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扶正理气合剂联合针刺治疗功能性便秘的近期及远期疗效。

Short and long-term efficacy of combining Fuzhengliqi mixture with acupuncture in treatment of functional constipation.

机构信息

Department of Gastroenterology, The First Affiliated Hospital of Xinxiang Medical University, Weihui 453100, China.

出版信息

J Tradit Chin Med. 2013 Feb;33(1):51-9. doi: 10.1016/s0254-6272(13)60100-4.

Abstract

OBJECTIVE

To explore the short and long-term efficacy of combining Fuzhengliqi mixture (FLM) with acupuncture in treating functional constipation (FC).

METHODS

The 560 patients with confirmed diagnosis of FC were randomly assigned to four groups: FLM group, acupuncture group, combined therapy group, and control group. There were 140 cases in each group. The FLM group was administered FLM 60 mL twice a day, while the acupuncture group was treated with acupuncture at acupoints Tianshu (ST 25), Shangjuxu (ST 37), Zusanli (ST 36), Dachangshu (BL 25), and Zhigou (TE 6) twice a day, the combined therapy group with FLM and acupuncture, and the control group was administered mosapride (5 mg thrice a day) and Macrogol 4000 (10 g twice a day). The treatment lasted 6 weeks. The defecation interval, stool property, constipation symptoms, and accompanying symptoms were recorded, graded, and scored. The gastrointestinal transit time (GITT) and motilin (MTL) level in serum and life quality score were detected at three time points (pre-treatment, at the end of treatment, and 60 weeks post-treatment). Moreover, the adverse reactions were also observed.

RESULTS

In the FLM group 2 cases were eliminated for not taking medication strictly according to the research plan and 1 case was lost to follow-up, while 2 cases in the acupuncture group and 2 cases in the combined therapy group were lost to follow-up. Compared with those detected pre-treatment, the defecation interval, stool property, constipation symptom grade, accompanying symptom grade, and GITT were all decreased markedly at the end of treatment in every group, while the MTL levels in serum and life quality score were increased markedly (P < 0.01), the above-mentioned detecting indices were better in the combined therapy group than those in other groups (P < 0.05). Compared with the end of treatment, above-mentioned detecting indices all recurred significantly in the FLM group and control group 60 weeks post-treatment (P > 0.05), but these indices recurred insignificantly in the acupuncture and combined therapy groups (P > 0.05). The short and long-term total effective rates in the combined therapy group were significantly different from those in other groups (P < 0.05 or P < 0.01). No serious adverse reactions were found in four groups.

CONCLUSION

Both FLM and acupuncture can significantly shorten the defecation interval and GITT, increase MTL levels in serum, decrease the scores of stool property, constipation symptoms, and accompanying symptoms in patients with FC to increase their life quality. The combined therapy is much better in long-term efficacy and the safety is also good, worth spreading in clinical practice.

摘要

目的

探讨扶正理气合剂联合针刺治疗功能性便秘(FC)的短期和长期疗效。

方法

将 560 例确诊 FC 患者随机分为 4 组,每组 140 例:扶正理气合剂组、针刺组、联合治疗组和对照组。扶正理气合剂组每天口服 60 mL 扶正理气合剂,针刺组每天针刺天枢(ST25)、上巨虚(ST37)、足三里(ST36)、大肠俞(BL25)和支沟(TE6),联合治疗组同时给予扶正理气合剂和针刺治疗,对照组每天口服莫沙必利(5mg,每日 3 次)和聚乙二醇 4000(10g,每日 2 次)。治疗持续 6 周。记录并分级评分排便间隔、粪便性状、便秘症状和伴随症状。在治疗前、治疗结束时和治疗结束后 60 周检测胃肠传输时间(GITT)和血清胃动素(MTL)水平及生活质量评分。此外,还观察了不良反应。

结果

扶正理气合剂组脱落 2 例(未按研究方案服药),1 例失访;针刺组脱落 2 例,联合治疗组脱落 2 例。与治疗前相比,各组治疗结束时排便间隔、粪便性状、便秘症状评分、伴随症状评分和 GITT 均明显降低,血清 MTL 水平和生活质量评分均明显升高(P<0.01),联合治疗组优于其他组(P<0.05)。与治疗结束时相比,扶正理气合剂组和对照组治疗结束后 60 周时上述检测指标均明显复发(P>0.05),但针刺组和联合治疗组复发不明显(P>0.05)。联合治疗组的短期和长期总有效率与其他组有显著差异(P<0.05或 P<0.01)。四组均未发现严重不良反应。

结论

扶正理气合剂和针刺均可显著缩短 FC 患者的排便间隔和 GITT,提高血清 MTL 水平,降低粪便性状、便秘症状和伴随症状评分,提高生活质量。联合治疗在长期疗效和安全性方面均有优势,值得在临床实践中推广。

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