济川煎加减结合穴位埋线治疗对老年功能性便秘临床疗效、症状积分及复发率的影响

Effects of Jichuan decoction combined with acupoint catgut embedding treatment on clinical efficacy,symptom score and recurrence rate of functional constipation in elderly patients

目的:分析济川煎加减结合穴位埋线治疗对老年功能性便秘临床疗效、症状积分及复发率的影响。方法:选取2020年7月~2023年1月本院治疗的老年功能性便秘患者122例,根据治疗手段分为对照组61例(济川煎加减治疗)、观察组61例(济川煎加减+穴位埋线)。两组均持续治疗1个月后,比较两组临床疗效、症状积分、完全自主排便次数(CSBMs)、血清肠神经递质水平[血管活性肠肽(VIP)、5-羟色胺(5-HT)]、血清水平[P物质(SP)、一氧化氮(NO)]安全性及复发率。结果:观察组总疗效率高于对照组(P<0.05)。两组治疗后,排便频率、粪便性状、排便费力程度、腹胀及腹痛症候积分均下降,但观察组排便频率、粪便性状、排便费力程度、腹胀及腹痛症候积分下降幅度更大(P<0.05)。两组治疗后,CSBMs均增加,且观察组CSBMs多于对照组(P<0.05)。观察组VIP水平低于对照组;5-HT水平高于对照组(P<0.05)。两组治疗后,血清SP水平均上升,NO水平均下降,且观察组SP、NO水平分别高、低于对照组(P<0.05)。3个月后,观察组复发率低于对照组(P<0.05)。结论:老年功能性便秘应用济川煎加减结合穴位埋线治疗疗效较为显著,对降低症状积分、复发率具有优势,且能进一步改善肠道功能,为老年功能性便秘治疗提供一定新思路。

Objective:To analyze the effects of Jichuan decoction combined with acupoint catgut embedding treatment on the clinical efficacy,symptom score and recurrence rate of functional constipation in the elderly paatients.Methods:One hundred and twenty-two cases of elderly patients with functional constipation treated in our hospital from July 2020to January 2023were selected and divided into 61cases in the control group(Jichuan Decoction plus and minus treatment)and 61cases in the observation group(Jichuan Decoction plus and minus+acupoints burying threads)according to the means of treatment.After 1month of continuous treatment in both groups,clinical efficacy,symptom score,number of completely spontaneous bowel movements(CSBMs),serum enteric neurotransmitter levels[vasoactive intestinal peptide(VIP),5-hydroxytryptophan(5-HT)],serum levels[substance P(SP),nitric oxide(NO)]safety and recurrence rate were compared between the two groups.Results:The total curative effect rate of observation group was higher than that of control group(P<0.05).The frequency of defecation,faecal characteristics,the degree of defecation effort,abdominal distension and abdominal pain symptom score decreased in both groups after treatment,but the decrease in the frequency of defecation,faecal characteristics,the degree of defecation effort,abdominal distension and abdominal pain symptom score was greater in the observation group(P<0.05).CSBMs increased in both groups after treatment,and there were more CSBMs in the observation group than in the control group(P<0.05).VIP level of the observation group was lower than that of the control group;5-HT level was higher than that of the control group(P<0.05).After the treatment of both groups,the serum SP level increased and NO level decreased,and the SP and NO levels of the observation group were higher and lower than those of the control group,respectively(P<0.05).After 3months,the relapse rate of the observation group was lower than that of the control group(P<0.05).Conclusion:The treatment of senile functional constipation with Jichuan decoction plus acupoint catgut embedding has obvious curative effect,which has advantages in reducing symptom score and recurrence rate and further improving intestinal function,providing some new ideas for the treatment of functional constipation in the elderly.