芪仁通便方治疗出口梗阻型便秘气虚证的疗效及对盆底表面肌电评估的影响

Efficacy of Qiren Tongbian Formula for outlet obstructive constipation of Qi deficiency and how it impacts on the pelvic floor surface electromyography

目的 观察芪仁通便方治疗出口梗阻型便秘(OOC)气虚证的疗效及对盆底表面肌电评估的影响。方法 将85例OOC气虚证患者按照随机数字表法分为2组,治疗组42例予芪仁通便方治疗,对照组43例予聚乙二醇4000散治疗,2组均治疗2周。比较2组疗效;比较2组治疗1、3、5、7 d内起效情况;比较2组治疗前后症状评分变化;比较2组治疗前后Glazer盆底表面肌电评估情况;比较2组治疗前后便秘患者生活质量量表(PAC-QOL)评分变化;比较2组不良反应情况。结果 治疗组总有效率80.95%(34/42),对照组总有效率53.49%(23/43),治疗组疗效优于对照组(P<0.05)。治疗组治疗1、3 d内起效率低于对照组(P<0.05),治疗组治疗5、7 d内起效率高于对照组(P<0.05)。治疗组治疗后排便费力、每次排便时间、排便间隔时间、排便不尽感评分及总评分均较本组治疗前降低(P<0.05),对照组治疗后大便性状、排便间隔时间评分及总评分均较本组治疗前降低(P<0.05);治疗组治疗后排便费力、每次排便时间、排便间隔时间、排便不尽感评分及总评分均低于对照组(P<0.05)。治疗组治疗后快速收缩电位、持续收缩电位均较本组治疗前升高(P<0.05),快速收缩10 s放松时间较本组治疗前降低(P<0.05),对照组治疗后快速收缩10 s放松时间较本组治疗前降低(P<0.05);治疗组治疗后快速收缩电位、持续收缩电位均高于对照组(P<0.05)。治疗组治疗后担忧因素、满意度因素、社会心理因素、生理因素评分及总评分均较本组治疗前降低(P<0.05),对照组治疗后担忧因素、满意度因素、社会心理因素评分及总评分均较本组治疗前降低(P<0.05);治疗组治疗后满意度因素、社会心理因素、生理因素评分及总评分均低于对照组(P<0.05)。结论 芪仁通便方治疗OOC气虚证,能增强患者盆底肌收缩力,有效改善患者肛门不适症状,缓解便秘。

Objective To observe the efficacy of Qiren Tongbian Formula for outlet obstructive constipation(OOC)of Qi deficiency and how it impacts on the pelvic floor surface electromyography(sEMG).Methods Totally 85 OOC patients(Qi deficiency)were randomly divided into the treatment group(n=42)and the control group(n=43);patients in the treatment group were treated with Qiren Tongbian Formula,and patients in the control group with polyethylene glycol 4000 powder.A 2-week treatment were performed to compare efficiency on days 1,3,5,and 7,symptom score,Glazer assessment,Patient Assessment of Constipation Quality of Life(PAC-QOL)scores;the curative effect and adverse reaction were assessed.Results The overall effective rate was 80.9%(34/42)in the treatment group,higher than that of 53.4%(23/43)in the control group(P<0.05).After treatment,lower efficiency on days 1,3,and higher efficiency on days 5,7 were detected in the treatment group than those in the control group(all P<0.05);scores of defecation difficulty,defecation time,defecation interval,defecation incompletely in the treatment group were decreased(P<0.05),and which were lower than those in the control group(P<0.05);scores of stool traits and defecation interval in the control group were decreased(P<0.05);rapid contraction electric potential and lasted contraction electric potential in the treatment were increased(P<0.05),which was higher in the treatment group than in the control group(P<0.05);10s relaxation time in the treatment were decreased(P<0.05),which was decreased(P<0.05)in the treatment group relevant to the control group;PAC-QOL(worry factors,satisfaction factors,social psychological factors,physiological factors)scores in the treatment group were decreased(P<0.05);PAC-QOL(worry factors,satisfaction factors,social psychological factors)scores in the control group were decreased(P<0.05);in comparison of the control group,the treatment group displayed decreased PAC-QOL(satisfaction factors,social psychological factors,physiological factors)scores.Conclusion For OOC patients(Qi deficiency),Qiren Tongbian Formula can effectively enhance the pelvic floor muscle strength,improve the anal discomfort symptoms and relieve constipation.