Clinical observation on therapeutic effect of acupuncture for chronic functional constipation

Methods Two Qihai （气海 CV Objective To discuss the efficacy of acupuncture for groups of points were applied alternatively to 90 cases by chronic functional constipation acupuncture： （1） Tianshhu （CFC）. ST 25）, 6）, Shemgjfuxu （上巨虚 ST 37）, etc. （2）Zhongliao （中髎 BL 33）, Xiadiao （下髎 BL 34）, Dachangshu （大肠俞 BL 25）, etc. Electroacupuncture was applied in combination at Zhongliao （中髎 BL 33）, Xialiao （下髎 BL 34）, Tianshu（天枢 ST 25） and Shamgjuxu （上巨虚 ST 37）, once a day, 10 treatments made one session. By constipation diary of patients, frequency of going to stool, straining severity, time of once bowl evacuation, a sense of incomplete bowel emptying, stool quality, a sense of defecation and the Patient Assessment of Constipation Quality of Life questionnaire （PAC-QOL）, as well as the changes before and after treatment were observed. Results After treatment, the apparent improvements were achieved in frequency of going to stool, straining severity, time of once bowl evacuation, a sense of incomplete bowel emptying, a sense of defecation and score of PAC-QOL as compared with those before treatment （all P〈0.01）. The total effective rate was 67.7% （61/70）. The acupuncture effieacies were various on CFC of different dynamic mechanisms. The efficacy on slow transit constipation （STC） was superior to that caused by spastic pelvic floor syndrome （SPFS-C） （P〈0.05）, the efficacy on constipation caused by irritable bowel syndrome （IBS-C） was superior to that on either SPFS-C or constipation caused by relaxant pelvic floor syndrome （RPFS-C） （both P〈0.05）. Of 52 eases in effective follow-up, 1 month after treatment, 3 eases were cured, 6 eases markedly effective, 23 eases effective, and 20 cases failed; 3 months after treatment, 3 eases were cured, 5 eases markedly effective, 16 cases effective and 28 cases failed. Conclusion Acupuncture has definite efficacy on CFC with definite etiology, loci and diagnostic classification. But, the efficacies are different due to various dynamic mechanisms. A further optimized treatment program is required to improve the efficacy on SPFS-C and RPFS-C.

Randomized controlled trial on chronic functional constipation treated with grain-shaped moxibustion and acupuncture

Objective To compare the differences of therapeutic effects of chronic functional constipation treated with the combined therapy of moxibustion and acupuncture and simple acupuncture. Methods One hundred cases of constipation were randomly divided into an acupuncture-moxibustion group and a simple acupuncture group with 50 cases for each group. Two groups of acupoints were adopted every other day alternatively for both groups. Point group 1： Tiansha （天枢ST 25）, Daheng （大横 SP 15）, Qihai （气海 CV 6）, Guanyuan （关元 CV 4）, Ztisanli （足三里 ST 36）, Shangjhxu （上巨虚 ST 37） and Sanyinjiao （三阴交 SP 6）. Point group 2： Zhsngliao （中髎 BL 33）, Xiatliao （下髎 BL 34）, Dachangsha （大肠俞 BL 25）, Shenshu （肾俞 BL 23） and Pisha （脾俞 BL 20）. Acupuncture was the only therapy adopted for acupuncture group on all the above mentioned points. While, for acupuncture-moxibustion group, moxibustion with grain-shaped moxa cones was applied on Qihai （所海 CV 6）, Zusatnli （足三里 ST 36）, Datchangshu （大肠俞 BL 25） and Pishu （脾俞 BL 20）, and acupuncture was applied on the rest points. Clinical therapeutic effect, clinical score of constipation, quality of life and score of psychological symptoms were observed before and after the treatment. Results The total effective rate in acupuncture-moxihustion group was 74.0%（37/50）, which was superior to that （52.0%, 26/50） in acupuncture group （P〈0.05）. The clinical scores of constipation, quality of life and scores of psychological symptoms of both groups improved after the treatment. For clinical scores of constipation, degree of difficulty in bowel movement, duration of defecation, abdominal pain, difficulty in exsufflation, incomplete sensation after defecation, obstruction sense of anus, purgative prescription dependence, score of life quality and psychological symptoms of acupuneture-moxibustion group were all better than those of simple acupuncture group （P〈0.05, P〈0.01）. Conclusion The combined therapy of both moxibustion with grain-shaped moxa cones and acupuncture is safe and effective in treatment of chronic functional constipation, and the effect is superior to simple therapy of acupuncture.

Pediatric functional constipation treatment with Bifi dobacterium-containing yogurt:A crossover,double-blind,controlled trial

AIM: To evaluate the treatment of pediatric functional chronic intestinal constipation (FCIC) with a probiotic goat yogurt. METHODS: A crossover double-blind formula-controlled trial was carried out on 59 students (age range: 5-15 years) of a public school in Belo Horizonte, MG, Brazil, presenting a FCIC diagnostic, according to Roma Ⅲ criteria. The students were randomized in two groups to receive a goat yogurt supplemented with 109 colony forming unit/mL Bifidobacterium longum (B.longum) (probiotic) daily or only the yogurt for a period of 5 wk (formula). Afterwards, the groups were intercrossed for another 5 wk. Defecation frequency, stool consistency and abdominal and defecation pain were assessed.RESULTS: Both treatment groups demonstrated improvement in defecation frequency compared to baseline. However, the group treated with probiotic showed most signif icant improvement in the f irst phase of the study. An inversion was observed after crossing over, resulting in a reduction in stool frequency when this group was treated by formula. Probiotic and formula improved stool consistency in the f irst phase of treatment, but the improvement obtained with probiotic was significantly higher (P = 0.03). In the second phase of treatment, the group initially treated with probiotic showed worseningstool consistency when using formula. However, the difference was not signif icant. A signif icant improvement in abdominal pain and defecation pain was observed with both probiotic and formula in the first phase of treatment, but again the improvement was more signif icant for the group treated with B. longum during phase I (P < 0.05). When all data of the crossover study were analyzed, significant differences were observed between probiotic yogurt and yogurt only for defecation frequency (P = 0.012), defecation pain (P = 0.046) and abdominal pain (P = 0.015).