六味能消胶囊联合粪菌移植对脾气虚弱型慢性功能性便秘患者的临床观察

目的:探讨六味能消胶囊联合粪菌移植对脾气虚弱型慢性功能性便秘的治疗效果。方法:以山东中医药大学附属医院收治的129例脾气虚弱型慢性功能性便秘患者为对象,按随机数字表法随机分为粪菌移植组、六味能消胶囊组、六味能消胶囊联合粪菌移植组,每组各43例,粪菌移植组予以粪菌移植治疗,六味能消胶囊组予以六味能消胶囊治疗,六味能消胶囊联合粪菌移植组予以六味能消胶囊联合粪菌移植治疗,对比3组疗效。结果:与本组治疗前比较,治疗后3组横结肠、乙状结肠以及降结肠中胃肠电频率、波幅明显上升(P0. 05)。治疗后,六味能消胶囊联合粪菌移植组横结肠、乙状结肠以及降结肠频率、波幅高于粪菌移植组、六味能消胶囊组(P0. 05)。治疗后,六味能消胶囊联合粪菌移植组患者P物质(substance P,SP),胃动素(motilin,MTL)高于粪菌移植组、六味能消胶囊组,一氧化氮(nitric oxide,NO)及血管活性肠肽(vasoactive intestinal peptide,VIP)低于粪菌移植组、六味能消胶囊组(P0. 05)。治疗后3组患者双歧杆菌、乳酸杆菌数量均高于本组治疗前,酵母菌、肠杆菌数量均低于本组治疗前(P0. 05),治疗后,六味能消胶囊联合粪菌移植组患者双歧杆菌、乳酸杆菌数量均高于粪菌移植组、六味能消胶囊组,酵母菌、肠杆菌数量均低于粪菌移植组、六味能消胶囊组(P0. 05);3组患者治疗后Bristole粪便性状评分量表(bristol stool form scale,BSFS)评分高于本组治疗前,Wexner便秘评分,便秘患者生活质量评定量表(patient assessment of constipation quality of life questionnaire,PAC-QOL)评分低于本组治疗前(P0. 05),治疗后六味能消胶囊联合粪菌移植组患者BSFS评分高于粪菌移植组、六味能消胶囊组,Wexner便秘评分,PAC-QOL评分低于粪菌移植组、六味能消胶囊组(P0. 05)。结论:采用粪菌移植联合六味能消胶囊治疗老年慢性功能性便秘可以有效促进患者肠电功能恢复,改善肠道菌群平衡,降低肠道氧化应激反应,促进患者症状消失,可以在临床中进一步推广应用。

Efficacy of Liuwei Nengxiao Capsule Combined With Fecal Bacteria Transplantation on Patients with Chronic Spleen Deficiency and Chronic Functional Constipation

Objective To explore the efficacy of Liuwei Nengxiao capsule combined with fecal bacteria transplantation on chronic functional constipation with spleen Qi deficiency.Method A total of 129 patients with chronic functional constipation of spleen Qi deficiency treated in Affiliated Hospital of Shandong University of Traditional Chinese Medicine were randomly divided into three groups by the computer numerical tablemethod fecal bacteria transplantation group, Liuwei Nengxiao capsule group, and Liuwei Nengxiao capsule combined with fecal bacteria transplantation group, with 43 cases in each group. Fecal bacteria transplantation group was treated with fecal bacteria, Liuwei Nengxiao capsule group was treated with Liuwei Nengxiao capsule, and Liuwei Nengxiao capsule combined with fecal bacteria transplanted group was treated with Liuwei Nengxiao capsule combined with fecal bacteria. The efficacy of the 3 groups was compared.Result After treatment, the frequency and amplitude of intestinal electricity increased significantly in three parts, with statistically significant differences from before treatment (P<0.05). After treatment, the frequency and amplitude of the transverse colon, sigmoid colon, and descending colon of patients in Liuwei Nengxiao capsule combined with faecal transplantation group were higher than those in faecal transplantation group and Liuwei Nengxiao capsule group (P<0.05). After treatment, substance P (SP) and motilin (MTL) of Liuwei Nengxiao capsule combined with faecal transplantation group were higher than those of faecal transplantation group and Liuwei Nengxiao capsule group, while nitric oxide (NO) and vasoactive intestinal peptide (VIP) were lower than those of faecal transplantation group and Liuwei Nengxiao capsule group (P<0.05). The number of bifidobacteria and lactobacillus after treatment was higher in three groups than before treatment (P<0.05). The numbers of yeast and enterobacteria were lower than before treatment (P<0.05). After treatment, the number of bifidobacteria and lactobacillus in Liuwei Nengxiao capsule combined with faecal transplantation group was higher than that in faecal transplantation group and Liuwei Nengxiao capsule group, whereas the numbers of yeast, and enterobacteria were all lower than those in bacterial transplantation group and Liuwei Nengxiao capsule group (P<0.05). After treatment, the BSFS scores of three groups were higher than before the treatment, while Wexner continence grading scale (Wexner) constipation score and patient assessment of constipation quality of life questionnaire (PAC-QOL) score were lower than before treatment (P<0.05). Bristol stool form scale (BSFS) score of Liuwei Nengxiao capsule combined with fecal bacteria transplantation group was higher than that of fecal bacteria transplantation group and Liuwei Nengxiao capsule group. Wexner constipation score and PAC-QOL score were lower than those of fecal bacteria transplantation group and Liuwei Nengxiao capsule group (P<0.05).Conclusion Fecal bacteria transplantation combined with Liuwei Nengxiao capsule can effectively promote the recovery of intestinal electrical function, improve the intestinal flora balance, reduce the intestinal oxidative stress response, and promote the disappearance of patients'' symptoms in the treatment of elderly chronic functional constipation, and thus is worth further promotion in clinic application.