“振腹疗法”调治女大学生慢传输型便秘的临床观察
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摘要
目的：通过对“振腹疗法”调治女大学生慢传输型便秘的临床研究,评价其对大便性状、便秘症状、结肠电生理活动以及生活质量的疗效,以及对女大学生慢传输型便秘的调治效果。
方法：将60例受试者随机分为治疗组和对照组各30例,治疗组采用“振腹疗法”治疗,对照组给予西药西沙必利片口服,疗程为两周,随访两个月。治疗即日起记录受试者每次排便时间。在治疗前和治疗后,分别嘱受试者填写Bristol大便性状量表、便秘患者症状自评量表及SF—36健康调查简表,并通过MP150电生理记录仪记录受试者升结肠与乙状结肠的电生理活动状况。治疗期间正常饮食,除了本试验选定的治疗方法以外,停用其他与便秘有关的药物及治疗方法。
结果：
1.大便次数：与治疗前相比,治疗组的改善率为68.75%；对照组的改善率为88.89%；
2.大便性状：与治疗前相比,治疗组与对照组的改善率均为92.5%；
3.便秘症状积分：与治疗前相比,治疗组与对照组的便秘症状积分均有显著改善(P<0.05)；
4.结肠电生理：与治疗前相比,治疗组与对照组升结肠与乙状结肠的波幅均有显著提高(P<0.05)；
5.生活质量：与治疗前相比,治疗组的生理职能维度有显著改善(P<0.05);
6.随访：随访两个月与治疗结束时相比,治疗组便秘症状积分无明显改变(P>0.05)；对照组便秘症状积分有明显的回升(P<0.05)；
7.总有效率：治疗组总有效率为90.00%,对照组为93.33%。
结论：“振腹疗法”能改善慢传输型便秘女大学生的大便性状、排便次数、便秘症状积分、结肠活动,还能提高其生理职能,而且远期疗效比西沙必利更持续。
Objective:To study the clinical effectiveness of "Vibrating Abdomen" therapy for treating female college student with Slow-transit constipation, by evaluating its effects on faecal property, constipation symptoms,the colon's activity and life quality.
Methods:60 female patients from different colleges were randomly divided into treatment group and control group,which has 30 cases separately. Treatment group is treated with "Vibrating Abdomen" therapy, control group with Cisapride tablets.Period of treatment is two weeks.During the period, diet is as usual but every medicine and medical therapy which has effects on constipation is prohibited except the treatments in this trial.Record the time of every case's defecating.Record case's faeces according to Bristol Stool Chart and the electrical activities of ascending and sigmoid colon by Electric Scooters MP150 before and after the period. Then follow up every month for 2 months to observe the clinical symptoms'changes after treatment.
Results:1.Defecation frequency:Compared with post-treatment, treatment group's improvement rate is 68.75%;control groups'is 88.89%;
2.Form of faeces:Compared with post-treatment, both groups'improvement rates are 92.5%;
3.Patient Assessment of Constipation-Symptom Questionnaire:Compared with post-treatment, both groups are well improved(P<0.05);
4.Colonic myoelectric activity:Compared with post-treatment, both groups' amplitudes are improved significantly(P<0.05);
5.Life quality:Compared with post-treatment, Role-physical in treatment group is improved significantly(P<0.05);
6.Follow-up:Compare 2-month-follow-up with the end of the treatment, PAC-Sym in treatment group maintain well(P>0.05);while PAC-Sym in control group rises back significantly(P<0.05)
Conclusion:"Vibrating Abdomen" therapy has a certain short-term and long-term effectiveness on female college student with slow transit constipation, whose faecal property, constipation symptoms, the colon's activity and life quality are well improved.
