中医辨证治疗功能性便秘的临床研究

目的探讨功能性便秘使用中医辨证治疗的临床疗效及安全性评价。方法 采用随机数字表将160例功能性便秘患者随机分为2组，试验组与对照组各80例，对照组予以乳果糖治疗，试验组则判断患者的中医证型，予以采用相应的中药汤剂联合中医特色疗法，疗程为8周；剔除脱落的病例，最终试验组完成70例，对照组69例。采用治疗前后证候积分、生活质量量表、用药安全性情况对功能性便秘患者进行观察。结果 （1）试验组可显著改善便秘患者的相关症状，在大便性状、排便困难、过度用力排便、排便频率、下坠、排便时间、四肢不温、小便清长、口渴喜饮、头晕耳鸣、手足心热、疲乏、失眠方面，疗效优于对照组；（2）试验组可明显改善患者的生活质量，在身体不适、心理社会不适、焦虑和担心、满意度4个维度方面，其疗效优于对照组；（3）试验组亚组4个证型通过中医辨证，分别采用补中益气汤加减、济川煎加减、增液汤合润肠丸加减及芪榔合剂4种汤剂联合中医特色疗法治疗后,疗效相当。（4）临床使用安全，未发现毒副作用。结论 中医辨证治疗疗效显著，安全性好，值得推广。

Clinical Study of TCM Syndrome Differentiation in the Treatment of Functional Constipation

Objective To explore the clinical efficacy and safety evaluation of functional constipation treated by TCM syndrome differentiation. Methods 160 patients with functional constipation were randomly divided into two groups by random number table. The experimental group and the control group had 80 cases in each group. The control group received lactulose treatment. The experimental group judged the TCM syndromes of the patients and adopted the corresponding Decoction of traditional Chinese medicine combined with TCM characteristic therapy for 8 weeks. Finally, 70 cases were in the experimental group and 69 cases in control group. The patients with functional constipation were observed by syndrome score, quality of life scale and medication safety before and after treatment. Results(1) The symptoms of constipation patients were significantly improved in the experimental group, which was superior to the control group in the aspects of stool characteristics, difficulty in defecation, excessive forced defecation, frequency of defecation, falling down, defecation time, limbs not warm, long urine, thirst and drinking, dizziness and tinnitus, hand-foot-heart heat, fatigue and insomnia; (2) The experimental group was superior to the control group in the treatment of constipation. The treatment group can significantly improve the quality of life of patients, and its efficacy is better than that of the control group in the four dimensions of physical discomfort, psychosocial discomfort, anxiety and worried, and satisfaction. (3) The four syndrome types of the experimental group are used by Buzhong Yiqi Decoction, Jichuan Decoction, Zengye Decoction with Runchang Pill and Qilang Decoction combined with TCM characteristic therapy. Four kinds of treatment have the same curative effect. (4) Clinical use is safe, no toxic and no side effects. Conclusion TCM syndrome differentiation therapy is effective, safe and worth popularizing.