加味四磨汤对成人习惯性便秘患者症状改善及肠道神经递质的影响

梁景露 刘宇聪 张燕云 邱志鸿 王少珊

【摘要】 目的：研究加味四磨湯对成人习惯性便秘患者症状改善及肠道神经递质的影响。方法：选取2018年5月-2020年3月本院收治的习惯性便秘患者90例作为研究对象，采用随机数字表法分为两组，每组45例。对照组采用口服枸橼酸莫沙必利片、比沙可啶肠溶片治疗，观察组在对照组治疗的基础上给予加味四磨汤治疗。治疗4周后，比较两组治疗效果及治疗后中医症状积分、临床症状评分以及肠道神经递质[血管活性肠肽（VIP）、一氧化氮（NO）及一氧化氮合酶（nNOS）]水平变化和不良反应发生情况。结果：观察组治疗总有效率为95.56%，显著高于对照组的77.78%（P<0.05）。治疗后，两组中医症状积分、临床症状评分以及肠道神经递质水平较治疗前均明显降低，且观察组均低于对照组，差异均有统计学意义（P<0.05）。两组不良反应发生率比较，差异无统计学意义（P>0.05）。结论：加味四磨汤治疗成人习惯性便秘能够显著改善患者便秘症状，降低肠道神经递质水平，改变大便性状，且不会增加不良反应，值得临床推广。

【关键词】 加味四磨汤 习惯性便秘 肠道神经递质

Effect of Modified Simo Decoction on Improvement Symptoms and Intestinal Neurotransmitters in Adult Patients with Habitual Constipation/LIANG Jinglu， LIU Yucong， ZHANG Yanyun， QIU Zhihong， WANG Shaoshan. //Medical Innovation of China， 2021， 18（29）： -111

[Abstract] Objective： To study the effect of modified Simo Decoction on improvement symptom and intestinal neurotransmitters in adult patients with habitual constipation. Method： A total of 90 patients with habitual constipation treated in our hospital from May 2018 to March 2020 were selected as study subjects and divided into two groups by randomized digital table， 45 cases in each group. The control group was treated with oral Mosapride Citrate and Bisarcomidine Enteric Tablets， and the observation group was treated with modified Simo Decoction on the basis of the control group. After 4 weeks of treatment， the integration of TCM symptoms， clinical symptom score and the levels of intestinal neurotransmitters [vasoactive intestinal peptide （VIP）， nitric oxide （NO） and nitric oxide synthase （nNOS）] of two groups were compared. Result： The total treatment efficiency of the observation group was 95.56%， which was significantly higher than 77.78% of the control group （P<0.05）. After treatment， the TCM symptom scores， clinical symptom scores and intestinal neurotransmitter levels in two groups were significantly lower than those before treatment， and the observation group were significantly lower than those of the control group （P<0.05）. There was no significant difference in the incidence of adverse reactions between the two groups （P>0.05）. Conclusion： Modified Simo Decoction in the treatment of adult patients with habitual constipation can significantly improve constipation symptom， reduce intestinal neurotransmitter level， change stool traits， and will not increase adverse reactions， which is worth of clinical promotion.

[Key words] Modified Simo Decoction Habitual constipation Intestinal neurotransmitters

First-author’s address： Yingde Hospital of Traditional Chinese Medicine， Yingde 513000， China

doi：10.3969/j.issn.1674-4985.2021.29.026

随着当代饮食结构的调整、成人日常生活的不规律性以及膳食纤维的缺乏，导致成人便秘已成为消化系统常见疾病之一[1]。现阶段，成人习惯性便秘发病率逐渐上升，其好发于老年人或体虚人群，病因为排便不规律、体虚津亏、肾精肾气亏虚等[2]。该症初期可导致营养不良、贫血、腹部胀气，后期会有脱肛、肛裂、痔疮、直肠癌等症状，并可诱发脑血管疾病，严重者可合并失眠及抑郁焦虑等，也出现过在排便时因便秘而猝死，危害严重[3]。……