右归丸治疗脾肾阳虚型老年功能性便秘的临床观察

目的:观察右归丸加减治疗脾肾阳虚型功能性便秘(CFC)的临床效果以及对血清超氧化物歧化酶(SOD)和丙二醛(MDA)的影响。方法:将120例CFC患者采用随机按数字表法分为对照组和治疗组各60例。对照组参照《中国慢性便秘诊治指南》治疗,包括调整生活方式;通便药采用酚酞片口服,100 mg/次,2次/d;促动力药采取多潘立酮片,1片/次,3次/d,饭前30 min服用;治疗组在对照组治疗的基础上采用右归丸加减,1剂/d,分2次内服,所有患者均治疗4周。对两组治疗前后CFC临床症状进行评分比较,采用中文版健康调查简表(SF-36)评价两组患者生活质量;检测两组治疗前后血清SOD和MDA水平。结果:治疗组临床总有效率为98.33%,对照组为85%,治疗组优于对照组(P0.05);治疗组治疗后CFC临床症状评分均低于对照组(P0.01);治疗组治疗后SF-36量表各项评分均明显高于对照组(P0.01);治疗后治疗组SOD水平明显高于对照组,MDA水平低于对照组,比较差异均有统计学意义(P0.01)。结论:在西医治疗的基础上,采取右归丸加减治疗脾肾阳虚型CFC能显著改善患者临床症状,提高临床治疗效果,其作用机制可能与升高血清SOD水平和降低MDA水平有关。

Clinical Observation of Yougui Wan in Treating Spleen and Kidney Deficiency Type Chronic Functional Constipation

Objective: To observe the clinical efficacy of Yougui wan in treating spleen and kidney deficiency type chronic functional constipation (CFC) and its influence on superoxide dismutase (SOD) and malondialdehyde (MDA) levels. Method: One hundred and twenty CFC patients were randomly divided into control group (60 cases) and treatment group (60 cases) according to random number table. Patients of control group were treated according to Guideline of Diagnosis and Treatment of Chronic Constipation in China, including adjustment of life-style, cathartic of phenolphthalein tablet (100 mg/time, bid), and impetus drug of domperidone tablets (1 tablet/time, tid, taking ante cibum 30 min). Based on the treatment in control group, patients in treatment group also received Yougui Wan (1 dose/d, tid). Course of treatment was 4 weeks for both groups. Main CFC symptoms were assessed before and after treatment between both groups. Quality of life for two groups was evaluated according to short-form 36 health survey scale (SF-36). Serum SOD and MDA levels were measured in all cases pre-post treatment. Result: The total clinical efficacy of treatment group was 98.33%, which was superior to 85% in control group, with statistical difference (P<0.01). After treatment, CFC symptom scores in treatment group were lower than those in control group (P<0.01). Score in each item of SF-36 in treatment group was significantly higher than that of control group after treatment (P<0.05). After treatment, serum SOD level in treatment group was significantly higher than that of control group while MDA level was lower than that in control group with statistical difference (P<0.01). Conclusion: Based on control group, Yougui Wan may improve clinical symptoms and clinical efficacy in treating spleen and kidney deficiency type CFC, and its effect may be relevant to rising SOD level and reducing MDA levels in serum.