清热润肠药膳(三仁窝头)治疗肠道实热证功能性便秘的临床观察

Clinical observation on the treatment of functional constipation with intestinal excess heat pattern using the heat-clearing and intestinemoistening medicated diet(Sanren Wotou)

目的 观察清热润肠药膳(三仁窝头)治疗肠道实热证功能性便秘(functional constipation,FC)的临床疗效。方法 将2022年2月至2022年8月于黑龙江中医药大学附属第一医院肝脾胃科门诊及健康体检中心就诊的72例肠道实热证FC患者随机分为试验组和对照组,每组34例。对照组给予中医护理健康教育及聚乙二醇4000散治疗,试验组在对照组的基础上食用自拟清热润肠药膳(三仁窝头)。两组均每日干预1次,连续干预两周。以首次排便时间、西医症状评分、中医证候评分和便秘患者生活质量量表(patient assessment of constipation-quality of life questionnaire,PAC-QOL)评分为主要结局指标评估临床疗效。结果 干预后,试验组首次排便时间明显早于对照组(P<0.01);试验组PAC-QOL评分,西医症状评分中的腹胀、Bristol粪便性状评分及中医证候评分中的脘腹胀满或痛、口干口臭、小便短赤评分均低于对照组(P<0.05);试验组患者总有效率(91.2%)高于对照组(76.5%)(P<0.05);两组不良事件发生率差异无统计学意义(P>0.05)。结论 清热润肠药膳(三仁窝头)能缩短FC肠道实热证患者的首次排便时间,改善患者部分便秘症状、中医证候评分,并提高患者生活质量。

Objective To observe the clinical effect of the heat-clearing and intestine-moistening medicated diet(Sanren Wotou) on functional constipation(FC) caused by intestinal excess heat pattern.Methods A total of 72 FC caused by intestinal excess heat pattern who were treated from February 2022 to August 2022 at the Liver,Spleen and Stomach Outpatient Department and Health Examination Center of the First Hospital of Heilongjiang University of Chinese Medicine were randomly assigned into experimental and control groups,with 34 patients in each group.The control group was given nursing health education of Chinese medicine and polyethylene glycol 4000 powder treatment,and the experimental group ate self-prepared heat-clearing and intestinemoistening medicated diet(Sanren Wotou) on the basis of control group.Both groups were intervened once a day,for two consecutive weeks.The clinical efficacy was evaluated with the time of first defecation,Western medicine symptoms score,Chinese medicine pattern score,and patient assessment of constipation-quality of life questionnaire(PAC-QOL) score as the main outcome measures.Results After intervention,the first defecation time of experimental group was significantly shorter than that of control group(P<0.01).Western medicine symptom scores(PAC-QOL score,abdominal distension,and Bristol fecal traits) and Chinese medicine pattern scores(distension or pain in the stomach duct and abdomen,dry mouth and bad breath,and short voidings of dark urine) for the experimental group were lower than those in control group(P<0.05).The total effective rate of experimental group(91.2%) was higher than that of control group(76.5%)(P<0.05).There was no significant difference in the incidence of adverse events between two groups(P<0.05).Conclusion The heat-clearing and intestine-moistening medicated diet(Sanren Wotou) can shorten the first defecation time of FC patients with intestinal excess heat pattern,improve some of the constipation symptoms and Chinese medicine pattern score,and enhance their quality of life.