方法：将60例受试者随机分为治疗组和对照组各30例,治疗组采用“振腹疗法”治疗,对照组给予西药西沙必利片口服,疗程为两周,随访两个月。治疗即日起记录受试者每次排便时间。在治疗前和治疗后,分别嘱受试者填写Bristol大便性状量表、便秘患者症状自评量表及SF—36健康调查简表,并通过MP150电生理记录仪记录受试者升结肠与乙状结肠的电生理活动状况。治疗期间正常饮食,除了本试验选定的治疗方法以外,停用其他与便秘有关的药物及治疗方法。
结果：
1.大便次数：与治疗前相比,治疗组的改善率为68.75%；对照组的改善率为88.89%；
2.大便性状：与治疗前相比,治疗组与对照组的改善率均为92.5%；
3.便秘症状积分：与治疗前相比,治疗组与对照组的便秘症状积分均有显著改善(P<0.05)；
4.结肠电生理：与治疗前相比,治疗组与对照组升结肠与乙状结肠的波幅均有显著提高(P<0.05)；
5.生活质量：与治疗前相比,治疗组的生理职能维度有显著改善(P<0.05);
6.随访：随访两个月与治疗结束时相比,治疗组便秘症状积分无明显改变(P>0.05)；对照组便秘症状积分有明显的回升(P<0.05)；
7.总有效率：治疗组总有效率为90.00%,对照组为93.33%。
结论：“振腹疗法”能改善慢传输型便秘女大学生的大便性状、排便次数、便秘症状积分、结肠活动,还能提高其生理职能,而且远期疗效比西沙必利更持续。
Objective:To study the clinical effectiveness of "Vibrating Abdomen" therapy for treating female college student with Slow-transit constipation, by evaluating its effects on faecal property, constipation symptoms,the colon's activity and life quality.
Methods:60 female patients from different colleges were randomly divided into treatment group and control group,which has 30 cases separately. Treatment group is treated with "Vibrating Abdomen" therapy, control group with Cisapride tablets.Period of treatment is two weeks.During the period, diet is as usual but every medicine and medical therapy which has effects on constipation is prohibited except the treatments in this trial.Record the time of every case's defecating.Record case's faeces according to Bristol Stool Chart and the electrical activities of ascending and sigmoid colon by Electric Scooters MP150 before and after the period. Then follow up every month for 2 months to observe the clinical symptoms'changes after treatment.
Results:1.Defecation frequency:Compared with post-treatment, treatment group's improvement rate is 68.75%;control groups'is 88.89%;
2.Form of faeces:Compared with post-treatment, both groups'improvement rates are 92.5%;
3.Patient Assessment of Constipation-Symptom Questionnaire:Compared with post-treatment, both groups are well improved(P<0.05);
4.Colonic myoelectric activity:Compared with post-treatment, both groups' amplitudes are improved significantly(P<0.05);
5.Life quality:Compared with post-treatment, Role-physical in treatment group is improved significantly(P<0.05);
6.Follow-up:Compare 2-month-follow-up with the end of the treatment, PAC-Sym in treatment group maintain well(P>0.05);while PAC-Sym in control group rises back significantly(P<0.05)
Conclusion:"Vibrating Abdomen" therapy has a certain short-term and long-term effectiveness on female college student with slow transit constipation, whose faecal property, constipation symptoms, the colon's activity and life quality are well improved.
引文
[1]魏艳静,卞红磊.便秘的国内流行病学研究进展[J].疾病控制杂志,2004,8(5)：449-451
[2]刘伟宏,陈长香.大学生便秘及影响因素调查,卫生职业教育[J].2007,25：88-89
[3]戴菲.The colonic transit test in the assessment of chronic constipation[J].西安医科大学学报英文版,1999,11：36-39
[4]连至诚,劳绍贤,秦川,等.不同类型大便改变患者的体表结肠电频谱异常[J].广州中医学院学报,1993,10(1)：25-30
[5]王国才.推拿手法学[M].北京：中国中医药出版社,2003.
