刘新红　周艳芳　雷军　叶茂　傅萍

【摘要】 目的：探析養血润肠方治疗气血亏虚型便秘的临床效果及对肠道菌群的影响。方法：选取2020年4月-2021年3月于江西中医药大学附属医院肛肠科与消化科就诊的80例气血亏虚型便秘患者，按随机数字表法将患者分为观察组和对照组，各40例。两组均给予标准处理后，观察组给予养血润肠方治疗，对照组给予芪归润肠汤治疗。对比两组临床疗效、治疗前后的中医症候积分、肠道菌群分布数量（双歧杆菌、乳酸杆菌、大肠杆菌）、肠神经递质水平[一氧化氮合酶（nNOS）、一氧化氮（NO）、血管活性肠肽（VIP）]。结果：观察组总有效率高于对照组，差异有统计学意义（P<0.05）;治疗后，观察组中医症候积分低于对照组，差异有统计学意义（P<0.05）;治疗后，观察组双歧杆菌、乳酸杆菌数量均高于对照组，而大肠杆菌数量低于对照组，差异均有统计学意义（P<0.05）;治疗后，观察组nNOS、NO、VIP水平均明显低于对照组，差异均有统计学意义（P<0.05）。结论：养血润肠方治疗气血亏虚型便秘的临床效果更加显著，可有效改善肠神经递质水平，恢复肠道菌群平衡，值得临床推广。

【关键词】 养血润肠方 芪归润肠汤 气血亏虚型便秘 肠道菌群

Clinical Effect of Yangxue Runchang Formula on Constipation of Qi Xue Deficiency Type and Its Influence on Intestinal Flora/LIU Xinhong， ZHOU Yanfang， LEI Jun， YE Mao， FU Ping. //Medical Innovation of China， 2021， 18（23）： 0-086

[Abstract] Objective： To explore the clinical effect of Yangxue Runchang Formula on constipation of Qi Xue deficiency type and its influence on intestinal flora. Method： A total of 80 patients who visited the department of coloproctology and gastroenterology， affiliated Hospital of Jiangxi University of Chinese Medicine for constipation of Qi Xue deficiency type from April 2020 to March 2021 were selected， they were randomly divided into the observation group and the control group， 40 cases in each group， according to the random number table. After the standard treatment was given to both groups， the observation group was given Yangxue Runchang Formula and the control group was given Qigui Runchang Decoction. The clinical efficacy， TCM symptom score， the number of intestinal flora （Bifidobacterium， Lactobacillus， Escherichia coli）， and intestinal neurotransmitter levels [nitric oxide synthase （nNOS）， nitric oxide （NO）， vasoactive intestinal peptide （VIP）] before and after treatment were compared between the two groups. Result： The total effective rate of the observation group was higher than that of the control group， the difference was statistically significant （P<0.05）; after treatment， the scores of TCM symptoms in the observation group were lower than those in the control group， the differences were statistically significant （P<0.05）; after treatment， the number of Bifidobacteria and Lactobacillus in the observation group were higher than those in the control group， while the number of Escherichia coli was lower than that in the control group， the differences were statistically significant （P<0.05）; after treatment， the levels of nNOS， NO and VIP in the observation group were significantly lower than those in the control group， the differences were statistically significant （P<0.05）. Conclusion： Yangxue Runchang Formula has more significant clinical effect in treating constipation of Qi Xue deficiency type， which can effectively improve the level of intestinal neurotransmitters and restore the balance of intestinal flora， is worthy of clinical promotion.

[Key words] Yangxue Runchang Formula Qigui Runchang Decoction Constipation of Qi Xue deficiency type Intestinal flora

First-author’s address： Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine， Nanchang 330006， China

doi：10.3969/j.issn.1674-4985.2021.23.020

便秘患者不僅会出现排便功能障碍，破坏其生理性肠道菌群，还会使其肠神经递质表达紊乱，继而诱发心脑血管、直肠癌等严重疾病[1-4]。临床西医主要采用合理膳食联合西药治疗，如促胃肠动力药物等，疾病复发率高，且长期服用不良反应多，因此临床推荐中医药治疗便秘有更明显优势[5-7]。……