Ghrelin receptors as targets for novel motility drugs

Constipation arises from a multitude of causes, including aging, spinal cord injury (SCI), and dietary issues. The heterogeneity of inciting factors has made the treatment of constipation particularly challenging. Agonists of ghrelin receptors have beneficial effects on delayed gastric emptying, but less is known about their ability to improve colorectal motility. Recent publications indicate that the activation of the ghrelin receptors in the spinal cord can alleviate constipation due to dietary causes, Parkinsonism, and SCI in rodents. Ghrelin‐responsive neurons in the intermediolateral cell column of the lumbosacral spinal cord can activate enteric microcircuits that coordinate propulsive colorectal contractions, leading to defecation. Learning more about the properties of neurons in the spinal defecation center and the roles of ghrelin receptors in the defecation reflex will accelerate the development of improved treatments of constipation.     

糖尿病患者便秘原因分析及护理管理研究进展

文章归纳了自主神经病变、药物、饮食、日常活动及患者的年龄和心理等导致糖尿病患者发生便秘的危险因素,并提出护理管理措施,包括通过控制血糖、减轻药物副反应、合理膳食、腹部按摩、适当运动、排便训练、心理健康指导等,以有效降低糖尿病患者便秘的发生率,提升患者的生活质量。     

中药口服兼灌肠缓解肿瘤晚期病人便秘的护理

[目的]观察口服中药联合灌肠法对肿瘤晚期便秘病人的干预护理效果。[方法]选择接受治疗的肿瘤晚期便秘病人174例,以随机数字表法分为观察组和对照组各87例,对照组单纯使用大量不保留灌肠法,观察组使用中药直肠滴入保留灌肠法并且增加同种中药口服。对比两组病人对护理满意度情况,以及记录护理后便秘及其他症状出现的频率。[结果]观察组护理满意度达95.40%,明显高于对照组的73.56%。并且观察组护理后出现便秘症状比例仅为12.64%,远小于对照组的37.93%,差异均有统计学意义(P <0.05)。[结论]口服中药联合中药直肠滴入保留灌肠能有效缓解肿瘤晚期病人便秘,护理效果显著,病人满意度高。     

预防精神病患者便秘的护理分析

目的：探讨综合护理干预对预防精神病患者便秘的临床效果。方法将80例精神病患者随机分为两组,研究组给予综合护理干预,对照组给予常规护理干预,观察2个月。结果研究组预防精神病患者便秘的显效率为52．7％、总有效率为85．8％,对照组分别为25．1％、42．3％,研究组显效率、总有效率显著高于对照组（χ2＝6．37、15．63,P＜0．01）。结论综合护理干预能有效预防精神病患者发生便秘,有利于提高患者的生活质量。     

Clinical characteristics and peripheral T cell subsets in Parkinson’s disease patients with constipation

Constipation is frequently reported in Parkinson’s disease (PD). We evaluated the characteristics of patients with PD and constipation and explored the role of T cell subsets in PD-associated constipation. One hundred and two patients with PD treated at the First Affiliated Hospital of Bengbu Medical College were enrolled in this study between January 2012 and October 2013. All patients completed KESS questionnaires and constipation was rated. The proportions of peripheral blood Thl7 and Treg cells were assessed by flow cytometry in 45 patients. Colonoscopies were performed in six patients. Thirty-one patients with PD reported slow-transit constipation (STC), 15 rectal evacuation disorder (RED) and 33 mixed constipation (Mixed). STC most frequently occurred before onset of PD motor symptoms, while Mixed occurred before or after motor symptoms, and RED occurred most frequently after motor symptoms. CD4⁺ T cell infiltration in the colonic mucosa was observed in patients with PD and constipation. The frequency of Th17 and Treg cells in patients with PD and constipation was significantly higher than in those without constipation (P<0.001). Among patients with PD and constipation, the frequency of Th17 and Treg cells in STC was the highest. However, there was no difference in the ratio of Th17/Tregs between the patients with PD with and without constipation, or patients with PD and different types of constipations (P>0.05). Constipation reported before the onset of PD motor symptoms was most often STC or Mixed, and PD constipation may be associated with immune activation in the colonic mucosa.     

