益肠通秘汤联合中药热奄包治疗老年脾肾阳虚型慢性便秘效果观察

目的探讨益肠通秘汤联合中药热奄包治疗老年脾肾阳虚型慢性便秘的临床疗效。方法选取2016年4月至2017年1月湖北省中医院肛肠科收治的60例老年脾肾阳虚型慢性便秘患者作为研究对象,并按照随机数表法随机分为试验组(30例)与对照组(30例),其中试验组患者在口服益肠通秘汤的同时采用中药热奄包热敷治疗,对照组患者单纯口服乳果糖口服溶液治疗,对比观察两组患者的腹胀、排便时间、排便顺畅度、便后不尽感等变化情况以及临床疗效与复发情况。结果治疗14 d后,两组患者腹胀、排便时间、排便顺畅度及便后不尽感较治疗前均明显改善,且尤以试验组改善最为显著,两组患者腹胀、排便时间、排便顺畅度及便后不尽感评分分别与治疗前对比,P均<0.05,差异具有统计学意义;治疗14 d后,两组患者腹胀及便后不尽感评分对比,P均<0.05,差异具有统计学意义;治疗14 d后,两组患者排便时间及排便顺畅度评分对比,P均>0.05,差异无统计学意义;治疗14 d后,试验组患者中痊愈17例、显效6例、有效4例、无效3例、总有效率为90.00%,对照组患者中痊愈9例、显效8例、有效3例、无效10例、总有效率为66.67%,两组对比,P<0.05,差异具有统计学意义;治疗后6个月随访,试验组17例痊愈患者中复发4例,对照组9例痊愈患者中复发6例。结论益肠通秘汤联合中药热奄包治疗老年脾肾阳虚型慢性便秘,可有效缓解患者腹胀不适、排便时间延长、排便费力及便后不尽感等临床症状,疗效显著,且复发率较低,值得临床推广应用。

Observation on the Clinical Efficacy of Yichang Tongmi Decoction in Combination with Chinese Herbs.packed Reyanbao in the Treatment of Chronic Constipation of Spleen-kidney Yang Deficiency Type in the Elderly

Objective To investigate the clinical efficacy of Yichang Tongmi decoction in combination with Chinese herbs-packed Reyanbao in the treatment of chronic constipation of spleen-kidney Yang deficiency type in the elderly.Methods Sixty elderly patients with chronic constipation of spleen-kidney Yang deficiency type admitted into the Anorectal Department of Hubei Provincial Hospital of TCM between April 2016 and January 2017 were selected as subjects to be divided into a test group(30 patients)and a control group(30 patients)according to the random number table.In the test group,patients were given Yichang Tongmi decoction orally in combination with Chinese herbs-packed Reyanbao,while patients in the control group were only given Lactulose Oral Solution.Condition changes including abdominal distension,defecation time,defecation smoothness and feeling of incomplete evacuation,clinical efficacy and relapse condition were observed and compared between the two groups.Results After 14 days of treatment,the conditions of abdominal distension,defecation time,defecation smoothness and feeling of incomplete evacuation were all improved significantly as compared with that before treatment,especially in the test group,and the scores of abdominal distension,defecation time,defecation smoothness and feeling of incomplete evacuation after 14 days of treatment all showed statistically significant differences as compared with that before treatment in each group,P<0.05.After 14 days of treatment,the scores of abdominal distension and feeling of incomplete evacuation were respectively compared between the two groups and the results showed statistically significant differences,P<0.05.However,no statistically significant difference was observed when the scores of defecation time and defecation smoothness were respectively compared between the two groups,P>0.05.After 14 days of treatment,17 patients were cured,6 patients presented marked effectiveness,4 patients showed effectiveness and 3 patients showed ineffectiveness,and the total effective rate was 90.00%in the test group,while in the control group,9 patients were cured,marked effectiveness in 8 patients,effectiveness in 3 patients,ineffectiveness in 10 patients and the total effective rate was 66.67%,between which the difference was statistically significant,P<0.05.During the follow-up of 6 months after treatment,4 patients relapsed among the cured 17 patients in the test group while 6 patients relapsed among the cured 9 patients in the control group.Conclusion In the treatment of chronic constipation of spleen-kidney Yang deficiency type in the elderly,Yichang Tongmi Decoction in combination with Chinese Herbs-packed Reyanbao can effectively relieve patients’discomforts of such clinical symptoms as abdominal distension,prolonged defecation time,defecation difficulty and feeling of incomplete evacuation,and realize a lower relapse rate,deserving to be promoted in clinical practice.