| Functional constipation (FC) is a more common functional gastrointestinal disorders, high incidence of the disease, the incidence of chronic constipation is about 6.07% in China, Europe and Oceania as high as 19.8%. Chronic constipation have negative impact on human physiology and psychological, seriously affecting people's quality of life,currently,western medicine lack of effective treatment. Traditional Chinese Medicine treatment of this disease lack of high-quality clinical trials. On the base of reviewing treatment and research on FC by TCM and modern medicine, this article considers that people with Qi asthenia and intestinal dryness is liable to suffer from FC and that Our lifestyle is very much to blame for constipation.On the basis of past experience, proposed treatment of Yiqirunchang for type functional constipation in order to "rebuild bowel regularity,".Through the observation of clinical cases, to prove the efficacy and safety of the treatment in order to sum up Chinese medicine theory and clinical expression advantages of functional constipation. This study has three parts:The first part is functional constipation literature review, namely the "Ancient Chinese medicine Books diagnosis and treatment of constipation " and " Present condition of mordern medicine Researches on FC "; the second part is systematic review, followed by details of the "Chinese Herb for functional constipation:a systematic review and Meta analysis"; The third part is a clinical observation on the treatment of Yiqirunchang decoction for functional constipation.Theory:Theory in Chinese ancient books about constipation summarized in this part. Especially on the pathophysiology,etiology and treatment of constipation in the view of TCM; Modern research development:include epidemiology (incidence, etiology and risk factors, health economics, medical burden, etc.), diagnostic criteria, disease classification, diagnosis search tools, treatment, problems etc. Give a comprehensive description of the current domestic and international research on the status of functional constipation. Systematic Review:To assess the efficacy and safety of Chinese herb for treating Chronic Functional constipation. The CNKI,CBM,VIP,Cochrane Library,Pubmed and EMBASE were searched electronically.Studies were included if they were randomized and quasi-randomized clinical trails.The quality of included studies was assessed according to the Cochrane Handbook5.0.2.21 trails fulled the inclusion criteria.The methodological quality was poor.The Chinese herb had significant effect on functional constipation compared with Gastrointestinal mortility drugs:relative risk and 95%CI:1.18[1.12,1.25] for effecative rate,1.59[1.35,1.88]for cure rate; the risk and 95%CI of effecative and cure rate are 1.18[1.10,1.27],1.59[1.35,1.88]compared with cathartic; integrative medicine compared with Gastrointestinal mortility drugs:the risk and 95%CI:1.21[1.09,1.34]for effecative rate,1.41[1.11,1.79] for cure rate. Althrough systematic of the available evidence suggests that Chinese herb is effecative and safty in treating chronic functional constipation,well designed trail is lacking.Clinical Observation:Objective:To evaluate the efficacy and safety of Yiqirunchang decoction for Qi asthenia and intestinal dryness type functional constipation.Methods:60 subjects were divided into two groups randomly:treatment group in which 30 cases were given"Yi qirunchang" decoction and control group in which 30 cases were treated by "Qi rong run chang" oral.The score of syndromes,adverse event and the change of colonic transit condition before and after treatment were observed.Results:Four weeks after treatment,effective rate in treatment group and control group was 90.0% and 66.7%, and the onset time of catharsis in treatment group is more short than the control group, the difference being significant(P<0.05). Symptom score such as defecation interval, defecation effort,stool characters, fatigue, poor appetite,significantly improved compare with before treatment.Both of the two interventions can significantly improve colonic transit,but Yiqirunchang decoction is more excellent. Four weeks after drug withdrawal, no matter some index show the duration of efficacy in treatment group is better than control group,3 patients recurred in treatment group and 6 patients recurred in control group,the difference being not significant(P>0.05).Adverse events:One observed case Suffering from intestinal obstruction in the control group, no serious adverse events were found in other included cases.Conclusion:Yiqirunchang decoction for Qi asthenia and Intestinal dryness functional constipation is safe and effective. Although the systematic review and Meta analysis results suggest that Chinese Herb for FC is relatively safe and effective, but generally low quality of included studies, currently unable to obtain credible evidence. |
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