润魄汤联合双歧杆菌三联活菌胶囊对老年糖尿病性便秘患者的影响

Effects of Runpo Decoction combined with Bifidobacterium Triple Viable Capsules for elderly patients with diabetic constipation

目的探讨润魄汤联合双歧杆菌三联活菌胶囊对老年糖尿病性便秘患者肛门动力学及肠道菌群水平的影响。方法选取2021年1月至2024年1月陕西省核工业二一五医院接收的122例老年糖尿病性便秘患者进行随机对照试验,通过随机数字表法分为参照组(61例)和联合组(61例)。参照组男16例、女45例,年龄(64.83±9.97)岁,糖尿病病程(7.49±2.31)年,便秘病程(1.40±0.61)年,给予双歧杆菌三联活菌胶囊治疗;联合组男19例、女42例,年龄(65.18±10.16)岁,糖尿病病程(7.36±2.27)年,便秘病程(1.37±0.52)年,在参照组基础上给予润魄汤治疗。对比两组患者治疗前及治疗2周后的排便症状、肠道菌群水平、肛门动力学、生活质量[便秘患者生活质量自评量表(PAC-QOL)]及不良反应发生情况。统计学方法采用t检验、χ^(2)检验。结果治疗前,两组患者排便症状、肠道菌群水平、肛门动力学及生活质量比较,差异均无统计学意义(均P>0.05)。治疗2周后,联合组排便次数、乳酸杆菌数量、双歧杆菌数量、直肠排便压均高于参照组[(6.93±1.18)次/周比(5.15±1.07)次/周、(7.04±0.61)IgCFU/g比(6.18±0.67)IgCFU/g、(8.73±0.79)IgCFU/g比(7.45±0.80)IgCFU/g、(54.69±3.86)mmHg(1 mmHg=0.133 kPa)比(41.63±1.72)mmHg],排便时间短于参照组[(7.75±1.64)min/次比(10.89±1.58)min/次],大肠杆菌数量、力排肛门残余压、直肠排便窘迫阈值、直肠初始感觉阈值及躯体不适、心理社会不适、焦虑担心、满意度评分均低于参照组[(5.28±0.39)IgCFU/g比(6.40±0.48)IgCFU/g、(46.92±3.37)mmHg比(62.08±3.98)mmHg、(160.18±3.85)ml比(165.07±4.01)ml、(40.93±2.97)ml比(46.93±3.14)ml、(3.98±1.17)分比(5.17±1.08)分、(11.64±1.75)分比(15.75±2.06)分、(14.56±2.95)分比(23.78±2.86)分、(5.34±1.97)分比(8.15±2.18)分],差异均有统计学意义(t=8.728、7.413、8.892、24.137、10.769、14.144、22.704、6.870、10.842、5.837、11.876、17.526、7.469,均P<0.05)。两组患者不良事件发生率比较,差异无统计学意义(χ^(2)=0.209,P=0.648)。结论润魄汤联合双歧杆菌三联活菌胶囊可显著改善老年糖尿病性便秘患者肛门动力学及肠道菌群水平,促进肠道功能恢复,治疗安全,适合临床推广应用。

Objective To explore the effects of Runpo Decoction combined with Bifidobacterium Triple Viable Capsules on anorectal dynamics and intestinal flora levels in elderly patients with diabetic constipation.Methods From January 2021 to January 2024,122 elderly patients with diabetic constipation treated at Nuclear Industry 215 Hospital of Shaanxi Province were selected for the randomized controlled trial,and were divided into a control group and a combined group by the random number table method,with 61 cases in each group.There were 16 males and 45 females in the control group;they were(64.83±9.97)years old;their diabetic course was(7.49±2.31)years;the constipation course was(1.40±0.61)years.There were 19 males and 42 females in the combined group;they were(65.18±10.16)years old;their diabetic course was(7.36±2.27)years;the constipation course was(1.37±0.52)years.Both groups took Bifidobacterium Triple Viable Capsules;in addition,the combined group took Runpo Decoction.The symptoms of defecation,intestinal flora levels,anorectal dynamics,and quality of life before and 2 weeks after the treatment and incidences of adverse reactions were compared between the groups using t andχ^(2)tests.Results Before the treatment,there were no statistical differences in symptoms of defecation,intestinal flora levels,anorectal dynamics,and quality of life between the two groups.After the treatment,the defecation frequency,counts of lactobacillus and bifidobacterium,and rectal evacuation pressure in the combined group were higher than those in the control group[(6.93±1.18)times/week vs.(5.15±1.07)times/week,(7.04±0.61)IgCFU/g vs.(6.18±0.67)IgCFU/g,(8.73±0.79)IgCFU/g vs.(7.45±0.80)IgCFU/g,and(54.69±3.86)mmHg(1 mmHg=0.133 kPa)vs.(41.63±1.72)mmHg];the defecation time in the combined group was shorter than that in the combined group[(7.75±1.64)min/time vs.(10.89±1.58)min/time];the count of Escherichia coli,residual anal pressure,rectal evacuation threshold,initial rectal sensation threshold,and scores of physical discomfort,psychosocial discomfort,anxiety concerns,and satisfaction in the combined group were lower than those in the control group[(5.28±0.39)IgCFU/g vs.(6.40±0.48)IgCFU/g,(46.92±3.37)mmHg vs.(62.08±3.98)mmHg,(160.18±3.85)ml vs.(165.07±4.01)ml,(40.93±2.97)ml vs.(46.93±3.14)ml,(3.98±1.17)vs.(5.17±1.08),(11.64±1.75)vs.(15.75±2.06),(14.56±2.95)vs.(23.78±2.86),and(5.34±1.97)vs.(8.15±2.18)];there were statistical differences(t=8.728,7.413,8.892,24.137,10.769,14.144,22.704,6.870,10.842,5.837,11.876,17.526,and 7.469;all P<0.05).There was no statistical difference in the incidence of adverse reactions between the two groups(χ^(2)=0.209,P=0.648).Conclusion Runpo decoction combined with Bifidobacterium Triple Viable Capsules for elderly patients with diabetic constipation can significantly improve their anorectal dynamics and intestinal flora levels,promote their restoration of intestinal function,and is safe,so it is worth being clinically generalized.