中西医结合治疗180例老年人慢性便秘的临床研究

Clinical study of the treatment of 180 cases of chronic constipation in the elderly by the combination of traditional Chinese and Western medicine

目的探讨中西医结合治疗老年慢性便秘的疗效和安全性,为临床治疗提供参考。方法选取180例老年慢性便秘患者为研究对象,根据随机数表法分为中西药结合组、汤药组和西药组。中西药结合组采用口服汤药和乳果糖联合治疗,汤药组采用口服汤药,西药组予以乳果糖治疗。通过比较3组排便评分、中医证候积分、临床疗效、不良反应及复发情况,来评估治疗效果。结果治疗4周后,3组Bristol评分、生活质量评分、每周排便次数均好于治疗前,并且中西药结合组优于其他2组(P<0.05)。停药2周后,3组均有复发情况,但是中西药结合组复发情况好于其他2组(P<0.05)。中西药结合组总有效率优于其他2组,差异有统计学意义(P<0.05)。研究过程中3组患者均未出现严重药物不良反应。结论中西医结合治疗老年人慢性便秘效果确切且疗效稳定,可以作为常规的诊疗方案对外推广。

Objective To explore the efficacy and safety of integrated traditional Chinese and Western medicine in the treatment of chronic constipation in the elderly,and provide reference for clinical treatment.Methods 180 elderly patients with chronic constipation were selected as the research subjects and divided into integrated traditional Chinese and Western medicine group(integrated group),decoction group,and Western medicine group according to the random number table method.The integrated group was treated with oral decoction and lactulose,the decoction group was treated with oral decoction and the Western medicine group was treated with lactulose.The defecation score,traditional Chinese and Western medicine(TCM)syndrome score,clinical efficacy,adverse reactions and recurrence of the three groups were compared to evaluate the therapeutic effect.Results After 4 weeks of treatment,the Bristol score,quality of life score,and weekly defecation frequency of the three groups were better than those of the same group before treatment,and the integrated group was better than those of the other two groups(P<0.05).After 2 weeks of drug withdrawal,recurrence occurred in all three groups,but the recurrence rate in the integrated group was lower than those in the other two groups(P<0.05).The total effective rate of the integrated group was superior to the other two groups,with a statistically significant difference(P<0.05).No serious adverse drug reaction occurred in the three groups during the study.Conclusion The integrated traditional Chinese and Western medicine has a definite effect in the treatment of chronic constipation in the elderly.It can significantly improve constipation symptoms,and has a stable therapeutic effect.It can be promoted as a routine diagnosis and treatment plan.