Efficacy of Electroacupuncture in the Treatment of Functional Constipation: A Randomized Controlled Pilot Trial

Objective: To evaluate the efficacy and safety of electroacupuncture at Tianshu (ST25) for patients with functional constipation (FC). Methods: Ninety-six patients with FC were randomized to receive deep needling on bilateral ST25 (group A, 48 cases) or shallow needling on bilateral ST25 (group B, 48 cases) with electroacupuncture once daily for 4 weeks. The proportion of patients with four or more complete spontaneous bowel movements (CSBMs) per week, and scores of constipation symptoms and satisfaction with treatment were compared between two groups. Safety was also assessed. Results: The proportion of patients with four or more CSBMs per week was 52.1% in group A, significantly higher than 25.0% in group B during the 4-week treatment (P<0.05). The constipation symptom score of patients were significantly improved in group A as compared with group B at week 2–4 (P<0.05). Patients in group A were more satisfied with their treatment compared with those in group B at week 1–4 (P<0.05). Five patients in group A felt significant pain and discomfort. No other adverse reaction was observed in both groups. Conclusion: Using electroacupuncture at ST25 to treat patients with FC is effectively, and deep needling had more stable effect than shallow needling.     

Functional constipation in children:non-pharmacological approach

Teb(medicine)as described by Avicenna on the opening pages of the al-Qānūn fīal-Tibb(The Cannon of Medicine)was"a science by which one learns the conditions of the human body in health and in the nonexistence of health to keep health or to bring it back".According to Avicenna’s Canon of Medicine and other traditional Persian medicine(TPM)resources,the observance of the six essential qualities provides guidance to any medical intervention.     

增液八珍汤治疗习惯性便秘

目的 观察增液八珍汤治疗习惯性便秘的临床疗效.方法 将100例习惯性便秘的患者随机分成治疗组和对照组,各50例.治疗组口服增液八珍汤(党参、白术、茯苓、当归等,1剂/d,早晚分服)治疗;对照组口服西沙比利(10 mg/次,3次/d,饭前口服),疗程1个月.分别检测治疗前后受试者血清中胃泌素(GAS)、P物质(SP)、生长抑素(SS)的含量.结果 治疗组治愈率58％,总有效率为98％,复发率10.3％;对照组治愈率24％,总有效率为72％,复发率33.3％.2组治愈率、总有效率比较,差异有统计学意义(P＜0.01,P＜0.05);治疗前后2组受试者血清中胃泌素(GAS)、P物质(SP)、生长抑素(SS)含量均有明显变化,治疗组变化明显优于对照组(P＜0.05).结论 增液八珍汤治疗习惯性便秘复发率低,无毒副作用,并能改善血清中GAS、SP、SS含量.     

老年功能性便秘患者主观疲劳与生存质量的相关性

目的 调查老年功能性便秘患者的主观疲劳现状和生存质量现状,并分析两者的相关性.方法 采用WHO生存质量量表简表(WHOQ0L-BREF)、疲劳严重度量表和自制问卷对216例老年功能性便秘患者进行调查分析.结果 老年功能性便秘患者疲劳得分(4.19±1.42)分,疲劳率达56.5％,生理领域、心理领域、社会关系领域和环境领域得分分别为(48.34±8.93)、(46.08±9.91)、(46.13±9.05)和(46.09±10.54)分.疲劳组的老年功能性便秘患者的生理领域、心理领域、社会关系领域和环境领域得分均低于非疲劳组,差异均有统计学意义(P=0.000,0.027,0.000,0.000).经Hotelling T2检验,非疲劳组的生存质量较高(P＜0.01).结论 老年功能性便秘患者的生存质量4个领域得分均较低,主观疲劳发生率较高,疲劳组的生存质量得分较非疲劳组低.