactobacillus/bifidobacterium was increased,and the quantities of coccobacillus and enterobacterium were reduced in the two groups(P<0.05).Changes of the numbers in the treatment group were greater than those in in the control group(P<0.05).The incidence of adverse reactions such as flushing,skin rash,nausea and vomiting in the two groups during treatment were 8.62%and 6.14%respectively(P>0.05).Conclusion:The method of invigorating qi and warming yang is markedly effective in the treatment of senile thoracolumbar fracture with constipation in middle and late stages.It can significantly improve constipation symptoms and gastrointestinal function,and correct alteration of intestinal flora.