调肠汤治疗功能性便秘的临床研究

【作者】 张飞；

【导师】 甘爱萍；

【作者基本信息】 湖北中医学院 ， 中医内科学， 2006， 硕士

【摘要】 目的：观察调肠汤治疗功能性便秘的临床疗效及安全性，并通过临床实验研究，探讨调肠汤治疗功能性便秘的作用机理，为其临床应用提供理论依据。 方法： 1、入选对象 (1)符合功能性便秘诊断标准(罗马Ⅱ标准) 在过去的12个月中，持续或累计至少12周有以下的2个或2个以上的症状： ①1／4时间以上有排便费力； ②1／4时间以上有粪便呈团块状或坚硬； ③1／4时间以上有排便不尽感； ④1／4时间以上排便时有肛门直肠阻塞感； ⑤1／4时间以上排便须用手法帮助(如手指抠，抵住骨盆底)； ⑥每周排便小于3次，不存在松散大便，不够肠易激综合征的标准。 (2)经中医辨证为气虚血瘀证者； 主症：粪便干结、排出困难或不尽感、有便意难以排出以及无便意、排便次数减少； 次症：腹痛拒按，面色白，神疲气怯，临厕努挣乏力，甚则汗出短气，大便并不干，舌质紫暗或见紫斑，苔白，脉细涩； 凡上述主症具备一项，兼症至少二项者，即可以诊断为气虚血瘀型便秘。 (3)其中必有粪便干结、排便困难或不尽感、有便意而难于排出以及无便意、排便次数减少，症状评分大于5分者； (4)年龄在18-65之间； (5)知情同意志愿受试并签署知情同意书。 2、排除对象 (1)经检查证实为消化道肿瘤，或其他累及消化道的系统性疾病如神经、肌肉的病变等，以及有明确病因的继发性便秘； (2)年龄在18岁以下或65岁以上者； (3)妊娠或哺乳期妇女； (4)过敏体质或对本药物过敏者； (5)合并有心脑肾及造血系统等严重原发病； (6)精神病患者； (7)凡不符合纳入标准，未按规定服药无法判定疗效或资料不全等影响疗效和安全性判断者，及不愿配合治疗者失访者。 3、60例门诊慢性功能性便秘患者(气虚血瘀型)随机分为治疗组和对照组，治疗组30例，对照组30例。 两组患者在性别、年龄、病程、病情等方面比较无显著性差异。更多还原

【Abstract】 Objietive:To investigate the efficacy of Tiaochangtang (TCT)in the treatment of chromnic functional constipation (CFC).Objective evaluate usefulness and safeties of TCT in the treatement of CFC,inquiry into its function mechanism .guide its in the clinical application. Methods:From march 2004 to march 2005, 60 patients with chronic functional constipation were enrolled in this study and divided randomly into two group. 30cases were received TCT as the study group, and 30 cases were received Liuweinengxiao as the control group. There were 60 patients in each group without significant in sex, age, symptom pattern between two group (P>0.05). Two groups have been received the medicine treatment for 4 weeks. The control group taking Liuweinengxiao third daily. The treatment group taking traditional Chinese herb of TCY twice daily. According to the observed results ,evaluated the treatment effectiveness. Security tests include the three routine exams ,kidney function (BUN ,Cr)and liver function (ALT).At last ,according to the treatment effect and the safe observation ,to evaluate the usefulness and the safety. Results:6 weeks later, we found the changes of two groups were better than before the treatment. The changes of clinic symptom and physical sign were significantly better after the treatment. The effective rate of the study group was 90% and the effective rate of the control group was 83.3%. But for the total efficiency, there were not difference between two groups(P>0.05). For the changes of clinic symptom and physical sign, the study group was significantly better than the control group(P<0.05). In the aspects of safety observing ,both groups have no the bad reaction. Conclusion:By four weeks treatment, the clinic effect of TCT is superior to LWNX in the aspects of sumptoms but the total effect of treatment is similar. Tiaochangtang was the significantly effective medicament for the functional constipation, especially for the cases with spleen qideficiency and stagnation slowly transferrd in the large intestines. It has been certified a safe and effective perscripyion of Chinese herbal medicine by clinic experiment .更多还原