润肠通便方治疗小儿功能性便秘肠道实热证42例临床观察

Clinical observation on 42 cases of functional constipation in children with intestinal heat syndrome treated by Runchang Tongbian Fang(润肠通便方)

目的观察润肠通便方治疗小儿功能性便秘肠道实热证的临床疗效及对患儿胃肠激素的影响。方法选取2019年3月至2021年3月温州医科大学附属衢州医院(衢州市人民医院)肛肠外科和中医科门诊收治的82例功能性便秘患儿,采用随机数字表法分为治疗组42例和对照组40例。对照组给予常规西药治疗,治疗组给予中药润肠通便方治疗,2组均1周为1个疗程,治疗2个疗程后统计临床疗效、便秘症状评分和胃肠激素[血清生长抑素(SS)、P物质(SP)]水平。结果治疗组总有效率为95.24%(40/42),显著高于对照组的80.00%(32/40),2组比较,差异有统计学意义(P<0.05)。治疗前,2组排便频率、排便不净感、排便疼痛感、排便费力感症状评分比较,差异无统计学意义(P>0.05),具有可比性;治疗后,2组上述症状评分均较同组治疗前显著降低(P<0.05),且治疗组降低更显著,差异有统计学意义(P<0.05)。治疗前,2组胃肠激素SS、SP水平比较,差异无统计学意义(P>0.05),具有可比性;治疗后,2组SS水平较同组治疗前显著降低(P<0.05),SP水平显著升高(P<0.05),且治疗组降低或升高更显著,差异有统计学意义(P<0.05)。对照组复发率为18.75%(6/32),显著高于治疗组的2.50%(1/40),2组比较,差异有统计学意义(P<0.05)。结论润肠通便方治疗小儿功能性便秘肠道实热证疗效显著,可明显减轻患儿便秘症状,调节胃肠激素水平,降低复发率,值得临床推广应用。

Objective To observe the clinical efficacy of Runchang Tongbian Fang(润肠通便方)in the treatment of functional constipation in children with intestinal heat syndrome and its influence on patients’gastrointestinal hormones.Methods 82 children of functional constipation with intestinal heat syndrome admitted to the Anorectal Surgery and Traditional Chinese Medicine Outpatient Department of Quzhou Hospital Affiliated to Wenzhou Medical University(Quzhou People’s Hospital)from March 2019 to March 2021 were divided into a treatment group of 42 cases and a control group of 40 cases with a random number table.The control group was treated with conventional Western medicine,and the treatment group was treated with traditional Chinese medicine Runchang Tongbian Fang.The 2 groups were treated with 1 week as a course of treatment.After 2 courses of treatment,we kept statistics about the clinical efficacy,symptom score of constipation,changes of gastrointestinal hormones[serum somatostatin(SS),substance P(SP)]levels.Results The total effective rate of the treatment group was 95.24%(40/42),which was significantly higher than that of the control group[80.00%(32/40)],and the difference between the two groups was statistically significant(P<0.05).Before treatment,the frequency of defecation,unclean defecation,defecation pain and defecation effort score of the two groups showed no statistical significance(P>0.05),which was comparable.After treatment,the score of above symptoms in 2 groups was significantly decreased compared with that before treatment(P<0.05),and the decrease was more significant in the treatment group,the difference was statistically significant(P<0.05).Before treatment,there was no significant difference in the the levels of gastrointestinal hormones SS and SP in the two groups(P>0.05),indicating comparable.After treatment,the SS level in the two groups was significantly decreased(P<0.05),and the SP level was significantly increased(P<0.05),and the SS level in the treatment group was decreased,and the SP level was increased more significantly(P<0.05).The recurrence rate in the control group was 18.75%(6/32),which was significantly higher than 2.50%(1/40)in the treatment group,the difference being significant(P<0.05).Conclusion Runchang Tongbian Fang has a significant effect in the treatment of functional constipation in children with intestinal excess heat syndrome.It can reduce the symptoms of constipation,regulate the level of gastrointestinal hormones,and lower the recurrence rate,which is worthy of clinical popularization and application.