补泻同调方治疗直肠前切除术后便秘的临床观察

Clinical observationof Buxie Tongtiao Prescription in the treatment of constipation after anterior rectum resection

目的:观察补泻同调方治疗直肠前切除术后便秘的临床疗效。方法:将2019年12月至2020年12月收集的60例行直肠前切除术,术后出现便秘的患者随机分为治疗组和对照组各30例。治疗组给予补泻同调方口服,对照组给予聚乙二醇口服,持续用药4周后,分别记录两组患者治疗前后排便次数、排便时间、大便性状等情况,观察其饮食、腹胀、体倦乏力等全身症状。采用Wexner便秘评分表、LARS量表(中文版)及中医症状分级量化标准进行评分。结果:治疗后,两组患者在Wexner便秘评分与LARS量表(中文版)评分等级方面优于治疗前(P<0.01,P<0.05),且治疗组均优于对照组(P<0.05);两组患者在中医主证候症状排便频次、大便性状、排便感觉评分及总积分方面均显著优于治疗前(P<0.01),且治疗组排便频次评分与总积分优于对照组(P<0.05,P<0.01);两组患者在中医次证候症状纳少、腹胀、体倦乏力评分及总积分方面均显著优于治疗前(P<0.01),且治疗组均显著优于对照组(P<0.01);治疗组中医总有效率100.00%(30/30)显著优于对照组76.67%(23/30)(P<0.01)。结论:补泻同调方治疗直肠前切除术后便秘疗效确切,其在改善便秘情况的同时能明显改善术后腹胀、纳少、体倦乏力等全身症状,提高患者的生活质量。

Objective: To observe the clinical effect of Buxie Tongtiao Prescription on constipation after anterior rectum resection. Methods: Sixty patients with constipation after anterior rectum resection collected from December 2019 to December 2020 were randomly divided into a treatment group and a control group, with 30 cases in each group. The treatment group was given Buxie Tongtiao Prescription orally, and the control group was given polyethylene glycolorally. After 4 weeks of continuous medication, the frequency of defecation, defecation time, stool characteristics and other conditions before and after treatment were recorded respectively in the two groups, and their diet, abdominal distension, body fatigue and other systemic symptoms were observed. Wexner constipation rating scale, LARS scale(Chinese version) and TCM symptom grading quantitative standard were used for scoring. Results: After treatment, Wexner constipation scores and LARS scale(Chinese version) scores in 2 groups were better than before treatment(P<0.01, P<0.05), and the treatment group was better than the control group(P<0.05);The defecation frequency, stool traits, defecation sensation score and total score of TCM main syndrome symptoms in 2 groups were better than before treatment(P<0.01), and the defecation frequency score and total score of treatment group were better than those of control group(P<0.05, P<0.01). The less food, abdominal distension, body fatigue score and total score of TCM secondary syndrome symptoms in 2 groups were better than before treatment(P<0.01), and the treatment group was significantly better than the control group(P<0.01);The total effective rate of TCM in the treatment group was 100.00%(30/30), which was superior to the 76.67%(23/30) in the control group(P<0.01). Conclusion: Buxie Tongtiao Prescription has definite efficacy in the treatment of constipation after anterior rectal resection, it can not only improve constipation, but also significantly improve postoperative abdominal distension, less food, body fatigue and other systemic symptoms, and improve the quality of life of patients.