Emile Gautier once said, “Freedom of the bowels is the most precious, perhaps even the most essential, of all freedoms—one without which little can be accomplished.” This paper will explore the neuronal physiology,...Emile Gautier once said, “Freedom of the bowels is the most precious, perhaps even the most essential, of all freedoms—one without which little can be accomplished.” This paper will explore the neuronal physiology, pathophysiology, theories regarding the correlation between stroke and constipation along with a few treatment options. Patients often recovering from stroke complain of constipation and it is most likely attributed to changes in diet, ambulation, or fluid balance. However, there are not many studies to reflect the correlation between other less significant symptoms and stroke presentation.展开更多
Constipation is a common complication of stroke,and it is increasing year by year,which is worthy of attention.In fact,as an effective treatment for Post-ischemic Stroke Constipation,massage has been recognized by doc...Constipation is a common complication of stroke,and it is increasing year by year,which is worthy of attention.In fact,as an effective treatment for Post-ischemic Stroke Constipation,massage has been recognized by doctors at home and abroad.However,In the known research reports,massage prescriptions are complicated,therefore,a simple and effective massage prescription is urgently needed to effectively guide the clinic and promote it.In this study,we used association rule and entropy clustering analysis methods to mine clinical literature on Post-ischemic Stroke Constipation in 7 databases,and combined with data analysis,traditional chinese massage theory and clinical practice,a core new prescription is summarized.The core new prescription of massage in treating Post-ischemic Stroke Constipation take tonifying spleen,nourishing Qi and generating Body Fluid,promoting Qi,invigorating the circulation of blood and eliminating phlegm as the principle of treatment,which is accord with the pathogenesis of this disease,can better guide the clinical practice and facilitate the popularization and application of massage therapy.展开更多
Modern research has shown that there is a special brain-gut axis between the brain and the gut,which can regulate and maintain the stable function of the body.Many studies have also proved that acupuncture at certain ...Modern research has shown that there is a special brain-gut axis between the brain and the gut,which can regulate and maintain the stable function of the body.Many studies have also proved that acupuncture at certain acupoints can affect the level of brain-gut peptide,an important material basis in the brain-gut axis,thereby improving the symptoms of constipation in patients after stroke.Through the angle of traditional Chinese medicine and meridian,it can prove the rationality of acupuncture at certain acupoints for the treatment of post-stroke constipation,and it is helpful for the selection of acupoints in the clinical treatment of post-stroke constipation.展开更多
Objective： To observe the differences in therapeutic effects of acupuncture and lactulose oral solution on constipation after stroke. Method： Sixty patients with constipation after stroke were divided into an acupun...Objective： To observe the differences in therapeutic effects of acupuncture and lactulose oral solution on constipation after stroke. Method： Sixty patients with constipation after stroke were divided into an acupuncture group and a western medicine group by a random number method, with 30 cases in each group. Based on the the conventional treatment and rehabilitation for function recovery, the acupuncture group was treated at the selected the bilateral acupoints： Daheng （SP15）, Fujie （SP14）, Zhigou （TE6）, Zhaohai （KI6）, Yingxiang （LI20）, and Shaoshang （LU11） while the western medicine group was treated with 30 ml of lactulose oral solution. The clinical symptoms score and clinical efficacy of the treatment provided for constipation in both groups were recorded pre-treatment, at one week of treatment, after treatment for two weeks, and one month after discharge respectively. Results： The clinical symptom scores of constipation in the two groups after one week of treatment, two weeks of treatment, and one month of treatment were significantly lower than those before treatment （P 〈 0.001）. The treatment efficacy in the acupuncture group showed significant improvement when compared with the western medicine group, at one week, two weeks and one month （1.03 ± 1.19 vs 1.43 ± 1.19, P 〉 0.05 ; 0.73 ± 1.01 vs 1.33 ± 1.18, P 〈 0.05; 0.53 ± 0.82 vs 1.27 ± 1.14, P 〈 0.05, respectively）. The efficacy rate was statistically significant at two weeks after treatment and one month after follow-up （86.67% vs 70%,P 〈 0.05; 93.33% vs 73.33%, P 〈 0.05, respectively）. Conclusion： The short-term and long-term efficacy of acupuncture on constipation after stroke is better thanthat of treatment with lactulose oral solution. This method is safe, free of side effects, durable, has high feasibility, and is suitable for clinical application.展开更多
