中药联合摩腹治疗老年功能性便秘伴结肠黑变病的临床观察

Clinical efficacy observation of traditional Chinese medicine combined with abdominal massage in the treatment of senile functional constipation with melanosis coli

目的 观察加味奔豚汤联合摩腹治疗肾虚气郁型老年功能性便秘伴结肠黑变病临床效果。方法 选取符合标准的患者120例为研究对象,随机分为西药组、摩腹组、中药联合摩腹组,每组40例。西药组给予双歧三联活菌胶囊、莫沙必利片口服,摩腹组给予腹部按摩,中药联合摩腹组给予中药加味奔豚汤口服联合腹部按摩治疗,观察各组治疗14、30及60 d便秘改善情况、中医证候积分;观察90 d后的肠镜检查表现,评价疗效。结果 治疗14、30、60 d后,3组患者便秘评分均较治疗前降低;治疗30、60 d后,中药联合摩腹组和西药组便秘评分无明显差异,但均低于单纯摩腹组(P<0.05);3组治疗后中医证候积分均较治疗前降低(P<0.05)。中药联合摩腹组总有效率100.00%,摩腹组为42.50%,西药组为67.50%。90 d后肠镜检查显示,中药联合摩腹组痊愈8例,总有效率80.00%,明显优于摩腹组和西药组。结论 中药联合摩腹组可以明显改善老年性便秘伴结肠黑变病患者临床症状,其总有效率优于摩腹组和西药组,对于肠道黑变病具有逆转效果,相对于单纯摩腹法及西药治疗具有明显优势。

Objective To observe the clinical efficacy of Jiawei bentun decoction combined with abdominal massage in the treatment of senile functional constipation with Melanosis Coli(MC).Methods 120 patients were selected as the research objects and randomly divided into western medicine group, abdominal massage group and traditional Chinese medicine combined with abdominal massage group, with 40 cases in each group. The western medicine group was given Bifido-triple viable capsules and Mosapride tablets, the abdominal massage group was given abdominal massage, and the Chinese medicine combined with abdominal massage group was given Jiawei bentun decoction combined with abdominal massage. The improvement of constipation and TCM syndrome score were observed after 14 d, 30d and 60d of treatment in each group, The colonoscopy performance after 90 d of treatment in each group was evaluated the curative effect.Results After 14 d, 30 d and 60 d of treatment, the scores of constipation were lower than those before treatment. After 30d and 60d of treatment, there was no significant difference in the constipation scores between the traditional Chinese medicine combined with abdominal massage group and the western medicine group, but they were all lower than those in the simple abdominal massage group(P<0.05). After treatment, the TCM syndrome scores were all lower than those before treatment. The total effective rate of the Chinese medicine combined with abdominal massage group was 100.00%,the total effective rate of the abdominal massage group was 42.50%,and the western medicine group was 67.50%. After 90 days, 8 cases in the Chinese medicine combined with abdominal massage group were cured, and the total effective rate was 80.00%,which was significant better than that in abdominal massage group and the western medicine group.Conclusion The traditional Chinese medicine combined with abdominal massage group can significantly improve the constipation of senile constipation patients with colon melanosis, and its total effective rate is better than the abdominal massage group and western medicine group. It has a reversal effect on intestinal melanosis, and has obvious advantages compared with the simple abdominal massage group and western medicine treatment.