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星蒌承气汤治疗急性缺血性脑卒中后便秘的有效性:一项随机对照试验。

Effectiveness of Xinglou Chengqi decoction on constipation in patients with acute ischemic stroke: a randomized controlled trial.

机构信息

Department of Neurology, Dongzhimen Hospital affiliated to Beijing University of Chinese Medicine, Beijing 100700, China.

The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University & Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing 100088, China.

出版信息

J Tradit Chin Med. 2020 Feb;40(1):112-120.

Abstract

OBJECTIVE

To evaluate the effectiveness of traditional Chinese herbal Xinglouchengqi (XLCQ) decoction for the treatment of constipation in acute ischemic stroke patients, and figure out the role that bowel movements play in the treatment of acute ischemic stroke.

METHODS

A total of 317 eligible patients were recruited and randomized to the XLCQ group (211 patients) or the control group (106 patients). In addition to conventional standard medical care and rehabilitation, participants in the XLCQ group received XLCQ decoction, while the control group received clysis therapy using glycerin enemas or lactulose oral solution. Both groups were given treatment for 3 to 6 d, during which they received daily visits to record defecation features and accompanying symptoms. Neurological assessments using the National Institutes of Health Stroke Scale (NIHSS) were conducted before and 1 month after treatment.

RESULTS

Patients in the XLCQ group had lower aggregate constipation scores compared with the control group on days 3 and 5 (P < 0.05). Spontaneous bowel movements tended to reappear more rapidly after taking the XLCQ decoction than after conventional laxative treatment. Both the average aggregate constipation score and the time taken to achieve spontaneous bowel movements showed positive correlations with NIHSS scores before and 1 month after treatment (P < 0.01).

CONCLUSION

Treatment with XLCQ decoction effectively alleviated the overall symptoms of constipation in acute ischemic stroke patients. The status of bowel movements in acute ischemic stroke can reflect the severity of neurological impairment and predict neurological outcomes at 1 month.

摘要

目的

评价中药杏芎承气汤治疗急性缺血性脑卒中便秘患者的有效性,探讨排便情况在急性缺血性脑卒中治疗中的作用。

方法

共纳入 317 例符合条件的患者,随机分为杏芎承气汤组(211 例)和对照组(106 例)。除常规标准医疗和康复外,杏芎承气汤组患者加用杏芎承气汤治疗,对照组患者加用甘油灌肠剂或乳果糖口服液进行灌肠治疗。两组均治疗 3~6 d,每天访视记录排便特征及伴随症状。治疗前后采用美国国立卫生研究院卒中量表(NIHSS)进行神经功能评估。

结果

治疗第 3、5 天,杏芎承气汤组患者的综合便秘评分均低于对照组(P<0.05)。服用杏芎承气汤后,自发排便恢复更快。治疗前后及 1 个月的 NIHSS 评分与平均综合便秘评分及自发排便时间均呈正相关(P<0.01)。

结论

杏芎承气汤治疗可有效缓解急性缺血性脑卒中患者的整体便秘症状。急性缺血性脑卒中患者的排便情况可反映神经功能缺损的严重程度,并预测 1 个月时的神经结局。

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