Constipation is one of the common gastrointestinal complications of stroke,which not only affects the quality of life of patients,but also easily induces and aggravates the primary disease and delays the recovery of t...Constipation is one of the common gastrointestinal complications of stroke,which not only affects the quality of life of patients,but also easily induces and aggravates the primary disease and delays the recovery of the disease.At present,most of the treatments for constipation after stroke are oral medicine and enema,but the curative effect is poor and unstable.Acupuncture has the advantages of simple operation,remarkable effect,high patient acceptance and a little toxic effect.It is one of the non-drug treatment ways to prevent and treat constipation after stroke,as well as widely used in the treatment of constipation after stroke.Therefore,the clinical research on acupuncture treatment of constipation after stroke in recent years is summarized to provide reference for the subsequent clinical treatment of constipation after stroke.展开更多
AIM: To assess the prevalence of bowel dysfunction in hemiplegic patients, and its relationship with the site of neurological lesion, physical immobilization and pharmacotherapy. METHODS: Ninety consecutive hemiplegic...AIM: To assess the prevalence of bowel dysfunction in hemiplegic patients, and its relationship with the site of neurological lesion, physical immobilization and pharmacotherapy. METHODS: Ninety consecutive hemiplegic patients and 81 consecutive orthopedic patients were investigated during physical motor rehabilitation in the same period, in the same center and on the same diet. All subjects were interviewed ≥ 3 mo after injury using a questionnaire inquiring about bowel habits before injury and at the time of the interview. Patients’ mobility was evaluated by the Adapted Patient Evaluation Conference System. Drugs considered for the analysis were nitrates, angiogenic converting enzyme (ACE) inhibitors, calcium antagonists, anticoagulants, antithrombotics, antidepressants, anti-epileptics. RESULTS: Mobility scores were similar in the two groups. De novo constipation (OR = 5.36) was a frequent outcome of the neurological accident. Hemiplegics showed an increased risk of straining at stool (OR: 4.33), reduced call to evacuate (OR: 4.13), sensation of incomplete evacuation (OR: 3.69), use of laxatives (OR: 3.75). Logistic regression model showed that constipation was significantly and independently associated with hemiplegia. A positive association was found between constipation and use of nitrates and antithrombotics in both groups. Constipation was not related to the site of brain injury. CONCLUSION: Chronic constipation is a possible outcome of cerebrovascular accidents occurring in 30% of neurologically stabilized hemiplegic patients. Its onset after a cerebrovascular accident appears to be independent from the injured brain hemisphere, and unrelated to physical inactivity. Pharmacological treatment with nitrates and antithrombotics may represent an independent risk factor for developing chronic constipation.展开更多
OBJECTIVE: To investigate the efficacy and safety of Xinglouchengqi(XLCQ) decoction in treatment of acute ischemic stroke with constipation.METHODS: In this prospective, multicenter, assessor-blinded, randomized contr...OBJECTIVE: To investigate the efficacy and safety of Xinglouchengqi(XLCQ) decoction in treatment of acute ischemic stroke with constipation.METHODS: In this prospective, multicenter, assessor-blinded, randomized controlled trial, 360 eligible participants will be randomized to the XLCQ group or the control group. Participants in the XLCQ group will receive XLCQ decoction, while those in the control group will undergo clysis therapy using glycerin enemas or oral administration of lactulose solution. Both groups will undergo a treatment period of(5 ± 2) d and a 1-month follow-up.The primary outcome measure will be the Constipation Scale score. The secondary outcome measures will include scores on the National Institutes of Health Stroke Scale, the Traditional Chinese Medicine(TCM) Stroke Scale, the Diagnostic Scale for TCM Syndromes of Ischemic Stroke and TCM Scale for Syndrome of Phlegm-heat and Fu-organ Excess.Therapeutic mechanism outcomes and safety outcomes will also be assessed. Assessments will be conducted at baseline, at the end of the treatment period, and at the follow-up. Moreover, daily visits will be scheduled to grade the status of constipation during the treatment period.DISCUSSION: The results of this study will provide scientific and objective data with which to assess the efficacy and safety of XLCQ decoction for patients with acute ischemic stroke and constipation.展开更多
