运脾生津通便汤联合常规西药治疗儿童功能性便秘临床研究

Clinical Study on Yunpi Shengjin Tongbian Decoction Combined with Routine Western Medicine for Functional Constipation in Children

目的:观察运脾生津通便汤联合常规西医疗法对儿童功能性便秘(FC)患者血清胃肠激素的影响及临床疗效。方法:将74例FC患儿按随机数字表法分为对照组和观察组各37例。2组均予以多饮水、调整饮食习惯、训练排便习惯和适量活动等基础治疗。对照组给予常规西药治疗,观察组在对照组基础上加运脾生津通便汤治疗,2组均治疗4周。评估2组临床疗效,比较2组治疗前后血清胃肠激素水平、中医证候评分及随访半年复发率。结果:观察组总有效率为94.59%,高于对照组78.38%,差异有统计学意义(P<0.05)。治疗后,2组血清胃动素(MTL)、P物质(SP)及神经降压素(NT)水平较治疗前上升(P<0.05),且观察组血清MTL、SP及NT水平高于对照组(P<0.05)。治疗后,2组大便间隔时间、大便性状和排便困难程度评分较治疗前降低(P<0.05),且观察组大便间隔时间、大便性状和排便困难程度评分低于对照组(P<0.05)。观察组复发率为17.14%,低于对照组41.38%(P<0.05)。结论:运脾生津通便汤联合西医疗法治疗儿童FC疗效确切,不仅改善临床症状,而且可降低复发率,其作用机制可能与调节胃肠激素水平、改善胃肠道功能密切相关。

Objective:To observe the clinical effect of Yunpi Shengjin Tongbian Decoction combined with routine western medicine therapy for functional constipation(FC)in children and its effect on gastrointestinal hormones in serum.Methods:A total of 74 cases of FC children were divided into the control group and the observation group according to the random number table method,with 37 cases in each group.Both groups were given basic treatment including drinking more water,adjusting eating habits,training defecation habits and conducting a moderate amount of physical activity.The control group was treated with routine western medicine,and the observation group was additionally treated with Yunpi Shengjin Tongbian Decoction based on the treatment of the control group.Both groups were treated for four weeks.The clinical effects were evaluated in the two groups.Before and after treatment,the levels of gastrointestinal hormones in serum,traditional Chinese medicine syndrome scores,and recurrence rates in half-a-year follow-up were compared in the two groups.Results:The total effective rate was 94.59%in the observation group,higher than that of 78.38%in the control group,the difference being significant(P<0.05).After treatment,the levels of motilin(MTL),substance P(SP)and neurotensin(NT)in serum in the two groups were increased when compared with those before treatment(P<0.05),and the levels of MTL,SP and NT in serum in the observation group were higher than those in the control group(P<0.05).After treatment,the scores of interval time of defecation,stool traits and defecation difficulties in the two groups were decreased when compared with those before treatment(P<0.05),and the scores of interval time of defecation,stool traits and defecation difficulties in the observation group were lower than those in the control group(P<0.05).The recurrence rate was 17.14%in the observation group,lower than that of 41.38%in the control group(P<0.05).Conclusion:Yunpi Shengjin Tongbian Decoction combined with western medicine has a definite curative effect in treating FC in children.It can not only improve the clinical symptoms,but also reduce the recurrence rates.Its mechanism may be closely related to its ability to regulate the levels of gastrointestinal hormones and improve gastrointestinal function.