Features Heat Constipation Symptoms And Treatment Of Patients

Background Functional constipation is one of the functional gastrointestinal disorders, it is divided into slow-transit constipation (STC), defecatory disorder (DD), mixed constipation (MIX) and normal transit constipation (NTC). In the "Chinese medical consensus of chronic constipation", it is divided into Heat Syndrome of Gut, Gut Qi Stagnation syndrome, Qi Deficiency Syndrome of Spleen and Lung, Yang Deficiency Syndrome of Spleen and Kidney, Jin and Blood Deficiency Syndrome. In clinical practice, we found that with the improvement of people’s living standards, addicting to eat greasiness, sedentary in front of the computer, prolonged using laxatives, these bad habits lead to the problems of Stomach and Spleen, produce internal damp evil and heat metaplasia, block Qi of Gastrointestinal. As the result of the problems, the stomach can’t digest food and form faecal. It results in constipation. Currently, damp-heat functional constipation is more and more common.Objective By observing the clinical symptoms, anxiety and depression scale, Pittsburgh Sleep Quality scale (PSQI),short form-36questionnaire(SF-36), gastrointestinal transit time(GITT), anorectal high-resolution manometry(AR-HRM), intestinal bacteria and fungi of the damp-heat functional constipation patients, we can learn constipation symptoms, intestinal motility, intestinal flora, psychological condition and the quality of life, to analyze the clinical characteristics of this kind of patients. By comparing the efficacy of the two groups, we knew the differences in efficacy between the TCM group and flora treatment group to find the effective treatment.Methods Between December2011to October2013,99patients as defined by the diagnostic criteria and exclusion criteria were recruited from outpatients of China-Japan Friendship Hospital. Accomplish GITT, AR-HRM, symptoms record, faecal culture, Zung’s Self-assessment of anxiety and depression scale (SAS, SDS), PSQI and SF-36. Patients were randomized into the different groups-the TCM group and flora treatment group, then fill CRF after2weeks and4weeks treatment. They were divided into subtypes of STC, DD, MIX, NTC. Faecal culture includes enterobacter, enterococcus, bifidobacterium, lactobacillus and fungus. Questionnaire analyzed symptoms of constipation and the efficacyto understand the psychological condition of patients and the difference of the efficacy between the TCM group and flora treatment group.Results (1)The study ncluded99damp-heat functional constipation patients(31males,67females).The median age was52years old and mean duration of constipation was10years.(2)High school education patients are64.1%.The highest proportion of profession was staff(21%), the lowest was soldier(2%).(3)Many FC patients addicted to drink tea(71.4%)and coffee(70%) and to eat spicy (73.1%)and fried(71.6%)food.(4)The most uncomfortable symptom was fail to defecate but with desire(30.3%),Compared to patients without outlet obstruction, outlet obstruction patients were more likely to be male(38.0%vs16.3%,p<0.05), and were more likely to eating less(1.00±0.90vs0.59±0.81,p<0.05).(5)There were no differences on the proportion of patients with anxiety (20.2%). FC patientswere likely to be depressed than control (51.5%, p<0.01). There were23patients completed PSQI, and sleep disorders accounted22%, SF-36scores were significantly lower than control (p<0.01).(6)There were64patients completed faecal culture. Bifidobacterium and Lactobacillus of the patients of damp-heat functional constipation were significantly reduced than control (p<0.01), and Enterococcus and mildew were increased (p<0.05), and there were no significant difference on Escherichia coli and Candida. The positive rate of Mildew was higher than control (17.2%vs0%, p<0.05).(7) After2weeks of treatment,the patients’ defecations of two groups were improved (p<0.05).After4weeks of treatment,the defecations of patients with traditional Chinese medicine treatment were improved (p<0.05), whereaspatients with flora treatment group were not significant improved (p>0.05).(8) Thescores of constipation symptom of two groups were both improved (p<0.05), while Chinese Medicines can significantly improve patients’ clinical symptoms points (p <0.01), whereas the flora can’t improveit (p>0.05).After4weeks treatment, the TCM symptom scores of the patients with Chinese Medicines were lower than flora group (p<0.05).(9) There was no statistically significant difference of two groups in total efficiency (p>0.05), which Chinese Medicine group was66.7%, flora group was50.0%after2weeks, and Chinese Medicine group was72.7%, flora group was50.0%after4weeks.Conclusion1. Intellectual workers are more likely to suffer damp-heat functional constipation.The patients of damp-heat functional constipation have poor diet, such as addicted to drink tea and coffee and eating spicy and fried food.2. The most uncomfortable symptom was fail to defecate but with desire. Damp-heat functional constipation can affect the patients’ psychological status, sleeping and quality of life.3. Patients with damp-heat have intestinal dysbiosis, representing decrease in the numbers of Bifidobacterium and Lactobacillus and increase in the numbers of Enterococcus and Mildew. The positive rate of Mildew is increased.4.Traditional Chinese medicine and the flora can both relieve the constipation symptoms.Traditional Chinese medicine can improve the TCM symptoms. Patients with using of traditional Chinese medicine can improve defecation better than flora treatment.