黄玉汤配合揿针疗法治疗慢传输型便秘患者的临床疗效

Therapeutic Effect of Huangyutang Combined with Pressing Acupuncture on Slow Transit Constipation

目的探讨黄玉汤配合揿针疗法治疗慢传输型便秘(STC)患者的临床疗效。方法选取2019年11月至2020年6月辽宁中医药大学附属第三医院门诊收治的STC患者90例作为研究对象,按就诊顺序随机分为观察组与对照组,各45例。观察组采用黄玉汤配合揿针疗法治疗,对照组口服麻仁软胶囊,两组以15d为1个疗程,连续治疗2个疗程。治疗前后分别进行临床疗效评价、便秘主要症状评分、便秘患者症状自评量表(PAC-SYM)评分、统计平均每周自主完全排便(SCBM)次数、结肠传输试验(CTT)及肠道菌群检测;并于治疗后12周对SCBM≥3次患者进行回访,计算复发情况。结果治疗后,观察组治疗有效率高于对照组,差异有统计学意义(P<0.05);治疗后两组各项症状评分及总分均较本组治疗前降低(P<0.05),且观察组均低于对照组(P<0.05);治疗后观察组PAC-SYM各症状评分和PAC-SYM总分低于对照组(P<0.05);治疗后第2~4周,SCBM次数观察组多于对照组(P<0.05);24 h、48 h、72 h残留标志物比例,观察组低于对照组(P<0.05);治疗后肠杆菌及球菌计数观察组低于对照组(P<0.05),双歧杆菌及乳酸杆菌计数观察组高于对照组(P<0.05);观察组复发率(30.77%)低于对照组的(56.25%)(P<0.05)。结论采用黄玉汤配合揿针疗法治疗STC,可明显改善便秘等症状,增加SCBM次数,调节肠道内菌群,改善结肠传输功能,并具有复发率低的特点,临床疗效好。

Objective To observe the clinical effect of Huangyu decoction combined with pressing acupuncture on slow transit constipation. Methods 90 outpatients with STC in the Third Affiliated Hospital of Liaoning University of traditional Chinese medicine from November 2019 to June 2020 were selected as the research object.According to the order of treatment, they were randomly divided into observation group and control group, with 45 cases in each group.The observation group were treated with Huangyu decoction combined with press needle therapy, the control group were treated with Maren soft capsule, both groups were treated with 15 days as a course of treatment for two consecutive coursesBefore and after treatment, clinical efficacy evaluation,score of main symptoms of constipation, score of self rating symptom scale for constipation patients(pac-sym), statistical average number of spontaneous complete defecation(SCBM) per week, colonic transit test(CTT) and detection of intestinal flora were carried out respectively.The patients with SCBM ≥3 times were followed up 12 weeks after treatment to calculate the recurrence.Results After treatment, the clinical effect of the observation group was better than that of the control group(P<0.05);After treatment, the symptom scores and total scores of the observation group were lower than those of the control group(P<0.05);The PAC-SYM symptom scores and total PAC-SYM scores of the observation group were lower than those of the control group(P<0.01);At 2~4 weeks after treatment, the number of SCBM in the observation group was more than that in the control group(P<0.05);The proportion of residual markers at 24 h, 48 h and 72 h in the observationt group was lower than that in the control group(P<0.05);The counts of Enterococcus and Bacillus in the observation group were lower than those in the control group(P<0.05),and the counts of Bifidobacterium and Lactobacillus in the observation group were higher than those in the control group(P<0.05);The recurrence rate of the observation group(30.77%) was lower than that of the control group(56.25%)(P<0.05). Conclusion Huangyu decoction combined with press needle therapy in the clinical treatment of slow transit constipation, can significantly improve constipation and other symptoms, increase SCBM, regulate intestinal flora, improve colonic transmission function, and has the characteristics of low recurrence rate, good clinical efficacy.