缩泉润肠汤联合生物反馈及“认知建构主义”精神心理干预治疗老年慢性便秘

目的:探讨缩泉润肠汤联合生物反馈及'认知建构主义'精神心理干预治疗老年慢性便秘的临床疗效。方法:将120例老年慢性便秘患者采用随机数字表法分为对照组(60例)和治疗组(60例)。治疗组予缩泉润肠汤联合生物反馈及'认知建构主义'精神心理干预;对照组予缩泉润肠汤治疗。两组患者均治疗2个疗程后,对治疗前后临床疗效、排便指标、精神心理、中医症状积分及停药3个月后复发情况进行比较。结果:两组患者治疗后中医症状积分均有不同程度的改善,其中临床疗效、排便指标(排便间隔、便后不尽感)、中医临床症状(腹胀腹痛)、精神心理疗效(躯体化、强迫症状、抑郁、焦虑、精神病性、睡眠和饮食情况、症状总积分)显著改善,治疗组显著优于对照组(P<0.05),其余各指标两组积分无明显差异。治疗组有效率76.7%,对照组63.3%,两组比较,差异有统计学意义(P<0.01)。停药3个月,治疗组复发率显著低于对照组(P<0.05)。结论:缩泉润肠汤联合生物反馈及'认知建构主义'精神心理干预治疗老年慢性便秘疗效优于缩泉润肠汤治疗,使患者精神心理症状及临床症状得到改善,也减少长期使用泻药引起的不良反应,降低了复发率。

Constructivism Representatives about Cognition Process

The article provides an analysis of the approach to cognition in the theory of constructivism according to different constructivism concepts such as： methodical constructivism, scientific-theoretical constructivism, natural epistemology, personal construct theory, social constructivism, concepts of some radical constructivism representatives, constructive realism. The analysis demonstrates that constructivism helps to establish subject＇s control over the reality perceived by him when eliminating any deviations or resentments from his preferable target condition. In this case, the model of the world cognized contains only the aspects which are relevant to subject＇s purposes and actions. It is advanced the idea the current stage of science development is connected with the change of its fundamental bases. As a result, the model of the reality becomes a result of interaction between subject of scientific and cognitive activity with the reality, but the ideas of constructivism in its classical meaning don＇t correspond to this conclusion. The author proves that cognition based on the constructive realism is the most appropriate to the modern stage of epistemology development as it cancels the opposition of constructivism and realism in some extent and promotes getting a rational knowledge about the reality by subject.