| In recent years, the incidence of constipation increased year by year. It has become one of the important diseases affecting the quality of life of modern people. It may be related to the working pressure, the change of diet structure, effects of mental stress and social factors. Constipation is divided into several types according to the characteristics of the disease; the slow transit constipation (STC) is one of the common types of constipation, which is about45.5%of functional constipation. The main characteristics is weakened colonic motor function, and the main performance is reduced stool frequency for a long time, no meaning or defecation difficult, sometimes accompanied by anorexia, abdominal distension etc. The cause is due to the long-term bad habits which can not bring adequate stimulation of gastro intestine, resulting in STC by long fecal retention time. Auxiliary examination:colonic transit test can be expressed as the transmission time prolonged, but the result of anorectal manometry, barium enema, defecography and electronic colonoscopy are negative.The pathogenesis of slow transit constipation is studied more at present, but there is no breakthrough progress. Modern medical research indicates that the patients with functional constipation may own pathological changes of colonic smooth muscle, colon motility disorder, and the distribution of colonic nerve fiber and neurotransmitter abnormalities. It may prompt the enteric nervous system, interstitial cells of Cajal and smooth muscle changes may be the key factors affecting the pathogenesis of slow transit constipation. The distribution and abnormal function of interstitial cells of Cajal as the gastrointestinal pacemaker cells, plays a very important role in gastrointestinal motility disorders. At the same time, parenteral neural factors, psychological factors and genetic factors will directly or indirectly lead to the occurrence of colonic slow transit resulting in slow transit constipation. With the continuous development and in-depth study of gastrointestinal dynamics and other related disciplines, pathogenesis of slow transit constipation will get more progress.For the treatment of slow transit constipation, drug therapy mainly used in clinical. including the different mechanisms of cathartic and promoting gastrointestinal motility drugs. Other methods include:psychological therapy, biofeedback therapy, surgical operation excision, placing the gastrointestinal pacemaker therapy, the therapy of traditional Chinese medicine. But each method has certain limitation. Drug therapy in addition to inconvenient taking and its side effects, drug dependence may also occur, biofeedback treatment only has effect for mild constipation and idiopathic constipation, operation for excision of colon and placement of gastrointestinal pacemaker has the disadvantages of high cost, large trauma, more postoperative complications, easy to relapse, etc. Therefore, the clinical application is not wide.In recent years, sacral nerve stimulation for the treatment of constipation is one of the hot research areas, and has gradually been applied in clinical practice.Acupuncture of traditional Chinese medicine in the treatment of slow transit constipation has a long history, there was recorded in many medical classics. Because of its effectiveness and safety, in recent years it has been paid more and more attention and research.With the guide of modern medical theory, we want to combine the modern medical anatomy and nerve theory as the theoretical basis, imagining eight Liao point catgut embedding technical and sacral nerve stimulation in treatment of slow transit constipation in combination with the theory of innovation, may bring a new method and means in clinical treatment of slow transit constipation.This topic through the stable and reliable establishment of rat model with convenient manufacture, consistent with the clinical features, explore the preliminary results in the treatment of slow transit constipation by eight Liao point catgut embedding, and elaborates its possible therapeutic mechanism, trying to preliminary clinical eight Liao point catgut embedding treatment of slow transit constipation, in order to provide experience and basis for further study.Experiment1Establishment of experimental SD rat model of slow transit constipationObjective:to approach with loperamide gavage establishing slow transit constipation rat model of SD, to evaluate the similarity degree of experimental model and clinical disease. Methods:40SD rats, were randomly divided into4groups:blank control group, model group, catgut embedding therapy group, acupuncture therapy group. Blank control group were given equal volume of isotonic saline, and other three groups were given2mg/kg/d, loperamide gavage, a total of15days, After modeling, rats were observed for stool, fecal dry weight measurement, and measure the first grain of black stool time by using biological stain black ink gastric perfusion method.Results:Model groups compared with blank control group before treatment, the first grain of black stool time was significantly prolonged (P<0.05); defecation were significantly reduced (P<0.05); fecal dry weight significantly reduced (P<0.05); water content decreased obviously (P<0.05). The blank group with fecal appearance soft, bulky, water more, fecal appearance of model group was hard, small size, less water.Conclusion:By the method of loperamide gavage, model of slow transit constipation SD rats were successfully established