| Objective:Based on Functional constipation(Functional constipation,FC)in children with defecation self-efficacy level and its influencing factors of research,discussion of modern factors,such as family environment influence on infantile constipation,and through the observation of qinggan purging fire purge party treat children FC(liver fire syndrome)clinical efficacy,to explore the effect of TCM treatment on children FC.Methods:Part I:115 children with FC who met the western medicine diagnostic criteria for FC in children were selected.All the cases were from the pediatric outpatient department of the first affiliated hospital of tianjin university of traditional Chinese medicine from July 2018 to January 2020.Children’s general information questionnaire,children’s FC self-efficacy questionnaire,family rearing style scale,children’s anxiety scale and parent health promotion lifestyle scale were used to investigate the level of defecation self-efficacy of children with FC and its correlation with gender,age,severity of constipation,anxiety level and family environment.Part II:from July 2018 to January 2020,a total of 80 cases of pediatric patients who met the diagnostic criteria of FC in children and were of the syndrome differentiation of traditional Chinese medicine and belonged to the syndrome of liver stagnation and inflammation were selected from the pediatric outpatient department of the first affiliated hospital of tianjin university of traditional Chinese medicine.A total of 80 children were randomly divided into treatment group and control group,with 40 children in each group.In the treatment group,oral self-designed qinggan xiehuo laxative formula was taken orally,while in the control group,oral llactofructose oral solution was taken orally.The basic treatment was the same in the two groups.In other words,psychological counseling and defecation training were carried out for the children at the first outpatient visit and the second visit after 2 weeks of treatment,and healthy lifestyle guidance was given to the parents of the children.The treatment course is 2 weeks.The total effective rate of disease efficacy was evaluated at the end of the course of treatment,the total effective rate of TCM syndrome efficacy,the improvement of main symptoms,secondary symptoms and total score of TCM syndrome,the improvement of single symptom of TCM syndrome and the incidence of clinical adverse reactions,and the recurrence rate of FC in children was followed up after 4weeks of drug withdrawal.Results:Part I: 1.In this study,115 children with FC were mainly girls(58.26%)and children of early school age(56.52%).Most of the children were mildly(36.52%)and moderately(57.39%)constipated,but 69(66.99%)of the 103 children had a disease course of more than one year,indicating that although the symptoms of FC were not serious,the disease course was relatively long.Of the 108 children with FC,only 33(30.56%)had received treatment,among which 16(48.48%)had a recurrence,indicating that the attention rate of parents of FC children is low and the recurrence rate is high.2.The total score of FC defecation self-efficacy questionnaire was 84.The mean score of defecation self-efficacy of 115 subjects was(59.687±12.426)points,and most of the children were at a medium level,indicating that the FC children were not confident enough to successfully complete self-defecation.3.Parents’ health promoting lifestyle,age and severity of constipation are significant related factors to the defecation self-efficacy of FC children.The results showed that the lighter the degree of constipation,the older the children were,the better the healthy lifestyle of their parents were,and the higher the level of defecation self-efficacy of FC children was.Part II: Two patients in the treatment group lost follow-up during the 4-week follow-up,and one patient in the control group fell off during medication,which was regarded as invalid.1.After 2 weeks of treatment,the total effective rates of the treatment group and the control group were 92.50% and 85.00%,respectively,with no statistically significant difference between the two groups.The total effective rate of TCM syndrome was 97.50% and92.50% respectively,and the difference between the two groups was not statistically significant.2.After 2 weeks of treatment,there were statistically significant differences in the main symptom,secondary symptom and total score between the two groups.There was no statistically significant difference between the two groups in the main symptom score,while the difference between the secondary symptom score and the total symptom score was statistically significant,indicating that the two groups had the same effect in improving the main symptom of TCM,but the treatment group was better than the control group in improving the secondary symptom.3.After 2 weeks of treatment,there were statistically significant differences in the scores of major symptoms and single symptom(except fecal incontinence)between the two groups.There was no statistically significant difference between the two groups in single symptom score,indicating that the two groups had the same effect in improving the single symptom of the main symptom in traditional Chinese medicine.4.After 2 weeks of treatment,the difference between the treatment group and the single symptom score group was statistically significant,while the difference between the control group and the control group was statistically significant in terms of fear of defecation and abdominal distension and fullness.There were statistically significant differences between the two groups in the aspects of irritability,abdominal distension,reduction of stomach intake,and dry mouth and halitosis,indicating that the treatment group was superior to the control group in improving the scores of individual symptoms of secondary symptoms.5.The recurrence rates of the treatment group and the control group were 13.79% and43.48%,respectively,after 4 weeks of drug withdrawal.The difference between the two groups was statistically significant,indicating that the treatment group was superior to the control group in terms of long-term efficacy.Conclusion:The level of defecation self-efficacy in children was significantly correlated with age,severity of constipation and healthy lifestyle of parents.Liver purging fire purge party for liver fire syndrome children FC,combining to the patient’s psychological counseling,training and defecate to healthy way of life education of parents,not only can improve the difficult defecation and stool stem node,still can alleviate the status of children with irritability,and often abdominal distension full,stay TCM symptom such as breath,dry mouth,reduce recurrence FC,and liver purging fire and purge the clinical process without any adverse reaction,has good clinical effectiveness and safety,also prove that Chinese medicine in promoting defecation,adjustment of modern,reduce recurrence rate aspect has certain effect,worth clinical promotion. |
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