董璐　宋花玲　车文　萧枫　沈利岩　陈一　郑洁皎　徐国会

[摘要] 目的 评价超声中频同步电疗法（UIFST）及朱氏一指禅推拿手法（ZOTM）治疗老年人功能性便秘的临床效果。 方法 选择2013年1月～2015年6月复旦大学附属华东医院收治的老年功能性便秘患者92例，按照随机数字表将其分为四组，即对照组（T0组）、超声中频组（T1组）、推拿组（T2组）和综合组（T3组），T0组接受常规治疗，T1组在常规治疗的基础上结合UIFST治疗，T2组在常规治疗的基础上结合ZOTM治疗，T3组在常规治疗的基础上结合UIFST及ZOTM治疗，疗程为6周。分别记录治疗前后排便时间（DT）、排便次数（DF）及便秘患者生活质量量表（PAC-QOL）评分。 结果 与治疗前比较，四组治疗6周后DT、PAC-QOL显著下降，DF显著上升，差异均有统计学意义（P < 0.05）。与T0组比较，T1组、T2组DT、DF及PAC-QOL前后差值增大，差异有统计学意义（P < 0.05），而T3组的DT、DF及PAC-QOL前后差值明显增大，差异有高度统计学意义（P < 0.01）。DT、DF及PAC-QOL的UIFST及ZOTM的主效应比较差异均有高度统计学意义（P < 0.01），两者的交互作用比较差异有统计学意义（P < 0.05）。 结论 UIFST或ZOTM治疗老年人功能性便秘，单用有效，联合应用具有协同作用。

[关键词] 超声中频同步电疗法；朱氏一指禅推拿；老年人；功能性便秘

[中图分类号] R256.35 [文献标识码] A [文章编号] 1673-7210（2016）10（a）-0040-04

Effect of ultrasonic intermediate frequency synchronous therapy combined with Zhushi One-Thump Manipulation for the elderly patients with functional constipation

DONG Lu1 SONG Hualing2 CHE Wen3 XIAO Feng4 SHEN Liyan3 CHEN Yi3 ZHENG Jiejiao3 XU Guohui3▲

1.Nursing College， Shanghai University of Traditional Chinese Medicine， Shanghai 201210， China； 2.Staff Room of Preventive Medicine， Shanghai University of Traditional Chinese Medicine， Shanghai 201210， China； 3.Department of Rehabilitation Medicine， Huadong Hospital Affiliated to Fudan University， Shanghai 200040， China； 4.Department of Manipulation， Huadong Hospital Affiliated to Fudan University， Shanghai 200040， China

[Abstract] Objective To evaluate the clinical efficacy of ultrasonic intermediate frequency synchronous therapy （UIFST） combined with Zhushi One-Thump Manipulation （ZOTM） for the elderly patients with functional constipation. Methods Total of 92 patients with functional constipation admitted to Huadong Hospital Affiliated to Fudan University from January 2013 to June 2015 were selected and randomly divided into 4 groups by random number table， which were control group （T0 group）， ultrasonic intermediate frequency group （T1 group）， manipulation group （T2 group） and combined group （T3 group）. T0 group received the routine treatment， T1 group received UIFST on basis of routine treatment， T2 group received ZOTM on basis of routine treatment， T3 group received UIFST and ZOTM on basis of routine treatment. The course was 6 weeks. The defecation time （DT）， defecation frequency （DF） and patient assessment of constipation quality of life （PAC-QOL） scores of the two groups were recorded before and after treatment. Results Compared with before treatment， DT， PAC-QOL of the 4 groups were all decreased and DF was increased， the differences were all statistically significant （P < 0.05）. Compared with T0 group， the differences of DT， DF， PAC-QOL before and after treatment in the T1， T2 group were increased， the differences were statistically significant （P < 0.05）， and the differences of DT， DF， PAC-QOL before and after treatment in the T3 group were obviously increased， the differences were highly statistically significant （P < 0.01）. The main effects of ZOTM and UIFST in DT， DF and PAC-QOL were highly statistically significant （P < 0.01）. The interaction efficacy for DT and PAC-QOL between the two therapies was statistically significant （P < 0.05）. Conclusion The joint application of ZOTM and UIFST has a synergistic effect， while either of which is effective for the elderly patients with functional constipation.

[Key words] Ultrasonic intermediate frequency synchronous therapy； Zhushi One-Thump Manipulation； Elderly； Functional constipation

慢性功能性便秘（functional constipation，FC）是临床常见病和多发病，发病率为5%～15%。国内一项对60岁以上人群的调查研究显示，老年人群FC发病率高达10%～20%，严重影响老年人的生活质量[1]。由于FC的病因及机制尚不完全清楚，临床上常采用润滑剂和泻药等进行对症治疗，近期疗效明显，但远期疗效差，长期应用还可损害肠壁神经，引起药物依赖，影响患者的生活质量。杨宇等[2]认为朱氏一指禅推拿可以增加平滑肌张力，加强胃肠蠕动。谭正巧[3]主张中频治疗可改善肠道血液循环，调整自主神经功能，促进正常排便功能的恢复。范俊[4]发现在频率为600 kHz时，14 W/cm2辐照7 min的低强度超声对大鼠肠管平滑肌收缩有一定影响。……