Clinical Study On RPH Combined With Yangxuetiaochong Decoction In The Treatment Of Female Mixed Constipation

Chronic constipation is a common disease,which is the serious influence of the quality of life.Recent data indicated that prevalence of chronic constipation in the general population in China is 3.6%-12.9%.The prevalence of female was obviously higher than that of men,men and women of constipation illness ratio of 1:3.Basis of clinical symptoms and pathological physiology mechanism of constipation,the constipation of functional disease is divided into the following four types:slow transit constipation(STC)?defecatory disorder(DD)?mixed constipation(MC)and normal transit constipation(NTC).The main types of constipation of female is MC.The treatment principle of constipation is individualized comprehensive treatment.The main treatment including drug therapy,acupuncture and massage,biofeedback,and surgery.The satisfactory curative effect is not depends on one way of treatment.Many electronic data show combined surgery and traditional Chinese medicine treatment in all levels hospital are applied in our country,it has certain curative effect to treat constipation,but diagnosis and curative effect evaluation standard is not unified.The clinical experience in the treatment of female mixed constipation in our department has shown that according to different types of constipation patients take different surgery combined Chinese medicine intervention have certain curative effect This research which based on the concept of evidence-based medicine use the method of Meta-analysis to evaluate the effect of analysis of traditional Chinese medicine combined surgery in the treatment of chronic constipation.Clinical data showed that blood deficiency type especially deficiency in ChongRen in female constipation occupies a large proportion in the TCM syndrome type,moreover,rectal mucosa prolapse is a common disease type in female outlet obstruction constipation.Based on the clinical experience for many years,we focus on the research object which is transmissive constipation combined slow rectal mucosa prolapse and blood deficiency in ChongRen of TCM type in women mixed constipation.Therefore,this study based on the principle of evidence-based medicine,the evaluation system and randomized controlled clinical trial.The randomized controlled trials on treatment chronic constipation meta-analysis,and to evaluate the efficacy of treatment of chronic constipation,in the hope of Chinese medicine combined with surgery for the treatment of MC and provide evidence to support modern.This study is divided into four parts:literature review,the summary of experience of Professor Li Guo-Dong,systematic review and clinical observation.1.Literature review:Firstly.Summarized from the aspects of western medicinediagnosis and treatment of female mixed constipation status quo.Second.Summarized from the perspective of traditional Chinese medicine of the historicalorigin and using of the ChongRen theory.2.The summary of experience of Professor Li Guo-Dong:Professor Li who iscombined with traditional Chinese and western medicine treatment of anorectaldiseases is an experienced expert.This part focus on the analysis and summaryprofessor Li's experience of surgery and traditional Chinese medicine combined intreatment of constipation.3.systematic review:Objective:To systematically evaluate the effectiveness of the treatment of chronic constipation by TCM combined with surgery.Methods:1.Retrieval methods:Electronic retrieval database in both English and Chinese a combination of electronic retrieval combind with manual retrieval anorectal diseases conference proceedings.2.Literature evaluation:Literature screening independently by two researchers who filtrated respectively according to the inclusion,exclusion standard of literature independently.Then.two reserchers extract relevant research characteristics of the data in literature.opinions are not unified to third party consultation.After assessed the methodological and reporting quality evaluation,Meta-analysis was carried out using Revman 5.3 software.Results:This study included 4 randomized controlled clinical trials literature.The methodological quality and the quality of the reports obtained were medium.Meta-analysis showed that:(1)Analysis of outcome indicators rate in the treatment of all four articles,It is concluded that oral Chinese medicine combined with surgery in the treatment of chronic constipation curative effect is better than that of control group(surgery combined therapy with western medicine or surgery alone)curative effect.(2)By analysised 2 articles,we concluded that 1-year recurrence rate in oral Chinese medicine combined surgery in the treatment of chronic constipation is lower than the control group(surgery combined therapy with western medicine or surgery alone).Conclusion:This study preliminarily describe the curative effect trend of oral Chinese medicine combined with surgery in the treatment of chronic constipation is better than pure surgery or surgery combined with western medicine treatment of chronic constipation.and 1-year recurrence rate is low.Therefore,effectiveness about the TCM combined with surgery treatment of chronic constipation still needs more large sample,high quality,multicenter randomized controlled trial to support.4.Clinical observation:a single-center,randomized controlled trial was used todemonstrate the effect of Yangxuetiaochong Decoction combined with RPH intreatment of female MC.Objective:To observe the clinical effect of decoction of YXTC and RPH to treat MC of female whose TCM type is Blood deficiency of ChongRen.Method:Using a single-center,randomized,multiple sets of parallel,controlled study,108 female patients from January 2017 to May 2018 with MC of blood-deficiency of ChongRen type were divided into 3 groups randomizedly.36 patients in observation group intervened with decoction of YXTC and RPH;the control group 1 of 36 patients in control group 1 take LOL with RPH,and the control group 2 of 36 patients take decoction of YXTC with PPH.We recorded the change of symptom scores,and calculate them of 3 groups and the respective scores of each symptom after 8 weeks treatment.Evaluate the results of colon transmission test and defecation imaging.The study on index including:weekly defecation frequency,the stool score,defecation difficulty,abdominal pain or distention.The score of life quality and the numerical value of female hormones were also analysised.Contrast the 3 stages:before treatment,after treatment and follow up situation.Results:Group A(YXTC+RPH)36 cases,complete clinical observation,group B(lactulose+ RPH)36 cases,fall off in 2 cases,group C(YXTC+PPH)36 cases,excluding 1 case.Group B falls off in 2 cases for the subjects adherence is poor,excluding cases for PPH group C had heavier rectal inflammation,eliminate.Using decoction of YXRC with RPH to treat female MC of blood-deficiency of ChongRen type is effective.This group surpassed the other two control groups.The total efficiency of each group were:72.22%,44.12%and 54.29%.After 8 weeks treatment.3 groups have significant difference(p<0.05)than before treatment.Curative effect in observation group was better than other 2 control groups.(p<0.05).4 weeks after treatment,the curative effect of observation group was better than the other two control groups too(p<0.05)Conclusions:Intervention method to treat female MC of blood-deficiency of ChongRen type with YXTC decoction and RPH was effective and surpassed two control groups.This treatment owned long term effect which can improve the character of stool,increased intestinal defecation frequency,and relieved the clinical symptoms.So it is suit for clinical application.