补气健脾疏肝法联合生物反馈治疗出口梗阻型便秘的临床研究

Clinical study on method of tonifying qi,strengthening the spleen,and soothing the liver combined with biofeedback therapy in treating outlet obstructive constipation

目的探究补气健脾疏肝法联合生物反馈治疗出口梗阻型便秘的临床疗效。方法选择河北省石家庄市中医院肛肠科气虚秘型出口梗阻型便秘患者80例作为研究对象,根据随机数字法分为试验组与对照组,两组各40例。对照组予以生物反馈治疗,30 min/次,每周3次;试验组在对照组基础上予补气健脾疏肝法治疗,每日1剂,水煎取汁400 mL,分早晚两次温服。两组均连续治疗4周。观察两组治疗前后的中医临床疗效、证候评分、肛门疼痛情况、生活质量及安全性。结果治疗后,试验组的临床总有效率(97.5%)优于对照组(72.5%)(P<0.05)。治疗后,与治疗前比较,两组排便频率、排便困难、粪便性状、排便时间、肛门堵塞感、排便不尽感的中医证候评分、疼痛数字评定量表(numerical rating scale,NRS)、便秘患者生活质量自评量表(patient assessment of constipation quality of life questionnaire,PAC-QOL)评分均下降(P<0.05);与对照组比较,试验组各项证候评分、NRS评分、PAC-QOL评分较低(P<0.05)。与对照组相比,试验组不良反应较低(P<0.05)。结论生物反馈联合补气健脾疏肝法治疗出口梗阻型便秘疗效确切,可有效缓解患者的临床症状,减轻患者的肛门疼痛,并提高患者的生活质量。

Objective To explore the clinical efficacy of the method of tonifying qi,strengthening the spleen,and soothing the liver combined with biofeedback therapy in treating outlet obstructive constipation(OOC).Methods A total of 80 patients with qi-deficiency type of OOC in the anorectal department of Shijiazhuang Hospital of Chinese Medicine in Hebei province were selected as the research subjects.According to the random number method,they were assigned into experiment group and control group,with 40 patients in each group.The control group was treated with biofeedback therapy 30 min per session,three times a week,while the experiment group received additional treatment with the method of tonifying qi,strengthening the spleen,and soothing the liver on the basis of control group,one dose per day,with 400 mL of decoction taken orally twice in the morning and evening.Both groups received continuous treatment for four weeks.The TCM clinical efficacy,pattern scores,anal pain condition,quality of life,and safety before and after treatment in both groups were observed.Results After treatment,the total clinical effective rate of experiment group(97.5%)was significantly higher than that of control group(72.5%)(P<0.05).Compared with those before treatment,the TCM pattern scores of defecation frequency,defecation difficulty,fecal character,defecation time,anal blockage,and incomplete defecation,numerical rating scale(NRS),and patient assessment of constipation quality of life questionnaire(PAC-QOL)of both groups decreased after treatment(P<0.05).Compared with the control group,the adverse reactions in the experiment group were lower(P<0.05).Conclusion The method of tonifying qi,strengthening the spleen,and soothing the liver combined with biofeedback therapy has shown definite efficacy in treating OOC,which can notably alleviate patients'clinical symptoms,reduce their anal pain,and improve their quality of life.