目的观察芍黄通便合剂治疗肠道气滞型便秘的临床疗效和安全性。方法 144例肠道气滞型便秘患者随机分为试验组和对照组,各72例。试验组口服芍黄通便合剂(主要成分:白芍,大黄,火麻仁,决明子等),每次20 m L,每日3次;对照组口服木香槟榔丸,...目的观察芍黄通便合剂治疗肠道气滞型便秘的临床疗效和安全性。方法 144例肠道气滞型便秘患者随机分为试验组和对照组,各72例。试验组口服芍黄通便合剂(主要成分:白芍,大黄,火麻仁,决明子等),每次20 m L,每日3次;对照组口服木香槟榔丸,每次6 g,每日3次,通便即停药,随访7 d。观察便意、排便频率、大便形状(根据Bristol粪便分型标准)、排便时间、排便量、排便时伴随症(排便疼痛、腹胀、排便困难、排气等)及主要相关体征、相关理化检查指标变化;观察2组药物不良反应发生情况。结果治疗后,试验组总有效率为91.94%(57/62例),对照组为90.16%(55/61例),差异无统计学意义(P>0.05)。治疗后,试验组和对照组便意评分分别为(4.81±0.80),(4.65±0.74)分;排便频率评分分别为(4.19±0.78),(4.26±0.84)分;便质评分分别为(4.91±0.76),(4.81±0.88)分;排便时间评分分别为(5.11±0.92),(5.02±0.99);排便量评分分别为(4.25±0.61),(4.12±0.54)分;排便困难程度评分分别为(4.20±0.77),(4.19±0.81)分;腹胀痛评分分别为(5.11±0.68),(5.02±0.76)分;嗳气评分分别为(5.06±0.79),(5.00±0.75)分;胸胁痞满评分分别为(3.73±0.61),(3.87±0.66)分;肠鸣评分分别为(4.40±0.64),(4.33±0.51)分;2组各单项评分与治疗前相比,差异有统计学意义(P<0.05),组间差异无统计学意义(P>0.05)。试验组和对照组的药物不良反应均为恶心和腹泻,试验组药物不良反应发生率为3.23%(2/62例),对照组为4.92%(3/61例),差异无统计学意义(P>0.05)。结论芍黄通便合剂和木香槟榔丸治疗肠道气滞型便秘的临床疗效相似。芍黄通便合剂治疗肠道气滞型便秘安全、有效。展开更多
I read with great interest the recent article by Chen et al in a recent issue of your esteemed journal.The article is highly thought provoking.One emerging therapeutic alternative for opioid induced constipation is th...I read with great interest the recent article by Chen et al in a recent issue of your esteemed journal.The article is highly thought provoking.One emerging therapeutic alternative for opioid induced constipation is the emergence of opioid/naloxone prolonged release combinations.For instance,naloxone when administered in a 1:2 ratio with oxycodone reverses the inhibitory effect of oxycodone on the gastrointestinal tract.The advantage of oxycodone/naloxone prolonged release(OXN) is that while its anti-nociceptive efficacy is equivalent to that of oxycodone prolonged release(OXC),it significantly decreases the "Bowel Function Index" thereby ameliorating symptoms of opioid induced constipation to a large extent.Schutter et al in a recent study have reported a decrease in the bowel function index from 38.2 to 15.1.Similarly,L wenstein et al in another recent study have reported that following a month of therapy,complete spontaneous bowel movements per week is increased from one in OXC therapy to three in OXN therapy.展开更多
Objective： To compare the different therapeutic effects of acupuncture and Phenolphthalein for constipation due to intestinal qi stagnation. Methods： A total of 50 patients with constipation due to intestinal qi sta...Objective： To compare the different therapeutic effects of acupuncture and Phenolphthalein for constipation due to intestinal qi stagnation. Methods： A total of 50 patients with constipation due to intestinal qi stagnation were randomly divided into an acupuncture group and a medication group by the random digital table, 25 cases in each group. The patients in the acupuncture group were treated by puncturing Gongsun（SP 4）, Sanyinjiao（SP 6）, Taichong（LR 3）, Zusanli（ST 36）, Shangjuxu（ST 37）, Hegu（LI 4）, Lieque（LU 7）, and Tianshu（ST 25）, once every day, and 7 d as one course, for continuous 3 courses; while the patients in the medication group were given Phenolphthalein, 7 d as one course, for continuous 3 courses. Compared the Cleveland clinic constipation score（CCS） between the two groups after one course, 3 courses and 3 months after the treatment, as well as the frequency of defecation within one week. Results： After one week of treatment, CCS scores and frequency of defecation per week were significantly changed in both groups compared with those before treatment（P〈0.05）, and CCS scores and frequency of defecation per week were improved more significantly in the patients of the medication group than in those of the acupuncture group（P〈0.01）. After 3 weeks of treatment, CCS scores and frequency of defecation per week were significantly changed in both groups compared with those before treatment（P〈0.05）, and CCS scores and frequency of defecation per week were improved more significant in the patients of the acupuncture group than in those of the medication group（P〈0.05）. Three months after the end of treatment, CCS scores and frequency of defecation per week were significantly changed in both groups compared with those before treatment（P〈0.05）, and CCS scores and frequency of defecation per week were improved more significantly in the patients of the acupuncture group than in those of the medication group（P〈0.05）. Conclusion： Acupuncture and medication are effective in the treatment of constipation due to intestinal qi stagnation. Their short-term therapeutic effect is similar, but the long-term therapeutic effect is better in the acupuncture group than in the medication group.展开更多
Background and aim:Gutmicrobiotamay contribute to regulate colonicmotility,which is involved in the etiology of constipation.Fecalmicrobiota transplantation(FMT)has been demonstrated to restore intestinal homeostasis....Background and aim:Gutmicrobiotamay contribute to regulate colonicmotility,which is involved in the etiology of constipation.Fecalmicrobiota transplantation(FMT)has been demonstrated to restore intestinal homeostasis.The aimof this study was to evaluate the clinical outcomes and prognostic factors of FMT for the treatment of slow transit constipation(STC).Methods:Fifty-two patients with STC received standardized FMT and were followed up for 6 months.Bowel habit,colonic transit time,constipation-related symptoms(PAC-SYM score),quality of life(PAC-QOL score),treatment satisfaction scores and adverse events were monitored.The primary efficacy endpoint was the proportion of patients having on average three or more complete spontaneous bowel movements(CSBMs)per week.Results:The primary efficacy endpoint was achieved in 50.0%,38.5%and 32.7%of patients over week intervals 3–4,9–12 and 21–24,respectively(P<0.01 for all comparisons).Significant improvements were also observed in other bowel movement assessments,colonic transit time,constipation-related symptoms and quality of life;but all improvements diminished at weeks 12 and 24.Incompleteness of evacuation served as the only factor associated with efficacy.No serious treatmentrelated adverse events were observed.Conclusion:This study suggested FMT was effective and safe for STC,while a late loss of efficacy was also observed.A lower degree of sensation of incompleteness predicted a better outcome.展开更多
