Factors associated with defecation patterns in 0–24-month-old children

To identify the normal defecation patterns and the factors affecting these patterns in the first two years of life, a questionnaire was given to the parents of 1,021 children who were followed in a well-child clinic. The time of first meconium passage, presence of colic symptoms, frequency, color, and consistency of stools were recorded.Mann Whitney U, Wilcoxon, chi-square, and correlation tests were used in the statistical analyses. The median number of defecations per day was six in the first month of life. This decreased to once in the second month and almost all cases remained so until the end of the 24th month. At the second month of age, 39.3% of infants passed stools less than once a day. This pattern of rare defecation was seen until the end of 6 months, when supplemental foods were started. Stool frequency was higher in exclusively breast-fed infants (p = 0.0001). Infants who had colic symptoms in the first 2 months had less frequent defecation during the first 2 years of life (p = 0.0001). In addition to confirming the previously observed defecation patterns of 0–2-year-old infants, this study provides the relationship between colic symptoms and stool frequency, and showed that the second month of life was unique in the sense that the frequency of stooling decreased to half of the previous month and 39.3% of these infants defecated less than once a day.     

Electroacupuncture combined with qibei mixture for diarrhea-predominant irritable bowel syndrome: A randomized controlled trial

Objective

To explore the short and long-term efficacy of combining electroacupuncture (EA) and Qibei mixture in the treatment of irritable bowel syndrome (IBSD).

自制肛门置管促进混合痔术后排便的临床观察

目的探讨肛门留置一次性自制导管并于首次排便前灌肠对混合痔术后患者排便的影响。方法将60例混合痔术后患者随机分为观察组与对照组各30例。对照组术后常规采用肛门放置京万红油纱条引流方法,试验组于术后肛门留置一次性自制导管,并于首次排便前灌肠。结果两组患者术后首次排便通畅程度、疼痛程度及腹胀发生率进行比较,差异有显著性意义(P<0.05)。结论本法能有效的防治术后首次排便困难,避免发生腹胀,有效缓解术后排便疼痛,值得推广。     

Clinical significance of obstructive defecatory symptoms in women with pelvic organ prolapse

Objective

To determine whether the presence of obstructive defecatory symptoms is associated with the site and severity of pelvic organ prolapse. Methods: A cross-sectional study was performed of women with pelvic organ prolapse of grade 2 or greater who had completed a validated questionnaire that surveyed pelvic floor symptoms. Associations between patient characteristics, site and severity of prolapse, and obstructive bowel symptoms were investigated.

Results

Among 260 women with pelvic organ prolapse, women with posterior vaginal wall prolapse were more likely to report obstructive symptoms, such as incomplete emptying (41% vs 21%, P = 0.003), straining at defecation (39% vs 19%, P = 0.002), and splinting with defecation (36% vs 14%, P < 0.001) compared with women without posterior vaginal wall prolapse. There was no significant association between any bowel symptom and increasing severity of prolapse.

Conclusions

Obstructive bowel symptoms are significantly associated with the presence of posterior vaginal wall prolapse, but not with the severity of prolapse.     

排便功能训练对保肛术后患者排便功能的影响

目的 探讨低位直肠癌保肛手术患者进行排便功能训练对肛门排便功能的影响。方法 将110例行低位前切除术的直肠癌患者按吻合口距齿状线的距离分为两组(A组:1.0~2.0cm,B组:2.0~3.0cm),术后对其进行排便功能训练,分别在术后3个月及1年进行Wexner评分,术后1年进行大便失禁生活质量问卷(FIQL)调查。结果 术后2～6周,患者排便次数控制在6～8次/d。8～14周,大便成形,次数控制在3～4次/d,并随着时间推移逐渐减少。术后3个月,A组的Wexner评分高于B组(P＜0.05);1年后,两组的Wexner评分无统计学意义(P＞0.05)。术后1年的FQIL问卷调查中,A、B两组各项指标均接近正常。结论 排便功能训练使患者的排便自控能力及生活质量得到不同程度的改善。     

不同子宫切除术式对女性排便功能的影响

目的探讨不同子宫切除术式对女性排便功能的影响.方法75例患者分为全子宫切除组(A组)60例,次全子宫切除组(B组)15例,对两组术后排便次数、排便难易程度的变化进行计数分析.结果75例子宫切除术后有52%的患者排便次数改变,A组术后排便次数减少发生率为53.33%,B组为20%,两者有显著性差异(P＜0.05).子宫切除术后有49.33%的患者排便难易程度改变,A组术后排便费力发生率为48.33%,B组为13.33%,两者有显著性差异(P＜0.05).结论子宫切除术后可影响女性排便功能,全子宫切除患者较次全子宫切除患者更明显.因此,次全子宫切除术是一种可选择的手术.     

