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加味四磨汤治疗成人功能性便秘及对肠道神经递质的影响

Effect of Modified Simotang on Adult Functional Constipation and Intestinal Neurotransmitter
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摘要 目的:观察加味四磨汤对成人功能性便秘(气滞秘)的疗效,探讨其对患者血清肠神经递质一氧化氮合酶(nNOS),一氧化氮(NO),血管活性肠肽(VIP)以及超氧化物歧化酶(SOD)和丙二醛(MDA),谷胱甘肽(GSH)水平的影响。方法:筛选就诊的功能性便秘患者110例,按随机数字表法分为治疗组和对照组各55例。对照组根据常规干预措施,口服促动力药多潘立酮片,1片/次,3次/d;和通便药酚酞片,100 mg/次,2次/d。治疗组采取加味四磨汤内服治疗,每日1剂。两组疗程均连续治疗4周。比较两组患者功能性便秘主要症状、气滞秘症状评分和临床疗效。分析两组患者停药后的便秘复发率。检测血清肠神经递质nNOS,NO,VIP水平以及SOD,MDA,GSH水平。结果:治疗结束后,主要临床症状[排便困难、腹胀、排便时间、排便次数、粪便性状(Bristol)]评分治疗组均明显少于对照组(P <0. 01)。治疗后,气滞秘症状(排便不爽、腹胀、肠鸣、矢气频、胸胁满闷)评分治疗组均明显低于对照组(P <0. 01)。治疗结束后4周,治疗组临床疗效总有效率为98. 04%显著高于对照组的84. 62%(χ^2=4. 379,P <0. 05)。停药4和8周时,治疗组便秘复发率分别为3. 92%和8. 16%,均明显低于对照组的18. 18%和27. 78%(P <0. 05)。治疗后,治疗组血清肠神经递质nNOS,NO,VIP水平均明显低于对照组(P <0. 01)。治疗组血清SOD,GSH水平均显著高于对照组,MDA水平低于对照组(P <0. 01)。结论:加味四磨汤治疗成人功能性便秘(气滞秘)可明显改善患者的临床症状和证候症状,提高临床疗效,减少复发率,调节患者体内肠神经递质水平及SOD,MDA,GSH的水平。 Objective: To observe the efficacy of modified Simotang in treatment of adult functional constipation( Qi-stagnancy constipation),and investigate its effects on serum levels of intestinal neurotransmitter nitric oxide synthase( nNOS),nitric oxide( NO),and vasoactive intestinal peptide( VIP),as well as superoxide dismutase( SOD),malonaldehyde( MDA),and glutathione( GSH) levels. Method: One hundred and ten patients with functional constipation were selected and randomly divided into control group( 55 cases) and treatment group( 55 cases) by referring to random number table. The patients in control group were given with routine therapy,Domperidone tablet( 1 tablet/time,tid),and Phenolphthalein tablets( 100 mg/time,bid). The patients in treatment group were treated with modified Simotang,1 dose/day. Both groups were treated for 4 weeks.Then the scores of main clinical symptoms of functional constipation,scores of Qi-stagnancy constipation and clinical efficacy were compared between two groups. Constipation recurrence rate was compared between two groups after stopping medicine. Serum levels of intestinal neurotransmitters nNOS,NO and VIP as well as SOD,MDA,GSH levels were detected in both groups. Result: After treatment,scores for main clinical symptoms( difficult defecation,abdominal distension,defecation time,number of defecation times) and Bristol scores in treatment group were obviously lower than those in control group( P < 0. 01). Scores for symptoms of Qi-stagnancy constipation( ungratifying defecation,abdominal distension, bowel ringing,frequent flatus, chest and flank tightness) in treatment group were obviously lower than those in control group after treatment( P < 0. 01). Total clinical efficacy in treatment group 98. 04% was superior to that in control group 84. 62%( P < 0. 05).Constipation recurrence rate was 3. 92% and 8. 16% in treatment group after 4 and 8 weeks of medication stopping,obviously lower than those in control group 18. 18% and 27. 78%( P < 0. 05). After treatment,serum levels of intestina
作者 相翠玉 刘洁 张永洲 徐吉祥 XIANG Cui-yu;LIU Jie;ZHANG Yong-zhou;XU Ji-xiang(Huaihe Hospital of Henan University,Kaifeng 475000,China;The First Chinese Medicine Hospital of Kaifeng in Henan Province,Kaifeng 475000,China)
出处 《中国实验方剂学杂志》 CAS CSCD 北大核心 2019年第2期150-155,共6页 China Journal of Experimental Traditional Medical Formulae
基金 河南省科技攻关项目(182102310293).
关键词 四磨汤 功能性便秘 气滞秘 肠神经递质 Simotang functional constipation Qi-stagnancy constipation intestinal neurotransmitter
作者简介 第一作者:相翠玉,主管中药师,从事临床药学的工作,E-mail:xiangcuiyu@dingtalk.com;通信作者:徐吉祥,主任医师,从事中医内科临床及教学工作,E-mail:hhyjk3906379@163.com.
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