| Functional constipation is a common chronic disease with high morbidity and recurrent rate, which affects patients’quality of life and gives them heavy economic and psychological burden. In addition, it can cause gastrointestinal and neurological disorders, cardiovascular disease and even tumor. Drugs for the treatment of functional constipation have significant long-term side effects and high recurrence rate. However, traditional Chinese medicine (TCM) bases on holism as the theoretical core. The diagnosis and treatment are based on syndrome differentiation. Therefore, it has good therapeutic effect and fewer side effects. TCM treatment for functional constipation has certain advantages that worth to be further researched. The thesis is divided into two parts, literature review and clinical research.Part1:Literature review1. Introduction of western medical progress about functional constipation from the following6parts:risk factors, pathogenesis, diagnosis, classification criteria, examination methods and treatments.2. TCM overview of the name, etiology and pathogenesis, syndrome differentiation and treatments of functional constipation.Part2:Clinical researchObjective:Compare clinical effect of San-ren-run-chang formulae and lactulose solution on the treatment of slow transit functional constipation (intestinal dryness with fluid deficient syndrome).Methods:The randomized, controlled study randomly divided60slow transit functional constipation (intestinal dryness with fluid deficient syndrome) patients into treatment group and control group.30patients in treatment group took San-ren-run-chang formulae, while30patients in control group took lactulose solution. Treatment course of both group were4weeks. Clinical symptom scores and gastrointestinal transit test were recorded and analyzed.Results:A total of59patients completed the clinical observation,30patients in treatment group and29patients in control group.1patient lost to follow-up in control group was not included in statistical analysis. Total efficacy of treatment group and control group were93.33%and82.76%respectively. The difference was not statistically significant (P>0.05). The remarkable efficacies were66.67%and24.14%respectively. Treatment group has a higher remarkable efficacy (,P<0.01). For treatment group, total symptom scores and each single symptom score at all observation time points had improved compared with the scores before treatment (P0.05). For control group, scores of stool shape and defecation difficulty had no significant improvement at4weeks after drug withdrawal (P>0.05); bloating score had no significant improvement at2weeks (P>0.05); other symptom scores and total symptom scores of control group had improved compared with the scores before treatment (P<0.05). The total symptom scores, defecation difficulty and bloating scores of treatment group had improved more at all observation time points compare with control group (P<0.05); defecation frequency and stool shape scores were improved at4weeks and4weeks after drug withdrawal compare with control group (P<0.05). Abdominal pain and unfinished feeling scores of two groups are not statistically significant (P>0.05). Gastrointestinal transit test of both groups had improved after4weeks treatment (P<0.05) but more barium sticks was discharged in treatment group (P<0.05).Conclusion:San-ren-run-chang formulae could increase defecation frequency, modify stool shape, relieve defecation symptoms and shorten gastrointestinal transit time without obvious side effects. The study showed that San-ren-run-chang formulae have good therapeutic effect on slow transit functional constipation. Therefore, the effect of San-ren-run-chang formulae on slow transit functional constipation should be further studied and promoted in the future. |
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