玛咖保肝通便及调节肠道菌群的作用研究

目的：评价玛咖保肝通便以及对肠道菌群的调节作用,进一步挖掘玛咖的药用价值,为玛咖应用提供参考。方法：采用酒精性肝损伤（ALD）小鼠模型,测定肝功能、炎症介质及脂质过氧化指标,评价玛咖水提液的保肝作用;采用小鼠小肠蠕动抑制模型,测定墨汁推进率、小鼠血清中胃动素（MTL）和环磷酸鸟苷（cGMP）的水平,评价玛咖水提液的通便作用;通过16S rDNA技术测定盲肠内容物的肠道菌群,对所得到数据进行生物信息学分析,评价玛咖水提液对肠道菌群的调节作用。结果：ALD小鼠模型中,与模型组比较,中剂量组小鼠血清中谷丙转氨酶（GPT）、谷草转氨酶（GOT）的活力明显下降（P<0.05）,低剂量组小鼠血清中碱性磷酸酶（ALP）的活力明显下降（P<0.05）,高剂量、低剂量能明显降低小鼠肝组织中炎症介质单核细胞趋化蛋白-1（MCP-1)的含量（P<0.05或P<0.01）,高剂量、中剂量能明显抑制小鼠血清中炎症介质肿瘤坏死因子-α(TNF-α)的含量（P<0.05或P<0.01）,高剂量、中剂量、低剂量能明显升高小鼠肝脏组织中谷胱甘肽(GSH)的含量（P<0.05或P<0.01）;小鼠小肠蠕动抑制模型中,与模型组比较,玛咖水提液高剂量能明显增加小鼠小肠推进率（P<0.01或P<0.05）,中剂量组能明显增加小鼠血清中MTL的含量（P<0.05）,高剂量、中剂量组能降低cGMP水平。玛咖调节肠道菌群的研究显示,与空白组比较,在门水平上,玛咖水提液高剂量、中剂量、低剂量可减少厚壁菌门（Firmicutes）的丰度;高剂量、低剂量可增加拟杆菌门（Bacteroidetes）的丰度。在属水平上,玛咖水提液中剂量增加了乳杆菌属（Lactobacillus）的丰度;中、低剂量增加了拟普雷沃菌属（Alloprevotella）的丰度,且高剂量、中剂量、低剂量剂量肠道微生物群落有显著性差异。代谢功能预测结果显示,与空白组比较,玛咖水提液高剂量、低剂量组RNA加工和修饰、细胞运动、细胞外结构、细胞骨架项降低,其他代谢功能升高;玛咖水提液中剂量组细胞运动、细胞骨架项降低,其他代谢功能升高。结论：玛咖水提液具有保肝、通便、调节肠道菌群的作用。     

结肠贮袋改善直肠癌术后排便功能的临床观察

目的:评价直肠癌低位前切除术后采用结肠贮袋吻合对术后排便功能的影响。方法:将1999年1月至2003年10月行低位前切除术的直肠癌患者70例随机分为两组,一组采用结肠J型贮袋吻合术(colon J-pouch anastomosis,CAP)30例,制作J型贮袋长约5cm。另一组采用结肠、直肠(肛管)端端吻合术(end to end anastomosis,EEA)40例,通过术后6、9、12、18个月随访比较两组直肠测压结果与排便功能。结果:术后并发症中,两组均无死亡病例、无临时性造口病例,无吻合口瘘发生,CAP组和EEA组分别发生吻合口狭窄1例和2例,术后肠梗阻CAP组1例,CAP组9～18个月复发1例。术后6个月时直肠测压结果及排便功能CAP组优于EEA组,差异有统计学意义(P<0.05);术后9个月时两组各项指标比较,仅大便失禁评分CAP组优于EEA组,差异有显著性(P<0.05),其他各项指标比较均无明显差异(P>0.05);术后12个月以上两组上述指标基本正常,两组比较,差异无统计学意义(P>0.05)。结论:对于中下段直肠癌在行根治性手术的前提下采用J型贮袋吻合术可以明显改善术后9个月内排便功能,并且不增加术后并发症。     

基于前瞻性人群队列的中国成年人排便频率与帕金森病的关联研究

目的检验成年人排便频率与随访期间确定的帕金森病的关联。方法研究对象来自于中国慢性病前瞻性研究,2004-2008年开展基线调查。在剔除基线自报患有恶性肿瘤者后,最终纳入510134人。随访截止到2016年12月31日,采用Cox比例风险回归模型计算排便频率和帕金森病的关联。结果研究对象随访(9.9±1.9)年,随访期间诊断帕金森病共808例。在全人群中,控制潜在混杂因素后,与排便频率1次/d者相比,排便频率<3次/周者、隔天1次者、>1次/d者随访期间出现帕金森病诊断的HR值(95%CI)分别为3.62(2.88~4.54)、2.13(1.74~2.60)和0.81(0.63~1.05),排便频率与帕金森病诊断之间的关联存在有统计学意义的线性趋势(P<0.001)。与排便频率≥1次/d者相比,排便频率<1次/d者的HR值(95%CI)在随访≤5年内为3.13(2.32~4.23),在随访>5年后为2.48(2.05~3.01)。分性别分析时的结果与全人群中相似。排便频率<1次/d与帕金森病诊断的关联在老年人中更强。结论基线排便频率越低的研究对象在未来平均10年的随访期内出现帕金森病诊断的风险越高。低排便频率作为一个容易识别的症状,可结合其他与帕金森病相关的早期症状,用于老年人群中帕金森病的早期发现。