OBJECTIVE:To evaluate the effectiveness of traditional Chinese herbal Xinglouchengqi(XLCQ)decoction for the treatment of constipation in acute ischemic stroke patients,and figure out the role that bowel movements play...OBJECTIVE:To evaluate the effectiveness of traditional Chinese herbal Xinglouchengqi(XLCQ)decoction for the treatment of constipation in acute ischemic stroke patients,and figure out the role that bowel movements play in the treatment of acute ischemic stroke.METHODS:A total of 317 eligible patients were recruited and randomized to the XLCQ group(211 patients)or the control group(106 patients).In addition to conventional standard medical care and rehabilitation,participants in the XLCQ group received XLCQ decoction,while the control group received clysis therapy using glycerin enemas or lactulose oral solution.Both groups were given treatment for 3 to 6 d,during which they received daily visits to record defecation features and accompanying symptoms.Neurological assessments using the National Institutes of Health Stroke Scale(NIHSS)were conducted before and 1 month after treatment.RESULTS:Patients in the XLCQ group had lower aggregate constipation scores compared with the control group on days 3 and 5(P<0.05).Spontaneous bowel movements tended to reappear more rapidly after taking the XLCQ decoction than after conventional laxative treatment.Both the average aggregate constipation score and the time taken to achieve spontaneous bowel movements showed positive correlations with NIHSS scores before and1 month after treatment(P<0.01).CONCLUSION:Treatment with XLCQ decoction effectively alleviated the overall symptoms of constipation in acute ischemic stroke patients.The status of bowel movements in acute ischemic stroke can reflect the severity of neurological impairment and predict neurological outcomes at 1 month.展开更多
文摘Emile Gautier once said, “Freedom of the bowels is the most precious, perhaps even the most essential, of all freedoms—one without which little can be accomplished.” This paper will explore the neuronal physiology, pathophysiology, theories regarding the correlation between stroke and constipation along with a few treatment options. Patients often recovering from stroke complain of constipation and it is most likely attributed to changes in diet, ambulation, or fluid balance. However, there are not many studies to reflect the correlation between other less significant symptoms and stroke presentation.
基金This study was supported by the Local Standard Construction Project of Jilin Provincial Market Supervision and Administration Department(DBXM097-2020)Standardization Construction Project of Jilin Provincial Administration of Traditional Chinese Medicine(zybz-zc-2020-004)of China JilinOperation specification of acupuncture on upper limb motor dysfunction after ischemic stroke(zybz-2021-005).
文摘Constipation is a common complication of stroke,and it is increasing year by year,which is worthy of attention.In fact,as an effective treatment for Post-ischemic Stroke Constipation,massage has been recognized by doctors at home and abroad.However,In the known research reports,massage prescriptions are complicated,therefore,a simple and effective massage prescription is urgently needed to effectively guide the clinic and promote it.In this study,we used association rule and entropy clustering analysis methods to mine clinical literature on Post-ischemic Stroke Constipation in 7 databases,and combined with data analysis,traditional chinese massage theory and clinical practice,a core new prescription is summarized.The core new prescription of massage in treating Post-ischemic Stroke Constipation take tonifying spleen,nourishing Qi and generating Body Fluid,promoting Qi,invigorating the circulation of blood and eliminating phlegm as the principle of treatment,which is accord with the pathogenesis of this disease,can better guide the clinical practice and facilitate the popularization and application of massage therapy.
