Wenyang Tongmi Tang Combined With Biofeedback And Psychological Intervention For Functional Constipation

Objective:FC is a common functional bowel disease in clinic.Although there is no relevant organic disease,but long-term FC can not only cause hemorrhoids,anal fissure,anal bulge,rectal cancer and other anorectal intestinal diseases,but also cardiovascular and cerebrovascular diseases,even life-threatening.With the growth of age,FC incidence is higher.The disease not only reduces the quality of life and happiness index of middle-aged and elderly people,but also aggravates the medical burden of China.At present,most of the treatments for FC use purgatives,but ignore the idea of seeking the root of the disease;In addition,modern studies have shown that most of FC patients suffer from mental and psychological problems such as anxiety and depression.Therefore,the treatment of FC requires both physical and psychological treatment.By combining theory with clinical practice,this study explored the practical application of the theory of"warming Yang and strengthening spleen,moistening intestine and relieving bowels"in TCM in the syndrome of spleen-kidney Yang deficiency.To explore the effects of electronic biofeedback therapy and"cognitive constructivism"on psychological intervention in the treatment of middle-aged and elderly FC and its mechanism of action;To observe the effect of wenyang tongmi tang combined with biofeedback and"cognitive constructivism"on improving patients'clinical symptoms,psychological problems,defecation symptoms and quality of life.To explore an effective and simple method for the treatment of FC.Methods:According to the inclusion criteria and exclusion criteria screening in March 2017 to October 2018 in hubei province of senile patients with FC hospital anus bowel division clinics,a total of 70 cases,patients according to random number table method can be divided into two groups:treatment group(iofeedback and psychological intervention)and 35 cases in the control group35 cases(lactulose oral liquid).General data(gender,age and course of disease),clinical symptoms,defecation symptoms,clinical symptoms of traditional Chinese medicine,mental and psychological problems of the two groups of patients were compared,P>0.05,the difference was not statistically significant,with comparability.Patients in the two groups were treated for 4 weeks,and each observation index after treatment was statistically analyzed;after 2 weeks of withdrawal,the recurrence was statistically analyzed.Finally,all the data are analyzed.Results:(1)Comparison of clinical efficacy:among the 35patients in the treatment group,17 were cured,8 were significantly effective,6 were effective,and 4 were ineffective.The total effective rate was 88.57%.Among the 35 patients in the control group,9 were cured,7 showed significant effect,8 were effective,11 were ineffective,and the total effective rate was 68.57%.Data of the two groups were tested by?~2test,P=0.041<0.05,the difference was statistically significant.(2)Comparison of defecation indexes:compared with that before treatment,four indexes of defecation were significantly improved in both groups(P<0.01).The difference between the treatment group and the control group was statistically significant(P<0.05).(3)Comparison of TCM clinical symptom indicators:The four clinical symptoms of TCM in the treatment group were significantly different from those before treatment(P<0.01);compared with the control group before treatment,the symptoms of abdominal distension and abdominal pain in FC patients were significantly improved(P<0.01).There were statistically significant differences between the treatment group and the control group in the improvement of the four indicators of TCM clinical symptoms(P<0.05).(4)Comparisonofpsychosocialefficacy:Therewere statistically significant differences in somatization,compulsive symptoms,psychosis,anxiety,depression,sleep and diet between the treatment group and the pre-treatment group(P<0.01);compared with the control group before treatment,sleep and diet of FC patients were significantly improved(P<0.05).In addition,the improvement of somatization,compulsive symptoms,psychosis,anxiety,depression,sleep and diet in the treatment group was statistically significant compared with the control group(P<0.05).(5)Recurrence:among the 17 cases cured in the treatment group,5 cases had recurrence,with a recurrence rate of 29.41%;Among the9 patients in the control group,7 patients had recurrence,with a recurrence rate of 77.78%.Two groups were tested by?~2test,?~2=5.538,P=0.019<0.05,the difference was statistically significant.Result is as follows:(1)The theory of"warming Yang and strengthening spleen,moistening intestine and relieving bowels"in Chinese medicine has guiding significance for the treatment of middle-aged and elderly FC with spleen-kidney Yang deficiency in clinical practice.(2)Wenyang tongmi tang combined with biofeedback and"cognitive constructivism"is an effective method for the treatment of middle-aged and elderly FC with spleen-kidney Yang deficiency.(3)Wenyang tongmi tang combined with biofeedback and"cognitive constructivism",the psycho-psychological intervention treatment of middle-aged and elderly patients with FC is an effective,comprehensive,simple and convenient,low recurrence rate treatment method,which is worthy of clinical promotion and application.