润肠汤加减治疗卒中后功能性便秘患者的应用效果

Effects of Modified Runchang Decoction on Patients with Functional Constipation after Stroke

目的 探讨润肠汤加减在卒中后功能性便秘患者治疗中的疗效。方法 回顾性分析2021年1月至2023年5月鹤壁市人民医院诊治的92例卒中后功能性便秘患者病历资料,按不同治疗方案分为对照组、观察组(46∶46)。对照组予以乳果糖口服溶液联合耳穴压丸治疗,观察组在对照组基础上予以润肠汤加减治疗。比较两组治疗4周后疗效,临床症状评分,两组治疗前、治疗4周后肠道菌群指标,血清肠神经递质指标[血管活性肠肽(VIP)、一氧化氮合酶(nNOS)]水平。结果 观察组总有效率为95.65%,高于对照组67.39%(P<0.05);治疗4周后,观察组临床症状(排便时间、排便难度、排便次数、便质)评分低于对照组(P<0.05);治疗4周后,观察组大肠杆菌数量少于对照组,乳酸杆菌、双歧杆菌数量均多于对照组(P<0.05);治疗4周后,观察组VIP、nNOS水平均低于对照组(P<0.05)。结论 润肠汤加减治疗脑卒中后功能性便秘患者能有效抑制肠神经递质因子分泌,改善临床症状、肠道菌群状态,从而修复肠道功能,利于患者预后转归。

Objective To explore the efficacy of the modified runchang decoction in the treatment of patients with functional constipation(FC)after stroke.Methods 92 patients with post-stroke FC in Hebi People's Hospital from January 2021 to May 2023 were retrospectively analyzed and divided into control group and observation group according to different treatment plans.The control group was treated with lactulose oral solution+auricular point pressure pills,and the observation group was treated with modified runchang decoction on the basis of the control group.The effects and clinical symptom scores,intestinal microbiota and serum intestinal neurotransmitter indexes[Vasoactive intestinal peptide(VIP)and Neuronal nitric oxide synthase(nNOS)]levels in the two groups before and 4 weeks after treatment were compared.Results The total effective rate of observation group was 95.65%,which was higher than that of control group 67.39%(P<0.05).After 4 weeks of treatment,the scores of clinical symptoms(defecation time,defecation difficulty,defecation frequency and defecation quality)in the observation group were lower than those in the control group(P<0.05);the number of escherichia coli in the observation group was lower than that in the control group,and the number of lactobacillus and bifidobacterium were higher than that in the control group(P<0.05);VIP and nNOS levels in the observation group were lower than those in the control group(P<0.05).Conclusion The treatment of post-stroke FC patients with modified runchang decoction can effectively inhibit the secretion of intestinal neurotransmitter factor,improve the clinical symptoms,intestinal bacterial flora status,and repair the intestinal function,which is beneficial to the prognosis of patients'regression.