基金Clinical efficacy study on the treatment of stroke sequelae with traditional Chinese medicine(201507001−05).
文摘Modern research has shown that there is a special brain-gut axis between the brain and the gut,which can regulate and maintain the stable function of the body.Many studies have also proved that acupuncture at certain acupoints can affect the level of brain-gut peptide,an important material basis in the brain-gut axis,thereby improving the symptoms of constipation in patients after stroke.Through the angle of traditional Chinese medicine and meridian,it can prove the rationality of acupuncture at certain acupoints for the treatment of post-stroke constipation,and it is helpful for the selection of acupoints in the clinical treatment of post-stroke constipation.
文摘Objective： To observe the differences in therapeutic effects of acupuncture and lactulose oral solution on constipation after stroke. Method： Sixty patients with constipation after stroke were divided into an acupuncture group and a western medicine group by a random number method, with 30 cases in each group. Based on the the conventional treatment and rehabilitation for function recovery, the acupuncture group was treated at the selected the bilateral acupoints： Daheng （SP15）, Fujie （SP14）, Zhigou （TE6）, Zhaohai （KI6）, Yingxiang （LI20）, and Shaoshang （LU11） while the western medicine group was treated with 30 ml of lactulose oral solution. The clinical symptoms score and clinical efficacy of the treatment provided for constipation in both groups were recorded pre-treatment, at one week of treatment, after treatment for two weeks, and one month after discharge respectively. Results： The clinical symptom scores of constipation in the two groups after one week of treatment, two weeks of treatment, and one month of treatment were significantly lower than those before treatment （P 〈 0.001）. The treatment efficacy in the acupuncture group showed significant improvement when compared with the western medicine group, at one week, two weeks and one month （1.03 ± 1.19 vs 1.43 ± 1.19, P 〉 0.05 ; 0.73 ± 1.01 vs 1.33 ± 1.18, P 〈 0.05; 0.53 ± 0.82 vs 1.27 ± 1.14, P 〈 0.05, respectively）. The efficacy rate was statistically significant at two weeks after treatment and one month after follow-up （86.67% vs 70%,P 〈 0.05; 93.33% vs 73.33%, P 〈 0.05, respectively）. Conclusion： The short-term and long-term efficacy of acupuncture on constipation after stroke is better thanthat of treatment with lactulose oral solution. This method is safe, free of side effects, durable, has high feasibility, and is suitable for clinical application.
文摘Constipation is one of the common gastrointestinal complications of stroke,which not only affects the quality of life of patients,but also easily induces and aggravates the primary disease and delays the recovery of the disease.At present,most of the treatments for constipation after stroke are oral medicine and enema,but the curative effect is poor and unstable.Acupuncture has the advantages of simple operation,remarkable effect,high patient acceptance and a little toxic effect.It is one of the non-drug treatment ways to prevent and treat constipation after stroke,as well as widely used in the treatment of constipation after stroke.Therefore,the clinical research on acupuncture treatment of constipation after stroke in recent years is summarized to provide reference for the subsequent clinical treatment of constipation after stroke.
