中医辨证论治对功能性出口梗阻型便秘患者的肛肠动力学影响

目的：观察研究中医辨证治疗前后功能性出口梗阻型便秘（functional outlet obstructive constipation FOOC）患者肛肠动力学改变，探讨中医辨证治疗对功能性出口梗阻型便秘的疗效及作用机制。方法：对40例FOOC患者进行中医辨证治疗，疗程为2周，并于治疗前后行肛门直肠测压。结果：（1）中医证型分布：40例FOOC患者中，肠胃积热23例、气虚10例，其他证型7例。（2）临床疗效：治愈率10％，显效率45．50％，有效率37．50％，无效率10％；（3）肛肠测压结果：治疗后40例患者直肠感知阈值、便意阈值及直肠最大耐受量均有下降，各项指标P〈0．01；肛门括约肌功能长度治疗后缩短，P〈0．05；最大缩榨压较治疗前上升，P〈0．05。结论：中医辨证论治对FOOC患者有良好治疗效果，可明显改善患者临床症状及肛肠测压指标。表现为直肠感知阈值、便意阈值、最大耐受量较正常明显升高，在治疗后随便秘等症状的改善直肠感知阈值、便意阈值、最大耐受量等指标明显下降；肛门括约肌功能长度较治疗前有缩短。

Influence of Treatment and Differentiation of TCM on Anorectal Dynamia of Functional Outlet Obstructive Constipation Patients

Objective ： To research the changing of anorectal kinetics and syndrome integration of TCM on the patients of functional outlet obstructive constipation （FOOC）, meanwhile, through the comparison between prior and post treatment, to research the curative effect and mechanism of treatment and differentiation of TCM on FOOC. Methods： According to astriction Rome Ⅲcriteria and 72 hour colon transmission test （CTT）, 40 patients of FOOC were compared research, anorectal manometry （ARM） between prior and post treatment of TCM based on syndrome differentiation. The course of treatment is 2 weeks. Results （ 1 ） TCM symptom of FOOC： In 40 pa- tients, the symptom of 23 patients is intestine and stomach heat, symptom of 10 patients is Qi deficiency, and the other symptoms only have 7 patients. （2） Clinical curative effect of 40 patients is 10% cure rate, the excellence rate is 45.50%, the utility rate is 37. 5%, the nullity rate is 10%. （3） The result of the anorectal manometry： After the treatment , the rectal volume atsensory threshold （RVST）, rectal volume at defecation threshold （RVDT）, and the maximal tolerable volume （MTV） of all patients are decrease than before, P 〈 0. 01 ; and the anal sphincter function length is shorter than before the treatment, p 〈 0.05 ; and the maximal squeeze pressure （MSP） is riser than before the treatment, p 〈 0. 05. Conclusion （ 1 ） Treatment and differentiation of TCM has good effect on FOOC patient, and it may obviously improve the clinical symptom, ARM index of the patients. （2） Intestine and stomach heat and Qi deficiency are the major symptoms of the TCM. （3） Because of the different symptom, the changing of the anal rectum kinesics of the patients is not all the same, however, there is impairment on function of the rectal volume at sensory in all patients of the FOOC, which is obviously improved on RVST, RVDT, MTV, following the improvement of the astriction, and above index obviously decreased; and the anal