[6]M.L.N.G.MALBRAIN,W.VIDTS, M,RAVYTS,et al.Acute intestinal distress syndrome: the importance of intra-abdominal pressure,MINERVA ANESTESIOL[J],2008;74 (11):657-673
[7]E.Vivier,O.Metton,V.Piriou,et al.Effects of increased intra-abdominal pressure on central circulation.British Journal of Anaesthesia[J],2006,96(6):701-707
[8]朱虹.“血行则气行”探析[J].江苏中医药,2006,27(6)：12-13
[9]付国兵,戴晓晖.不同振源振法的操作特点及临床应用[J].按摩与导引,2008,24(5)：6-7
[10]郑娟娟,赵毅.振法参数的理论探讨及临床应用研究[J].中国中医药信息杂志,2008,15(7)：104-106
[11]荒木佳代,须釜孝子,中山美穗.腹部薄荷热敷对皮肤温度及肠蠕动的影响[J].看护技术.2003,49(7)：39-41.
[12]赵毅,孙鹏,郑娟娟,等.推拿掌振法对局部皮肤温度场红外热像的影响[J],辽宁中医杂志.2007,34(11)：1624-1626
[13]理疗手册(国外按摩基本手法)[M].沈阳：辽宁人民出版社,1979,12
[14]Hansen MB.The enteric nervous system Ⅱ:gastrointestinal functions[M].Pharmacol Toxicol,2003,92(6):249-257
[15]田在善,吴咸中.承气方对肠神经系统-Cajal间质细胞-平滑肌细胞网络的影响[J].中国中西医结合外科杂志,2009,15(3)：328-332
[16]马文M.舒斯特.胃肠动力学[M].上海：上海科学技术文献出版社,2003：3-19,231-239
[17]周吕,柯美云.神经胃肠病学与动力：基础与临床[M].北京：科学出版社,2005：554-564
[18]Lee JI,Park H,Kamm M A,et al.Decreased density o2 interstitial cells of Cajal and neuronal cells in patients with slow-transit constipation and acquired megaeoJon[J].J Gastroenterol Hepatol,2005,20(8):1292-1298
[19]He CL,Burgart L,Wang L,et al.Decreased interstitial cell of Cajal volume in patients with slow-transit constipation[J].Gastroenterology,2000,118(1):14-21
[20]Tong WD,Liu BH,Zhang LY,et al.Decreased interstitial cells of Cajal in the sigmoid colon of patients with slow transit constipation[J].Int J Colorectal Dis,2004,19(5): 467-473
[21]Tong WD,Liu BH,Zhang LY,et al.Expression of c-kit messenger ribonucleic acid and c-kit protein in sigmoid colon of patients with slow transit constipation[J].Int J Colorectal Dis,2005,20(4):363-367
[22]陈洁,卜平.Cajal间质细胞与慢传输型便秘研究的现状与趋势[M].国际消化病杂志,2008,28(5)：383-412
[23]Mei F, Guo S,He YT, et al.Apoptosis of interstitial cells of Cajal, smooth muscle cells, and enteric neurons induced by intestinal ischemia and reperfusion injury in adult guinea pigs[M].Virchows Arch,2009,454(4):401-409.
[24]Suzuki M, Takahashi A, Toki F, et al.The effects of intestinal ischemia on colonic motility in conscious rats[M].J Gastroenterol.2008,43(10):767-773
[25]Shimojima N, Nakaki T, Morikawa Y, et al.Interstitial cells of Cajal in dysmotility in intestinal ischemia and reperfusion injury in rats[M].J Surg Res.2006,135(2):255-261
[26]de Oliveira EP, Burini RC.The impact of physical exercise on the gastrointestinal tract[M].Curr Opin Clin Nutr Metab Care,2009,12(5):533-538
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[2]刘伟宏,陈长香.大学生便秘及影响因素调查,卫生职业教育[J].2007,25：88-89
[3]戴菲.The colonic transit test in the assessment of chronic constipation[J].西安医科大学学报英文版,1999,11：36-39
[4]连至诚,劳绍贤,秦川,等.不同类型大便改变患者的体表结肠电频谱异常[J].广州中医学院学报,1993,10(1)：25-30
[5]王国才.推拿手法学[M].北京：中国中医药出版社,2003.
