补中益气汤加减联合“东垣针法”治疗气虚型功能性便秘的疗效观察

Efficacy of modified Buzhong Yiqi Decoction combined with Dongyuan acupuncture method in the treatment of functional constipation due to Qi deficiency

目的观察补中益气汤加减联合“东垣针法”治疗气虚型功能性便秘的临床疗效。方法将82例气虚型功能性便秘患者按照随机分配原则,分为试验组41例和对照组41例。对照组给予口服乳果糖溶液治疗,试验组给予补中益气汤加减联合“东垣针法”治疗,治疗疗程为4周。评价2组患者中医证候积分、临床疗效、便秘患者症状自评积分(PAC-SYM)、汉密尔顿焦虑(HAMA)评分及治疗8周后的复发率。结果治疗后,试验组的总有效率为95.12%(39/41),对照组的总有效率为73.17%(30/41),试验组临床有效率显著优于对照组(P<0.05)。2组患者治疗后的中医证候总积分均明显降低(P<0.01),且试验组对中医证候总积的降低程度明显优于对照组(P<0.05)。2组患者中医各单项证候积分均较治疗前显著降低(P<0.01),组间比较,试验组对有便意但排便费力、力努挣则汗出短气这两项单项证候积分的降低作用优于对照组(P<0.05),但便后乏力、神疲懒言方面2组疗效相当(P>0.05)。治疗后,2组患者便秘症状自评表积分较治疗前均明显下降(P<0.01),试验组评分显著低于对照组(P<0.01)。停药8周后随访,试验组复发率为11.8%(4/34),对照组复发率为35.5%(11/31),试验组复发率明显低于对照组(P<0.05)。结论补中益气汤加减联合“东垣针法”能明显改善气虚型功能性便秘患者的临床症状,降低便秘的复发率。

Objective To observe the clinical efficacy of modified Buzhong Yiqi Decoction combined with Dongyuan acupuncture method in the treatment of functional constipation due to Qi deficiency.Methods Eighty-two patients with functional constipation due to Qi deficiency were divided into control group(n=41,oral lactulose solution)and experimental group(n=41,modified Buzhong Yiqi Decoction combined with Dongyuan acupuncture method)according to the principle of random assignment.A 4-week treatment was performed.The aim was to evaluate traditional Chinese medicine(TCM)syndrome score,clinical efficacy,Patient Assessment of Constipation symptom(PAC-SYM),Hamilton Anxiety Scale(HAMA)score,and the recurrence rate on week 8 of treatment.Results After treatment,the clinical effective rate of the experimental group was significantly better than that of the control group(95.12%[39/41]vs 73.17%[30/41],P<0.05).The total TCM symptom score of the patients in both groups was significantly reduced after treatment(P<0.01),and the reduction in the experimental group was more common relative to the control group(P<0.05).The dimension score of TCM syndrome in both groups was significantly lower than that before treatment(P<0.01).The symptom scores of having the intention to defecate but struggling to defecate,and sweating and shortness of breath when struggling in the experimental group were more effective than the control group(P<0.05),while the symptom scores of fatigue after defecation,and laziness of speech efficacy of the two groups were comparable(P>0.05).After treatment,the PAC-SYM scores were significantly decreased in both groups than those before treatment(P<0.01).The scores in the experimental group were significantly lower than those in the control group(P<0.01).At the follow-up after 8 weeks of drug discontinuation,the recurrence rate of the experimental group was significantly lower than that of the control group(11.8%[4/34]vs 35.5%[11/31],P<0.05).Conclusion Modified Buzhong Yiqi Decoction combined with Dongyuan acupuncture method can significantly improve the clinical symptoms and reduce the recurrence rate of patients with functional constipation due to Qi deficiency.