in a relatively short time. This model accords with the characteristics of disease constipation, good safety, easy to electromyography studies of the gut, which lays a foundation for further experimental study.Experiment2Research on intestinal transit function in the treatment of slow transit constipation rat model of SD thought eight Liao point catgut embeddingObjective:To observe the effect of catgut embedding eight Liao point on intestinal transit function of slow transit constipation rat model of SD.Methods:The establishment of slow transit constipation rat model of SD by using the experimental method of Experiment1.40rats were randomly divided into4groups: blank control group, model control group, eight Liao acupuncture therapy group, and eight Liao point catgut embedding therapy group. After20days, treatment of SD rats of each group, determinate the first grain of black stool time by the black ink gastric perfusion method. The black dye was accounted for the entire intestine; and observed the changes of rat colonic electrical amplitude and frequency.Results:Before treatment, the blank control group first grain of black stool time and defecation time of other groups had statistical difference (P<0.05). After treatment, except the blank group and the model control group, the two groups first grain of black stool time decreased. At the10day of treatment, treatment group and model group, decreased significantly (P<0.05),catgut embedding therapy group and the model control group had no difference(P>0.05);20days after treatment compared to the control group, electro acupuncture treatment group and model group, catgut embedding therapy, were significantly decreased (P<0.05), and blank control group had no difference (P>0.05); the two group and the treatment itself had significant difference (P<0.05), from the black dye was observed before and after treatment the total intestinal proportion, the comparison between the treatment group and catgut embedding therapy group, no significant difference (P>0.05),but the two groups was significantly higher than that in the control group the numerical model (P<0.05), and the blank control group had no difference (P>0.05), the detection of colonic smooth muscle contraction of rat amplitude and frequency of contraction, two indexes and blank treatment group compared to the control group, slightly higher than the catgut embedding therapy group, but no statistical difference (P>0.05); treatment group and catgut embedding therapy group frequency slightly higher than the model group, but no statistical significance (P>0.05), while the contraction amplitude treatment group and catgut embedding therapy group was significantly higher than the model group (P<0.05), two indicators and the blank control group had no significant difference(P>0.05).Conclusion:This study group rats were eight Liao point acupuncture and catgut embedding therapy, results showed that treatment two groups can improve intestinal transmission function, shorten the intestinal transit time. The electro acupuncture group has a rapid onset, embedding group slow onset, finally can improve the intestinal transit function in rats, and the effect is similar, the effect may be achieved through enhanced intestinal smooth muscle contraction, which was independent of increased smooth muscle contraction frequency.Experiment3Clinical observation on the treatment of slow transit constipation by eight Liao point catgut embeddingObjective To observe the clinical curative effect of eight Liao point catgut embedding treatment of slow transit constipation.Methods80cases of patients with slow transit constipation were randomly divided into treatment group and control group with40cases in each. Treatment of eight Liao point catgut embedding was1time in2weeks, a total of2times. The control group was given Mosapride Citrate Tablets orally,5mg each time,3times a day, for4weeks. Two groups of patients were observed before and after4weeks of treatment, the stool score, weekly independent defecation frequency and colonic transit test results, compared2groups of patients the treatment efficiency.Results In the treatment group, the cure rate and improvement rate were35%and50%,the total efficiency of85%; In the control group, the cure rate and improvement rate were40%and47.5%, the total efficiency of87.5%, compared with two groups had no statistical difference (P>0.05). Two groups of patients after a week of spontaneous defecation frequency, stool traits were significantly increased (P<0.05), after treatment scores and the number of stool defecation show no significant differences between the two groups (P>0.05). Colonic transit test results show, the two groups after treatment for48hours and72hours of residue number markers were significantly lower than those before treatment (P<0.05), after treatment between the two groups had no significant difference compared to the same period (P>0.05).Conclusion The treatment of slow transit constipation, conclusion eight Liao point catgut embedding therapy efficacy, can improve the character of stool, increased intestinal defecation frequency, reduce the stool residue. This method has a small wound, simple operation and good effect. It will be easily accepted by patients for treatment, and the efficacy match oral gastrointestinal motility drug. Otherwise, it own more safety and high validity, after further research and technical specifications, it will be welt developed in clinic. |
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