[6]M.L.N.G.MALBRAIN,W.VIDTS, M,RAVYTS,et al.Acute intestinal distress syndrome: the importance of intra-abdominal pressure,MINERVA ANESTESIOL[J],2008;74 (11):657-673
[7]E.Vivier,O.Metton,V.Piriou,et al.Effects of increased intra-abdominal pressure on central circulation.British Journal of Anaesthesia[J],2006,96(6):701-707
[8]朱虹.“血行则气行”探析[J].江苏中医药,2006,27(6)：12-13
[9]付国兵,戴晓晖.不同振源振法的操作特点及临床应用[J].按摩与导引,2008,24(5)：6-7
[10]郑娟娟,赵毅.振法参数的理论探讨及临床应用研究[J].中国中医药信息杂志,2008,15(7)：104-106
[11]荒木佳代,须釜孝子,中山美穗.腹部薄荷热敷对皮肤温度及肠蠕动的影响[J].看护技术.2003,49(7)：39-41.
[12]赵毅,孙鹏,郑娟娟,等.推拿掌振法对局部皮肤温度场红外热像的影响[J],辽宁中医杂志.2007,34(11)：1624-1626
[13]理疗手册(国外按摩基本手法)[M].沈阳：辽宁人民出版社,1979,12
[14]Hansen MB.The enteric nervous system Ⅱ:gastrointestinal functions[M].Pharmacol Toxicol,2003,92(6):249-257
[15]田在善,吴咸中.承气方对肠神经系统-Cajal间质细胞-平滑肌细胞网络的影响[J].中国中西医结合外科杂志,2009,15(3)：328-332
[16]马文M.舒斯特.胃肠动力学[M].上海：上海科学技术文献出版社,2003：3-19,231-239
[17]周吕,柯美云.神经胃肠病学与动力：基础与临床[M].北京：科学出版社,2005：554-564
[18]Lee JI,Park H,Kamm M A,et al.Decreased density o2 interstitial cells of Cajal and neuronal cells in patients with slow-transit constipation and acquired megaeoJon[J].J Gastroenterol Hepatol,2005,20(8):1292-1298
[19]He CL,Burgart L,Wang L,et al.Decreased interstitial cell of Cajal volume in patients with slow-transit constipation[J].Gastroenterology,2000,118(1):14-21
[20]Tong WD,Liu BH,Zhang LY,et al.Decreased interstitial cells of Cajal in the sigmoid colon of patients with slow transit constipation[J].Int J Colorectal Dis,2004,19(5): 467-473
[21]Tong WD,Liu BH,Zhang LY,et al.Expression of c-kit messenger ribonucleic acid and c-kit protein in sigmoid colon of patients with slow transit constipation[J].Int J Colorectal Dis,2005,20(4):363-367
[22]陈洁,卜平.Cajal间质细胞与慢传输型便秘研究的现状与趋势[M].国际消化病杂志,2008,28(5)：383-412
[23]Mei F, Guo S,He YT, et al.Apoptosis of interstitial cells of Cajal, smooth muscle cells, and enteric neurons induced by intestinal ischemia and reperfusion injury in adult guinea pigs[M].Virchows Arch,2009,454(4):401-409.
[24]Suzuki M, Takahashi A, Toki F, et al.The effects of intestinal ischemia on colonic motility in conscious rats[M].J Gastroenterol.2008,43(10):767-773
[25]Shimojima N, Nakaki T, Morikawa Y, et al.Interstitial cells of Cajal in dysmotility in intestinal ischemia and reperfusion injury in rats[M].J Surg Res.2006,135(2):255-261
[26]de Oliveira EP, Burini RC.The impact of physical exercise on the gastrointestinal tract[M].Curr Opin Clin Nutr Metab Care,2009,12(5):533-538
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