Clinical Study On Xuanbai Chengqi Decoction In The Treatment Of Post-stroke Constipation

Objective: To observe the clinical efficacy,safety and adverse reactions of Xuanbai Chengqi Decoction on patients with phlegm-heat and fu-organ excess syndrome of post-stroke constipation,and to explore a new idea of clinical treatment of post-stroke constipation.Methods: From October 2020 to September 2021,66 patients with phlegm-heat and fu-organ excess syndrome of post-stroke constipation were randomly divided into33 cases in the control group and 33 cases in the treatment group.After the two groups were enrolled,they need to cultivate the living habits of reasonable diet and regular daily life,carry out mental health education,and give basic treatment of Neurology.The control group was treated with Lactulose Oral Solution(Duphalac),with an oral dose of 30 m L/day and a maintenance dose of 7.5～15m L a day,which was taken at breakfast every day;The treatment group was treated with Xuanbai Chengqi Decoction(Armeniacae Semen Amarum 9g,Gypsum Fibrosum 30g(decocted first),Trichosanthis Fructus 30 g,Rhei Radix Et Rhizoma 6g(decocted after)),decocted to 400 m L,200 m L each time,twice a day.The course of treatment was 2 weeks.The changes of traditional chinese medicine syndrome scores(TCMSS),modified barthel index(MBI),constipation symptom assessment form(CSAF)and patient assessment of constipation quality of life(PAC-QOL)were recorded before and after treatment,the safety and adverse reactions of the two schemes were evaluated.Result:1.Before treatment,the scores of age,gender,stroke course and four scales of the two groups were statistically analyzed.All P values were greater than 0.05,indicating that there was no significant difference in the basic situation between the two groups,which was comparable.2.Before and after treatment,,the scores of TCMSS,CSAF and PAC-QOL in the two groups decreased significantly compared with those before treatment,P<0.05,which proves that Xuanbai Chengqi Decoction and Lactulose Oral Solution can improve the clinical symptoms and quality of life of patients with constipation;The MBI score of the two groups was higher than that before treatment,and there was a significant difference(P<0.05),indicating that the treatment schemes of the two groups were helpful to improve the ability of daily living of patients with constipation after stroke.3.After treatment,the scores of TCMSS,CSAF and PAC-QOL in the treatment group were significantly lower than those in the control group,and the MBI score was significantly higher than that in the control group(P<0.05),indicating that the therapeutic effect of Xuanbai Chengqi Decoction is better than that of Lactulose Oral Solution.4.Comparison of clinical efficacy between the two groups: in terms of TCMSS,the control group was effective in 23 cases and ineffective in 9 cases,with a total effective rate of 71.9%;In the treatment group,26 cases were effective and 6 cases were ineffective,with a total effective rate of 81.3%.There was no significant difference in the efficacy of TCMSS between the two groups(P>0.05).In terms of CSAF,26 cases were effective and 6 cases were ineffective in the control group,and the total effective rate was 81.3%;In the treatment group,27 cases were effective and5 cases were ineffective and the total effective rate was 84.4%.There was no significant difference in the efficacy of CSAF between the two groups(P>0.05).It shows that whether TCMSS or CSAF is used as the curative effect standard,Lactulose Oral Solution and Xuanbai Chengqi Decoction have the same clinical effect.5.During the treatment,there were no obvious adverse reactions in the treatment group,and only one patient in the control group had abdominal pain,with mild symptoms and self remission,indicating that Xuanbai Chengqi Decoction and Lactulose Oral Solution have high clinical safety.Conclusion: Xuanbai Chengqi Decoction and Lactulose Oral Solution have the same clinical efficacy and high safety in the treatment of phlegm-heat and fu-organ excess syndrome of post-stroke constipation.Xuanbai Chengqi Decoction is better than Lactulose Oral Solution in the improvement of overall observation indexes,indicating that although there is little difference in clinical efficacy between each other,Xuanbai Chengqi Decoction has a better effect on the improvement of overall state of patients with constipation.And there was no obvious adverse reaction during the treatment,which is worthy of clinical promotion.