| Background Slow-transit constipation (STC) is one type of the functional constipation. Its symptoms include the reducing numbers of defecation, difficulty of defecation, no urge to defecate, poorly defecation and dry or little stool. With the changing of people’s diet structure and life styles together with addiction to eating greasy and spicy food, drinking alcohol, lack of exercise, more pressure and fast rhythm of living, the prevalence of STC is increasing, especially the syndrome of dampness heat of spleen-stomach.Objective The aims of the study were:to get the information of constipation symptoms, intestinal motility, intestinal flora, psychological condition and the quality of life in STC patients; to analyze the clinical characteristics of the STC patients; to compare differences about clinical effects in (Traditional Chinese Medicine TCM) group and probiotics group, fusong group and probiotics group.Methods According to the diagnostic criteria and exclusion criteria,95 patients with STC and 45 control subjects were consecutively recruited from the outpatient department of China-Japan Friendship Hospital from March 2013 to December 2014. All subjects were asked to finish the questionnaire (the baseline information of symptom:Zung"s Self-assessment of anxiety and depression scale, SAS and SDS; short form 36 questionnaire, SF-36).Researchers provided the detailed information to the subjects about how to collect stool specimens (for the sake of flora analysis). According to the diagnostic criteria,95 patients were divided into two groups:the syndrome of dampness heat of spleen-stomach together with the syndrome of non-dampness heat of spleen-stomach. Patients in former group were randomly divided into the different groups:TCM group or probiotics group, similarly, patients with the syndrome of non-dampness heat of spleen-stomach were randomly divided into fusong group or probiotics group.Results (1) Of the 95 patients,40 fulfilled the criteria for having the syndrome of dampness heat of spleen-stomach, and 55 cases were the syndrome of non-dampness heat of spleen-stomach. The male to female ratio of the two group were 1/5.67 and 1/5.88, no statistical difference was found between the two groups in sex ratio (p=0.980). (2)The median age of the syndrome of dampness heat of spleen-stomach group was 49 years, with an average medical history of 9.8 years, the proportion of patients with a medical history of more than 10 years was 47.5%, to the group of the syndrome of non-dampness heat of spleen-stomach, the median age was 54 years, with an average medical history of 10.0 years and the proportion of patients which had a medical history of more than 10 years was 56.4%. No significant differences were found in the relevant parameters between the two groups. (3) Within the STC patients, the proportion of mental workers, mental and physical workers and physical workers was 78.0%,13.2% and 8.8%. (4)We found statistically significant differences in eating fried food between the two groups (71.0% vs 65.7% p=0.021). (5)The defecation exertion integral and constipation symptom scores of syndrome of dampness heat group were lower than non-dampness heat(p=0.016, p=0.023).(6)Ratio of patients combined with anxiety and depression were 18.1% and 47.9%, the prevalence of anxiety and depression among patients were higher than the control group (p<0.05), STC integration anxiety and depression were significantly higher than the control integral resistance (p<0.01), no statistical difference between dampness heat and non-dampness heat type(p>0.05). SF-36 scores were lower than the controls (p<0.05).(7) Compared with the controls, the numbers of Bifidobacterium was significantly reduced, and the Enterococcus number was significantly increased in the STC group(p<0.01) and Mildew number was increased(p=0.039), no significant difference on the numbers of Lactobacillus, Enterobacter spp. and Candida.The syndrome of dampness-heat of spleen-stomach had more numbers of mildew than the syndrome of non-dampness heat of spleen-stomach (p=0.016).(8)As for the syndrome of dampness heat group, after 2 and 4 weeks of treatment, the patients’defecations of both the TCM group and probiotics group improved (p<0.05), and there were no difference between the two groups(p>0.05), while there was no statistical difference on the improvement rate of the defecations (p>0.05). The scores of constipation symptoms of the two groups both improved after 2 and 4 weeks of treatment (p<0.05), while Chinese Medicines can significantly improve patients’ clinical symptoms (p<0.01), whereas the probiotics group can’t improve it (p>0.05). After 2 weeks of treatment, the total efficiency of TCM group and probiotics group were 55.56% and 53.85%, while after 4 weeks of treatment the numbers were 83.33% and 76.92%.and there was no statistical difference of the two groups(p>0.05).(9)As for the syndrome of non-dampness heat group, after 2 and 4 weeks of treatment, patients’ defecations of the fusong group and probiotics group were significantly improved (p<0.01),and there was statistical difference between the two groups(p< 0.05), while there was no statistical difference on the improvement rate of the defecations (p> 0.05).The stool character scores of the fusong group and probiotics group were significantly higher after 2 and 4 weeks of treatment (p<0.01),and there was statistical differences between the two groups after 4 weeks (p< 0.05),while there was no statistical difference on the improvement rate of the stool character (p> 0.05).The scores of constipation symptom of the two groups were both improved after 2 weeks of treatment (p<0.05),and the scores were improved after 4 weeks of treatment (p<0.01),and there was no statistical difference of two groups(p> 0.05).After 2 and 4 weeks of treatment the total efficiency of the fusong group were 54.17% and 79.17%,while the probiotics group were 44.44% and 61.11%. There were no statistical differences in the significant efficiency, good efficiency, effectiveness, non efficiency and total efficiency between the two groups(p> 0.05).Conclusion1.The formation of dampness heat of spleen-stomach STC were related to the diet.2.STC can affect the patients’psychological status and quality of life.3.Patients with STC have intestinal dysbiosis.The syndrome of dampness heat of spleen-stomach had more numbers of mildew than the syndrome of non-dampness heat of spleen-stomach.4. Traditional Chinese medicine and the probiotics can both relieve the constipation symptoms. Traditional Chinese medicine can improve the TCM symptoms.5. Fosson and probiotics treatment of non-dampness heat-type STC can improve the symptoms of constipation. |
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