宁夏无果枸杞叶改善肝肾阴虚型慢性传输型便秘的研究

The effect of fruitless lycium barbarum leaves in Ningxia on liver and kidney Yin deficiency type chronic transit constipation

目的观察宁夏无果枸杞叶对肝肾阴虚型慢性传输型便秘(STC)患者肠动力学的影响及临床疗效。方法将80例经辨证分型为肝肾阴虚型慢性传输型便秘患者按照随机数字表法分为治疗组和对照组,实验组分为宁夏无果枸杞叶低剂量组、中剂量组和高剂量组,分别予以3 g/次、6 g/次和12 g/次,每次用500 mL开水浸泡,餐后30 min温服;对照组给予六味地黄丸(8丸/次)口服,并饮水500 mL/次,2次/d。7 d为1个疗程,治疗2个疗程,比较4组治疗前后临床症状评分、肠电图变化和临床疗效。结果治疗前4组症状积分差异无统计学意义(P>0.05),无果枸杞叶治疗组患者低、中、高剂量组总有效率分别为70%、80%、85%,和对照组患者总有效率75%相比,差异无统计学意义(P>0.05)。4组治疗后各项临床症状评分均较本组治疗前降低(P<0.05),且治疗组治疗后评分均低于对照组(P<0.05)。治疗前后各组结肠的平均幅值、频率和正常慢波百分比差异无统计学意义(P>0.05);治疗后,低剂量组和中剂量组结肠的平均幅值、频率和慢波百分比与对照组比较差异无统计学意义(P>0.05);高剂量组结肠正常慢波百分比与对照组差异无统计学意义(P>0.05),升结肠的平均频率在不同治疗剂量下的差异有统计学意义(P<0.05),且高剂量组的显著高于对照组(P<0.05);横结肠和降结肠的平均幅值在不同治疗剂量下的差异有统计学意义(P<0.05),且高剂量组的显著高于对照组(P<0.05)。结论中、高剂量宁夏无果枸杞叶可有效缓解肝肾阴虚型慢性传输型便秘患者的临床症状,高剂量宁夏无果枸杞叶改善便秘的机制可能与影响结肠传输功能有关。

Objective To study the effect of fruitless Lycium barbarum leaves in Ningxia on intestinal motility and clinical efficacy in patients with liver and kidney Yin deficiency type chronic transit constipation.Methods 80 patients with liver and kidney Yin deficiency type chronic transit constipation were divided into two groups:experimental group and control group according to random number table method.The experimental group was divided into low,medium and high dose groups according to the dosage of fruitless lycium barbarum leaves.Then 3 treatment groups were given 3 g/times,6 g/times and 12 g/times,immerging by 500 mL hot water,and drank warmly after half an hour of the meal;the patients in the control group were allowed to take Liuwei Dihuang pill orally,8 pills/times,and drink 500 mL/times,the medication plan of 2 times/d for 7 days is one treatment course and two courses for treatment.Compared the clinical symptoms,electrointestinogram and clinical effect among four groups before and after treatment.Results There were no significant differences among 4 groups in the integral of the symptoms before treatment(P>0.05).After treatment,the total efficiency of patients with low,medium and high dose treatment group were 70%,80%,85%,the difference was not statistically significant(P>0.05).After the treatment,the scores of clinical symptoms of 4 groups were lower than the before treatment(P<0.05),and the clinical symptom scores in treatment group were lower than the control group(P<0.05).The average amplitude,frequency and percentage of slow wave of colon before and after treatment were not significantly different among all groups(P>0.05).After treatment,the mean amplitude,frequency and percentage of slow wave of colon in the low-dose group and the medium-dose group were not significantly different from those in the control group(P>0.05),the percentage of normal slow wave in the high-dose group was not significantly different from the control group(P>0.05),the average frequency of ascending colon was statistically significant between different therapeutic doses(P<0.05),and the high-dose group was significantly higher than that in the control group(P<0.05).The mean amplitude of transverse colon and descending colon was statistically significant at different therapeutic doses(P<0.05),and significantly higher in the high-dose group than in the control group(P<0.05).Conclusion Medium and high doses of Ningxia fruitless Lycium barbarum leaf can effectively relieve the clinical symptoms of patients with chronic transmission constipation of liver-kidney Yin deficiency type.The mechanism by which high-dose Lycium barbarum leaves improving constipation may be related to the change of colonic transit function.