| Chronic constipation is a common disease, which may impact on quality of life seriously. Data of epidemiology becomes higher than before. Chronic constipation play an important role in the happen of colon carcinoma, hepatic encephalopathy, dementia praesenilis etc. For example, chronic constipation may result in emergency of life of patients with coronary heart disease and cerebral vascular disease.Data of epidemiology shows that incidence of functional constipation is10%-15%in China, and slow transit constipation (STC) is45.5%. STC is a kind of chronic intractable constipation with the main character of abdominal distention and indifferent desire to defecation. The clinical manifestation of disease is defecation difficulties of no visible cause, no desire or decline to defecation, defecation frequency reduce, dry stool, prolonged defecation time and abdominal distention. The special test of STC is:gastrointestinal transit test, GITT, barium defecography, BD, anorectal manometry, ARM,pelvic floor electromyography. The cause of disease and pathogenesis of STC is not clear in modern medicine, drug, bad food and defecation habits, endocrine system disorders, gastrointestinal regulatory, peptides and ICC abnormal, psychological barriers and systemic disease are the possible factors. More doctors pay attention to gastrointestinal regulatory peptides recent years, opioid peptides, VIP, NO and somatostatin may cause constipation by change intestinal smooth muscle.Clinical methods can’t bring good curative effect. There are lots of restrictions on clinical treatment because of the side effect, and the operation own high risk and recurrence rate. TCM accumulates lots of experiences in treatment on STC, which treats by the combination of oral drug and external treatment in recently years.Doctors have used electro acupuncture to treat constipation from1950s in China, and the curative effect for treat STC is excellent with the character of simple operation, low cost and stable effect. Choosing Yangming Meridian to treat constipation is common at present, however, the kidney meridian, the bladder meridian and the spleen meridian are frequently use in ancient times. The kidney meridian and the bladder meridian are in charge of the produce and distribution of body fluid, which is the key of normal function of intestine. Eight Liao point which behind of rectum located at sacral. Needing Eight Liao point can promote defecation by stimulating parasympathetic nerve, which is similar to sacral nerve stimulation treatment. Chengshan point is the second of19commonly used acupuncture point to treat constipation. According to the literature research, we considered that needling Eight Liao point and Chengshan point(BL57) to cure constipation, which is different from choosing Yangming Meridian to treat constipation by other exports. Professor Li Guodong researched the ancient books of traditional Chinese medicine and modern medical literature, so he created herbs of yang xue run chang recipe(YXRCR) to treat blood deficiency type STC based on his many years clinical experience. This prescription achieved good clinical curative effect. Professor Li adjusted dosage forms from traditional decoction to dispensing granule decoction which is convenient for patients. He owned good curative effect through the combination of internal treatment and external treatment, recent treatment and far treatment, short acting and controlled release.This research proofs the theoretical basis and the clinical curative effect through literature review and clinical research, so the thesis concludes two parts:Section one:Documental summary1. Deepen understanding of Traditional Chinese Medicine for constipationThis overview summarized TCM history of constipation, names of disease, TCM type, the etiology and pathogenesis, prevention and treatment based on syndrome differentiation of constipation.2. Mechanism study and proven cases summary of constipation by TraditionalChinese medical external treatment.This overview summarized the mechanism and reported literature by various external treatments, including umbilical therapy of TCM, enema therapy, acupoint catgut embedding therapy, acupuncture, auricular buried beans and other therapies.3. Modern medicine treatment for slow transit constipation.This overview introduce present situation of STC by using modern medicine treatment, and summarized various modern medicine treatments.Section two:Clinical researchObjective:to observe therapeutic effect of dispensing granule decoction of YXRC and electro acupuncture to treat STC, and research the efficacy comparison among YXRC with electro acupuncture, lactulose oral liquid(LOL) with electro acupuncture and simply electro acupuncture treatment. To evaluate the validity of choosing Eight Liao point and Chengshan point to treat STC, and analysis the onset mechanism.Method:90patients with STC of blood-deficiency type were divided randomizedly into three groups.30patients to take dispensing granule decoction of YXRC with electro acupuncture in observation group; the control group1of30patients take LOL with electro acupuncture, and the control group2of30patients take electro acupuncture treatment only. After20days treatment, we recorded the change of symptom scores, and calculate the overall symptom scores of three groups and the respective scores of each symptom. The study on index include:the stool score, weekly defecation frequency, defecation difficulty, abdominal distention and abdominal pain. Contrast the before treatment and after treatment and follow up situation.Results:Using dispensing granule decoction of YXRC with electro acupuncture to treat STC of blood-deficiency type is effective and surpass two control groups. The total efficiency of treatment group is93.3%, control group1is90.0%, and control group2is86.6%. After treatment, three groups have significant different (p<0.01) than before. Observation group is better than control group2.(p<0.01)3months after treatment, we fund that observation group is better than two control groups.(p<0.01)Conclusions:Choosing the method of dispensing granule decoction of YXRC with electro acupuncture to treat STC of blood-deficiency type is effective and surpasses two control groups. This treatment own long term effect which can improve the character of stool, increased intestinal defecation frequency, and reduce the waste residue. So it is suit for clinical application. |
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