| Along with the social population ageing tendency, the diet structure changes as well as the mental psychology and the social factor and so on, constipation, as one kind of common disease, has become an important illness affecting people's quality of life. Constipation itself seldom threats to life, but the long-term constipation not only may affect patients' quality of life severely, but also increase the incidence rate of colon carcinoma, crissum disease and prostatic hypertrophy, even aggravate or induce cardiovascular disease, cerebrovascular disease and so on because of inducing patients' anxious and tense mood, thus threat to life. At present the etiology of Slow transmit constipation(STC) is still unclear and difficult to treat. The constipation may roughly divide into STC, Outlet obstructive constipation(OOC) and Mixed constipation(MC).STC is defined as whose intestinal contents slow-moving due to colon transmission steps down because of various kinds of reasons. According to statistics, this type account for constipation 16%～40% and function constipation 45．5% approximately. Its symptom is stubborn and common to the senior citizen and the women of child-bearing age. The parents usually has taken the laxative medicine for a long time. At present, it was still not clear to the pathology of STC. The long-term medicine treatment frequently causes the colon melanopathy and various kinds of colectomy not only can cause big wound, but also be difficult to avoid postoperative complications, etc problems.MC includes STC and OOC, occupying the majority.of constipation. OOC is defined as that excrement is blocked when through rectum and anal tube, which causes to be difficult. According to its pathology characteristic, it is divided into two kinds: The first kind is relaxed pelvic floor syndrome, including rectocele, proctoptosis, Intussusception of rectum, perineum descend, enterocele, sacro-rectum disjunction, splanchnoptosis and so on; The second kind is spastic pelvic floor syndrome, including puborectalis syndrome, internal sphincter achalasia and so on. Treatment chose surgery primarily and it was simple and effective.How to display the predominance of traditional Chinese medicine and use micr-wound therapy to relief even cure radically the stubborn symptom of chronicity diseases, are our main research directions at present.According to the related traditional Chinese medicine theory and combining modern operation method, we treated STC 62 cases by intensive catgut embedding therapy and MC 62 cases by intensive catgut embedding and anus operations therapy. Objective:Under the emission image supporting, to study the curative effect of STC by intensive catgut embedding therapy in specific acupuncture point and MC by intensive catgut embedding and anus operations therapy. To search and formulate a new program of effective treatment of STC and MC.Method:We selected non-RCT method to observe the therapeutic efficacy and clinicalmonitoring index of STC and MC systematically. The table 1 showed the grouping. Table 1 grouping:SAMPLEGROUPINGTREATMENTSIZE(case)The first part, the clinical study oncatgut embedding groupintensive catgut embedding therapy62STC by intensive catgut embedding therapyDecoction of Four-Drug Juice groupDecoction of Four-Drug Juice62The second part, the clinical study on MC by intensivecatgut embedding and anus operation groupintensive catgut embedding and anus operation therapy62catgut embeddingDecoction of Four-DrugDecoction of Four-Drug62and anus operationJuice groupJuicetherapyanus operation groupanus operation therapy62 The catgut embedding group adopted intensive catgut embedding therapy, which based on ordinary catgut embedding therapy and augmented acupoint stimulus intensity. We selected NO-2 double strands medicinal chromic suture and its length was about 4cm, meanwhile, implanted each corresponding acupoint thrice at the same time. The acupoints included: Dachangshu, Tianshu, Qihai, Zhongji, Zusanli; Decoction of Four-Drug Juice, Hunan Hansen Pharmaceutical CO.LTD provided. The ingredient included: common aucklandia root,orange fruit,combined spicebush root,areca seed; 10ml/ramus; Each time takes orally 20ml;three times a date, half hour before dinner ; 7 day is a course of treatment, total 2 courses. Catgut embedding and anus operation group included: intensive catgut embedding therapy, part internal sphincter mutilation operation and PPH(procedure for prolapsed hemorrhoids) stapler operations. Anus operation group included: part internal sphincter mutilation operation and PPH stapler operations. Result:The clinical study on STC by intensive catgut embedding therapy1．Clinical curative effects comparisonsThe cure rate of Group of catgut embedding was 41．9%, total excellence rate was 43．5% and total effective rate was 69．4%. Group of Decoction of Four-Drug Juice had no curing, excellence cases and effective rate was 14．5%.The curative effect of Test group was obviously better than Control group(P<0．01) .2．Comparison of gastrointestinal transit test marker remnant numberThe average marker remnant number of Catgut embedding group in post-treatment(1,3,6 months after treatment)reduced obviously comparing with pretherapy(P<0．01) . The method was helpful to revive enterokinesia. The average marker remnant number of Decoction of Four-Drug Juice group in post-treatment(1,3 month)have no improvement compared with pretherapy. The treatment of intensive catgut embedding therapy and anus operation were superior to medicine or anus operations therapy( P<0．01) . 3．The integration of principal syndrome comparisons of patients with constipationThe principal syndrome of catgut embedding group in post-treatment(1,3,6 month)improved obviously compared with pretherapy(P<0．01) . The principal syndrome of Decoction of Four-Drug Juice group in post-treatment(1month) improved obviously compared with pretherapy(P<0．05) . But it had no long-term improvement compared with pretherapy(1,3,6 month). Catgut embedding group was better than Decoction of Four-Drug Juice group(P<0．01) .the clinical study on MC by intensive catgut embedding and anus operation therapy1．Clinical curative effects comparisonsThe cure rate of catgut embedding group was 41．9%, total excellence rate was 48．4% and total effective rate was 82．3%. Decoction of Four-Drug Juice group had no curing, excellence cases and effective rate was 12．9%. The anus operation group had no curing cases either, and excellence rate was 12．9%, total effective rate was 32．3%. The curative effect of Test group was obviously better than Control group(P<0．01) .2．Comparison of gastrointestinal transit test marker remnant numberThe average marker remnant number of catgut embedding group in post-treatment(1, 3, 6 months)reduced obviously comparing with pretherapy(P< 0．01) . The method was helpful to revive enterokinesia. The average marker remnant number of Decoction of Four-Drug Juice group in post-treatment(1, 3 months)have no improvement compared with pretherapy. Anus operation group, 1 month after treatment, had strengthened enterokinesia and average marker remnant number had obvious reduction(P<0．05) . Nevertheless, the average marker remnant number in post-treatment(3, 6 month)had no long-term change compared with pretherapy. The treatment of intensive catgut embedding therapy and anus operation were superior to medicine or anus operations therapy(P<0．01) .3．The integration of principal syndrome comparisons of patients with constipationThe principal syndrome of catgut embedding and anus operation group inpost-treatment(1, 3, 6 month)improved obviously compared with pretherapy(P< 0．01) . The principal syndrome of Decoction of Four-Drug Juice group inpost-treatment(1, 3, 6 month)had no improvement compared with pretherapy. Theprincipal syndrome of anus operation group in post-treatment improved obviouslycompared to pretherapy(P<0．05) . Catgut embedding and anus operation group wasbetter than control groups( P<0．01) .Adverse reaction:There were no adverse reaction in catgut embedding group and Decoction ofFour-Drug Juice group. In the anus operation group, there were 3 cases bleedingafter operation and were stopped in time, then the symptomatic relief. So the adversereaction didn't affect test observation and cases didn't fall off.Conclusion:Intensive catgut embedding therapy could treat STC safely and efficiently, compounding anus operation could solve MC. Thus we could solve the treatment of majority constipation. |
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