通便汤治疗老年泻药性便秘临床观察及对肠道菌群的影响

发布时间：2018-01-08 14:27

本文关键词：通便汤治疗老年泻药性便秘临床观察及对肠道菌群的影响　出处：《中国实验方剂学杂志》2017年21期 　论文类型：期刊论文

【摘要】：目的:观察通便汤对老年泻药性便秘(STC)的临床疗效,探讨其可能机制。方法:采用多中心、随机对照、双盲的研究方法,将92例老年STC患者随机分为治疗组(通便汤)和对照组(酪酸梭菌活菌散剂),其中治疗组47例,对照组45例,分别予以药物干预4周。观察两组治疗前后便秘临床症状积分、粪便性状评分以及临床有效率;采用主成分分析(PCA)-QOL评分评价两组患者的生活质量;检测粪便中短链脂肪酸和酪酸含量,并观察两组患者停药后4,8周复发情况及不良反应。结果:治疗组临床总有效率为91.4%,对照组为80.0%,治疗组优于对照组(P0.05);经通便汤干预后,治疗组可显著提升泻药性便秘患者粪便中短链脂肪酸和酪酸含量(P0.01),改善粪便性状积分、每次排便时间积分、排便时间间隔积分、排便困难积分及PAC-QOL评分(P0.05);停药4,8周时治疗组患者复发率均低于对照组,用药期间均无明显不良反应发生。结论:通便汤对老年泻药性便秘临床疗效显著,值得临床推广应用,其作用机制可能与提高便秘患者结肠中短链脂肪酸和酪酸的水平从而改善结肠动力有关。
[Abstract]:Objective: to observe the clinical effect of Tongbian decoction on senile laxative constipation (STC) and to explore its possible mechanism. 92 cases of elderly STC patients were randomly divided into treatment group (Tongbian decoction) and control group (Clostridium caseinate active bacteria powder), including 47 cases in the treatment group and 45 cases in the control group. The clinical symptom score, fecal trait score and clinical effective rate of the two groups were observed before and after treatment. The quality of life (QOL) of the two groups was evaluated by principal component analysis (PCA). The contents of short chain fatty acid and butyric acid in feces were detected, and the recurrence and adverse reactions were observed at 4 weeks after withdrawal. Results: the total effective rate was 91.4 in the treatment group and 80.0% in the control group. The treatment group was superior to the control group (P 0.05). After intervention with Tongbian decoction, the treatment group could significantly increase the content of short-chain fatty acid and butyric acid in feces of patients with cathartic constipation (P 0.01), improve the score of fecal traits and the score of defecation time per time. Defecation interval integral, defecation difficulty score and PAC-QOL score P0.05A; The recurrence rate of the treatment group was lower than that of the control group after 4 weeks. Conclusion: the clinical effect of Tongbian decoction on senile laxative constipation is remarkable, and it is worth popularizing. The mechanism may be related to the improvement of colon motility by increasing the levels of short chain fatty acids and tyroic acid in colon of constipation patients.
【作者单位】：苏州市中医医院;河南中医药大学第三附属医院;南京中医药大学附属医院;河南中医药大学第一附属医院;南京市鼓楼医院;
【基金】：国家自然科学基金项目(81573979) 江苏省中医药管理局科技项目(YB2017061) 苏州市产业技术创新专项(SYS201775,SYSD2016136) 苏州市中医医院院级课题项目(YQN2015007)
【分类号】：R256.35
【正文快照】： [网络出版地址]http://kns.cnki.net/kcms/detail/11.3495.R.20170731.1040.050.html[网络出版时间]2017-07-31 10:40泻药性便秘(STC)指长期使用刺激性泻剂造成肠道正常蠕动和排便功能紊乱,最终形成对泻剂的依赖性,无泻剂不排便,一旦停药便秘立即复发,反复多次易引起大肠上皮

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