The Relations Of Slow Transit Constipation (Intestinal Qi Stagnation) And Colon Motility

BackgroundThe ancient Chinese medical books did not explicitly propose the nonaggressive slow transit constipation, but according to STC main clinical manifestations attributed to the disease areas of "constipation","closed","Yin knot","Yang knot" and so on. Its pathogenesis is mainly focused on the enteric nervous system and gastrointestinal peptide hormone changes, colonic motility disorders, interstitial cells of Cajal and other aspects of anomalies. Treatment, mainly in Western laxatives, prokinetic drugs, biofeedback based. TCM is mainly two methods of dialectical therapy and basic addition and subtraction. As relatively little is known of human colonic motor activity either in health, or in pathological conditions.ObjectiveTo study the colonic motility of slow transit constipation (intestinal qi stagnation) and assess its clinical significance.MethodsPatients with slow transit constipation have been excluded organic disease and the dialectical analysis of patients met the intestinal qi stagnation type. Twenty-four-hour ambulatory colonic manometry was performed in21patients with slow-transit constipation and20healthy controls by placing a water perfusion manometry probe up to the Ascending colon with the colonoscope. Using statistical software to analyze the relation of slow transit constipation (intestinal qi stagnation) and colon motility.ResultSlow transit constipation (intestinal qi stagnation) compared with healthy controls, showed fewer pressure waves (29.35±3.91vs12.48±3.37, p<0.01) uring daytime, but not at night. Slow transit constipation postprandial motility index was significantly lower than normal (11.87±1.41vs5.67±1.01, p<0.01), their preprandial based motility index also lower (4.66±0.87vs3.50±5.72,p<0.01). High-amplitude propagating contractions (HAPCs) of patients compared to controls with lower incidence (7.15±1.76vs1.71±0.72, P<0.01) and duration of pressure wave (14.00±2.73vs7.00±1.34, p<0.01). Proximal colon’s number of waves of patients compared to controls with lower incidence (296.95±11.302vs264.20±9.23, p<0.01), and their proximal and distal colon motility also lower.ConclusionPatients with slow-transit constipation exhibited decreased pressure activity with manometric features suggestive of colonic neuropathy or myopathy as evidenced by absent HAPC or attenuated colonic responses to meals. In slow transit constipation (intestinal qi stagnation) patients, This study demonstrates that colonic motor activity is abnormal in slow-transit idiopathic constipation;decreased motor activity leads to a reduction in propulsion of intraluminal contents. We learn the change of the pressure on the colon slow transit constipation, especially in patients with weak type temper in guiding clinical treatment.