摘要
目的:基于“大肠主津”理论探讨增液通便汤治疗慢传输型便秘(slow transit constipation,STC)的临床疗效及“增水行舟”的作用机制。方法:选取2024年1月至2025年1月河南中医药大学第三附属医院治疗的慢传输型便秘(阴虚肠燥证)患者67例为研究对象,采用随机数字表法分为对照组33例和观察组34例。对照组给予乳果糖口服液口服治疗,观察组给予增液通便汤口服治疗。观察两组治疗后便秘症状积分、中医证候积分、胃肠功能水平[血清胃动素(motilin,MTL)、P物质(substance P,SP)、血管活性肠肽(vasoactive intestinal peptide,VIP)]、肠道菌群含量、水通道蛋白(aquaporin,AQP)表达、结肠传输实验变化情况及临床疗效。结果:观察组有效率为91.18%,对照组有效率为84.85%,观察组有效率高于对照组,差异有统计学意义(P<0.05);两组治疗后中医证候积分均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05);两组治疗后便秘症状积分均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05);观察组治疗后MTL、SP水平高于对照组,VIP水平低于对照组,差异具有统计学意义(P<0.05);观察组治疗后肠杆菌低于对照组,双歧杆菌、乳酸杆菌、丁酸均高于对照组,差异具有统计学意义(P<0.05);两组治疗后AQP3、AQP9均低于治疗前,且观察组AQP3、AQP9低于对照组,差异有统计学意义(P<0.05);观察组24 h、48 h、72 h排出标记物数量均高于对照组,差异有统计学意义(P<0.05)。结论:增液通便汤治疗STC阴虚肠燥证能够明显改善患者便秘症状和中医证候,促进结肠传输运动,其发挥“增水行舟”功效的作用机制可能与调节胃肠激素、调控水通道蛋白、维持肠道菌群平衡有关。
Objective:To explore the clinical efficacy of Fluid-Increasing and Defecation-Promotin on slow transit constipation(STC)and the mechanism of action of its"adding water to float a boat",based on the theory of"large intestine governing body fluids."Methods:A total of 67 hospitalized patients with STC(with syndrome of intestinal dryness due to yin deficiency)at The Third Affiliated Hospital of Henan University of Traditional Chinese Medicine from January 2024 to January 2025 were selected as subjects and randomly divided into the control group with 33 cases and the observation group with 34 cases using the random number table method.The control group received lactulose syrup for oral administration,while the observation group received oral Fluid-Increasing and Defecation-Promoting Decoction.The changes in constipation symptom scores,TCM syndrome scores,gastrointestinal function levels[including serum motilin(MTL),substance P(SP),and vasoactive intestinal peptide(VIP)],intestinal microbiota content,aquaporin(AQP)expression,colon transit test results before and after treatment,and clinical efficacy were observed in the two groups.Results:The effective rate was 91.18%in the observation group,which was higher than 84.85%in the control group,with a statistically significant difference(P<0.05).After treatment,TCM syndrome scores were lower than those before treatment in the two groups,with statistically significant differences(P<0.05).Constipation symptom scores were lower than those before treatment in the two groups,with statistically significant differences(P<0.05).The levels of MTL and SP were significantly higher,while VIP levels were significantly lower in the observation group compared with the control group,with statistically significant differences(P<0.05).The levels of enterobacteria were significantly lower,while levels of bifidobacterium,lactobacillus,and butyric acid were significantly higher in the observation group compared with the control group,with statistically significant differences(P<0.05).The levels of AQP3 and AQP9 were lower than those before treatment in the two groups,and the above levels were significantly lower in the observation group compared with the control group,with statistically significant differences(P<0.05).The observation group had a significantly higher amount of stool excretion at 24 h,48 h,and 72 h compared with the control group,and the difference was statistically significant(P<0.05).Conclusion:Fluid-Increasing and Defecation-Promoting Decoction can significantly improve constipation symptoms and TCM syndromes in STC patients with syndrome of intestinal dryness due to yin deficiency,and promote colonic transit motility.The mechanism by which it exerts its"adding water to float a boat"effect may be related to regulating gastrointestinal hormones,modulating aquaporin expression,and maintaining intestinal microbiota balance.
作者
周凤蕊
杨会举
张苗
贾飞亮
ZHOU Fengrui;YANG Huiju;ZHANG Miao;JIA Feiliang(The Third Affiliated Hospital of Henan University of Chinese Medicine,Zhengzhou,Henan,China,450008;Henan University of Chinese Medicine,Zhengzhou,Henan,China,450046)
出处
《河南中医》
2026年第3期444-450,共7页
Henan Traditional Chinese Medicine
基金
河南省科技攻关计划项目(222102310417)
河南省中医药科学研究专项课题项目(2023ZY2116)。
关键词
慢传输型便秘
增液通便汤
“大肠主津”理论
“增水行舟”理论
水通道蛋白
结肠传输
临床疗效
slow transit constipation(STC)
Fluid-Increasing and Defecation-Promoting Decoction
"large intestine governing body fluids"theory
"adding water to float a boat"theory
aquaporin
colon transit
clinical efficacy