文摘I read with great interest the recent article by Chen et al in a recent issue of your esteemed journal.The article is highly thought provoking.One emerging therapeutic alternative for opioid induced constipation is the emergence of opioid/naloxone prolonged release combinations.For instance,naloxone when administered in a 1:2 ratio with oxycodone reverses the inhibitory effect of oxycodone on the gastrointestinal tract.The advantage of oxycodone/naloxone prolonged release(OXN) is that while its anti-nociceptive efficacy is equivalent to that of oxycodone prolonged release(OXC),it significantly decreases the "Bowel Function Index" thereby ameliorating symptoms of opioid induced constipation to a large extent.Schutter et al in a recent study have reported a decrease in the bowel function index from 38.2 to 15.1.Similarly,L wenstein et al in another recent study have reported that following a month of therapy,complete spontaneous bowel movements per week is increased from one in OXC therapy to three in OXN therapy.
文摘Objective： To compare the different therapeutic effects of acupuncture and Phenolphthalein for constipation due to intestinal qi stagnation. Methods： A total of 50 patients with constipation due to intestinal qi stagnation were randomly divided into an acupuncture group and a medication group by the random digital table, 25 cases in each group. The patients in the acupuncture group were treated by puncturing Gongsun（SP 4）, Sanyinjiao（SP 6）, Taichong（LR 3）, Zusanli（ST 36）, Shangjuxu（ST 37）, Hegu（LI 4）, Lieque（LU 7）, and Tianshu（ST 25）, once every day, and 7 d as one course, for continuous 3 courses; while the patients in the medication group were given Phenolphthalein, 7 d as one course, for continuous 3 courses. Compared the Cleveland clinic constipation score（CCS） between the two groups after one course, 3 courses and 3 months after the treatment, as well as the frequency of defecation within one week. Results： After one week of treatment, CCS scores and frequency of defecation per week were significantly changed in both groups compared with those before treatment（P〈0.05）, and CCS scores and frequency of defecation per week were improved more significantly in the patients of the medication group than in those of the acupuncture group（P〈0.01）. After 3 weeks of treatment, CCS scores and frequency of defecation per week were significantly changed in both groups compared with those before treatment（P〈0.05）, and CCS scores and frequency of defecation per week were improved more significant in the patients of the acupuncture group than in those of the medication group（P〈0.05）. Three months after the end of treatment, CCS scores and frequency of defecation per week were significantly changed in both groups compared with those before treatment（P〈0.05）, and CCS scores and frequency of defecation per week were improved more significantly in the patients of the acupuncture group than in those of the medication group（P〈0.05）. Conclusion： Acupuncture and medication are effective in the treatment of constipation due to intestinal qi stagnation. Their short-term therapeutic effect is similar, but the long-term therapeutic effect is better in the acupuncture group than in the medication group.
基金supported by the National Natural Science Foundation of China(81670493)the National Gastroenterology Research Project(2015BAI13B07).
文摘Background and aim:Gutmicrobiotamay contribute to regulate colonicmotility,which is involved in the etiology of constipation.Fecalmicrobiota transplantation(FMT)has been demonstrated to restore intestinal homeostasis.The aimof this study was to evaluate the clinical outcomes and prognostic factors of FMT for the treatment of slow transit constipation(STC).Methods:Fifty-two patients with STC received standardized FMT and were followed up for 6 months.Bowel habit,colonic transit time,constipation-related symptoms(PAC-SYM score),quality of life(PAC-QOL score),treatment satisfaction scores and adverse events were monitored.The primary efficacy endpoint was the proportion of patients having on average three or more complete spontaneous bowel movements(CSBMs)per week.Results:The primary efficacy endpoint was achieved in 50.0%,38.5%and 32.7%of patients over week intervals 3–4,9–12 and 21–24,respectively(P<0.01 for all comparisons).Significant improvements were also observed in other bowel movement assessments,colonic transit time,constipation-related symptoms and quality of life;but all improvements diminished at weeks 12 and 24.Incompleteness of evacuation served as the only factor associated with efficacy.No serious treatmentrelated adverse events were observed.Conclusion:This study suggested FMT was effective and safe for STC,while a late loss of efficacy was also observed.A lower degree of sensation of incompleteness predicted a better outcome.
