畅尔舒方联合针刺治疗脾肾阳虚型便秘临床研究

Clinical Study on Changershu Prescription Combined with Acupuncture for Constipation of Spleen-Kidney Yang Deficiency Type

目的:观察畅尔舒方联合针刺治疗脾肾阳虚型便秘的疗效。方法:选取70例脾肾阳虚型便秘患者,按随机数字表法分为治疗组及对照组各35例。治疗组给予畅尔舒方联合针刺治疗,对照组给予乳果糖口服溶液治疗。比较2组临床疗效,比较2组治疗前后便秘症状积分、中医证候积分、生活质量评分标准(PAC-QOL)、血清胃泌素(GAS)、胃动素(MTL)、P物质(SP)、血管活性肽(VIP)、一氧化氮(NO)水平的变化。结果:治疗后,2组便秘状积分及中医证候积分均较治疗前下降(P<0.05),治疗组上述2项积分均低于对照组(P<0.05)。治疗后,2组血清SP、GAS、MTL水平均较治疗前升高(P<0.05),NO、VIP水平均较治疗前下降(P<0.05);治疗组血清SP、GAS、MTL水平均高于对照组(P<0.05),NO、VIP水平均低于对照组(P<0.05)。治疗后,2组PAC-QOL评分均较治疗前下降,治疗组PAC-QOL评分低于对照组(P<0.05)。治疗组临床疗效总有效率为91.43%,对照组为68.57%,2组比较,差异有统计学意义(P<0.05)。结论:畅尔舒方联合针刺治疗脾肾阳虚型便秘能较好地改善患者临床症状,提高生活质量。

Objective:To observe the curative effect of the therapy of Changershu Prescription combined with acupuncture on constipation of spleen-kidney yang deficiency type.Methods:A total of 70 patients with constipation of spleen-kidney yang deficiency type were selected and divided into the treatment group and the control group according to the random number table method,with 35 cases in each group.The treatment group was treated with Changershu Prescription combined with acupuncture,and the control group was given Lactulose Oral Solution for treatment.The clinical effects,and the changes of symptom scores of constipation,traditional Chinese medicine(TCM)syndrome scores,scores of Patient Assessment of Constipation Quality of Life(PAC-QOL),and levels of serum gastrin(GAS),motilin(MTL),substance P(SP),vasoactive intestinal polypeptide(VIP)and nitric oxide(NO)were compared before and after treatment between the two groups.Results:After treatment,the symptom scores of constipation and TCM syndrome scores in the two groups were decreased when compared with those before treatment(P<0.05),and the above scores in the treatment group were lower than those in the control group(P<0.05).After treatment,the levels of serum SP,GAS and MTL in the two groups were increased when compared with those before treatment(P<0.05),and the levels of NO and VIP were deceased when compared with those before treatment(P<0.05):the levels of serum SP,GAS and MTL in the treatment group were higher than those in the control group(P<0.05),and the levels of NO and VIP were lower than those in the control group(P<0.05).After treatment,the PAC-QOL scores in the two groups were decreased when compared with those before treatment,and the PAC-QOL score in the treatment group was lower than that in the control group(P<0.05).The total clinical effective rate was 91.43%in the treatment group and 68.57%in the control group,the difference being significant(P<0.05).Conclusion:The therapy of Changershu Prescription combined with acupuncture can greatly improve the clinical symptoms of patients with constipation of spleen-kidney yang deficiency type and enhance the quality of life.