文摘AIM: To assess the prevalence of bowel dysfunction in hemiplegic patients, and its relationship with the site of neurological lesion, physical immobilization and pharmacotherapy. METHODS: Ninety consecutive hemiplegic patients and 81 consecutive orthopedic patients were investigated during physical motor rehabilitation in the same period, in the same center and on the same diet. All subjects were interviewed ≥ 3 mo after injury using a questionnaire inquiring about bowel habits before injury and at the time of the interview. Patients’ mobility was evaluated by the Adapted Patient Evaluation Conference System. Drugs considered for the analysis were nitrates, angiogenic converting enzyme (ACE) inhibitors, calcium antagonists, anticoagulants, antithrombotics, antidepressants, anti-epileptics. RESULTS: Mobility scores were similar in the two groups. De novo constipation (OR = 5.36) was a frequent outcome of the neurological accident. Hemiplegics showed an increased risk of straining at stool (OR: 4.33), reduced call to evacuate (OR: 4.13), sensation of incomplete evacuation (OR: 3.69), use of laxatives (OR: 3.75). Logistic regression model showed that constipation was significantly and independently associated with hemiplegia. A positive association was found between constipation and use of nitrates and antithrombotics in both groups. Constipation was not related to the site of brain injury. CONCLUSION: Chronic constipation is a possible outcome of cerebrovascular accidents occurring in 30% of neurologically stabilized hemiplegic patients. Its onset after a cerebrovascular accident appears to be independent from the injured brain hemisphere, and unrelated to physical inactivity. Pharmacological treatment with nitrates and antithrombotics may represent an independent risk factor for developing chronic constipation.
基金Supported by the National Science and Technology Pillar Program during the 12th Five-year Plan Period of the People's Republic of China:Heritage Study on the Special Therapeutic Principles and Methods of Famous Experts in Traditional Chinese Medicine(No.2013BAI13B022)
文摘OBJECTIVE: To investigate the efficacy and safety of Xinglouchengqi(XLCQ) decoction in treatment of acute ischemic stroke with constipation.METHODS: In this prospective, multicenter, assessor-blinded, randomized controlled trial, 360 eligible participants will be randomized to the XLCQ group or the control group. Participants in the XLCQ group will receive XLCQ decoction, while those in the control group will undergo clysis therapy using glycerin enemas or oral administration of lactulose solution. Both groups will undergo a treatment period of(5 ± 2) d and a 1-month follow-up.The primary outcome measure will be the Constipation Scale score. The secondary outcome measures will include scores on the National Institutes of Health Stroke Scale, the Traditional Chinese Medicine(TCM) Stroke Scale, the Diagnostic Scale for TCM Syndromes of Ischemic Stroke and TCM Scale for Syndrome of Phlegm-heat and Fu-organ Excess.Therapeutic mechanism outcomes and safety outcomes will also be assessed. Assessments will be conducted at baseline, at the end of the treatment period, and at the follow-up. Moreover, daily visits will be scheduled to grade the status of constipation during the treatment period.DISCUSSION: The results of this study will provide scientific and objective data with which to assess the efficacy and safety of XLCQ decoction for patients with acute ischemic stroke and constipation.
基金Supported by the National Science and Technology Pillar Program during the 12th Five-year Plan Period of the People’s Republic of China(No.2013BAI13B02).
文摘OBJECTIVE:To evaluate the effectiveness of traditional Chinese herbal Xinglouchengqi(XLCQ)decoction for the treatment of constipation in acute ischemic stroke patients,and figure out the role that bowel movements play in the treatment of acute ischemic stroke.METHODS:A total of 317 eligible patients were recruited and randomized to the XLCQ group(211 patients)or the control group(106 patients).In addition to conventional standard medical care and rehabilitation,participants in the XLCQ group received XLCQ decoction,while the control group received clysis therapy using glycerin enemas or lactulose oral solution.Both groups were given treatment for 3 to 6 d,during which they received daily visits to record defecation features and accompanying symptoms.Neurological assessments using the National Institutes of Health Stroke Scale(NIHSS)were conducted before and 1 month after treatment.RESULTS:Patients in the XLCQ group had lower aggregate constipation scores compared with the control group on days 3 and 5(P<0.05).Spontaneous bowel movements tended to reappear more rapidly after taking the XLCQ decoction than after conventional laxative treatment.Both the average aggregate constipation score and the time taken to achieve spontaneous bowel movements showed positive correlations with NIHSS scores before and1 month after treatment(P<0.01).CONCLUSION:Treatment with XLCQ decoction effectively alleviated the overall symptoms of constipation in acute ischemic stroke patients.The status of bowel movements in acute ischemic stroke can reflect the severity of neurological impairment and predict neurological outcomes at 1 month.
