Effect Of High Retention Enema With Traditional Chinese Medicine On Intestinal Flora In The Treatment Of Slow Transit Constipation

Objective:By studying the effect of high retention enema with traditional Chinese medicine on intestinal microflora in the treatment of slow transit constipation,the efficacy and safety of the treatment as well as the influence on intestinal flora were evaluated in order to find an accurate basis for the subsequent treatment of the need to add intestinal microecological agents,so as to improve the clinical cure rate.Methods:A total of 90 patients with chronic transit constipation meeting the inclusion criteria were randomly divided into the treatment group(n=30),the control group1(n=31)and the control group2(n=29).The treatment group was treated with high retention enema of Tongfu Runchang decoction,the control group1 was treated with colon hydrotherapy,and the control group2 was treated with oral macrogol 4000 powder.The treatment time was 2 courses,14 days was a course of treatment,and the interval between the two courses was 1 week.The therapeutic effect of each group was evaluated by analyzing the main symptom score and total score before and after treatment,and the self-rating scale of quality of life(PAC-QOL)score of patients with constipation,and the effect of treatment on the abundance and diversity of intestinal flora was evaluated by high-throughput sequencing and analysis of 16s amplifiers in the feces of the subjects before and after treatment.Results:After 1 month of follow-up,symptom score and PAC-QOL score in the three groups were significantly decreased compared with before treatment(P<0.05),and the treatment group was significantly better than the two control groups(P<0.05).The total effective rates were 93.5%,83.3%and70.4%,respectively.Comparison of the abundance and diversity of intestinal microflora among the three groups before and after treatment:Chao1 index,P<0.05,while Simpson index and Shannon index,P>0.05.After treatment,Chao1 index,Simpson index and Shannon index in the treatment group were compared with those of the two control groups,P>0.05.After treatment,the Chao1 index,Simpson index and Shannon index in the treatment group were compared with those in the two control groups:There was no statistically significant difference in the relative abundance of microflora among the three groups before and after treatment(P>0.05),but after treatment,the relative abundance of the treatment group was significantly different from that of the control groupl(P<0.05),and there was no significant difference compared with the control group2(P>0.05).Conclusion:High retention enema with traditional Chinese medicine in the treatment of slow transit constipation can effectively soften stool,increase defecation times,shorten defecation time,alleviate defecation difficulty and improve patients’ quality of life.the clinical effect is significantly better than that of colon hydrotherapy and oral macrogol 4000 powder.The three treatments have no significant effect on the diversity of intestinal flora,but can relatively reduce their abundance.Compared with colon hydrotherapy,thehigh retention enema of traditional Chinese medicine can increase the abundance of Bacteroidetes and decrease the abundance of Firmicutes in the intestinal tract of patients.Intestinal microecological agents should be added to the treatment in the future to improve the clinical cure rate.