潘慧 姚宏健 常为伟 李阳 陈淑君 刘佃温 刘世举

【摘 要】 目的：观察自拟补气通秘方加减治疗气阴两虚证老年便秘的临床疗效及对患者血清SP、VIP和NO水平的影响。方法：将50例老年患者且诊断为气阴两虚证者随机分为对照组和观察组，每组25例。对照组给予芪蓉润肠口服液口服治疗;观察组给予自拟补气通秘方加减口服治疗。治疗1月后观察两组排便顺畅度，便后汗出气喘、粪便性状和腹胀腹痛等各项临床症状的改善情况及治疗前后血清SP、VIP和NO水平的变化。结果：治疗后观察组排便顺畅度，便后汗出气喘、粪便性状和腹胀腹痛等各項临床症状改善均优于对照组（P<0.05）;同时观察组整体有效率优于对照组（P<0.05）;观察组SP升高，VIP、NO降低，显著优于对照组（P<0.05）。结论：自拟补气通秘方加减治疗老年气阴两虚证便秘疗效显著，可升高血清SP，降低VIP、NO并有效缓解患者排便不顺畅，便后汗出气喘，粪便干结和腹胀腹痛等症状，具有一定的临床价值。

【关键词】 老年便秘;自拟补气通秘方;气阴两虚证;临床观察

【中图分类号】R256.35【文献标志码】 A 【文章编号】1007-8517（2021）07-0114-05

Clinical Observation on the Treatment of 25 Cases of Senile

Constipation with Deficiency of Qi and Yin by Self-made Recipe

PAN Hui1 YAO Hongjian2 CHANG Weiwei1 LI Yang1 CHEN Shujun1 LIU Dianwen3 LIU Shiju3*

1.The First Affiliated Hospital to Henan University of Traditional Chinese Medicine， Zhengzhou 450000，China;

2.The Huanghe Central Hospital， Zhengzhou 450000，China;

3.The Third Affiliated Hospital to Henan University of Traditional Chinese Medicine， Zhengzhou 450000，China

Abstract：ObjectiveTo observe the clinical efficacy of self-made Buqi Tongmi Decoction in treating constipation in the elderly with deficiency of both Qi and Yin， and its effect on the serum levels of SP， VIP and NO. Methods Fifty elderly patients who were diagnosed with Qi and Yin deficiency were randomly divided into 2 groups， 25 cases in each group. The control group was given Qirong Runchang Oral Liquid for oral treatment; the observation group was given the self-made Buqi Tongmi Recipe plus or minus oral treatment. After 1 month of treatment， the two groups of patients were observed to observe the smoothness of defecation， sweating and wheezing after defecation， the improvement of various clinical symptoms such as stool characteristics， bloating and abdominal pain， and the changes of serum SP， VIP and NO levels before and after treatment. Results After treatment， the observation group patients had better defecation smoothness， sweating and wheezing after defecation， fecal characteristics， abdominal distension and abdominal pain and other clinical symptoms improved better than the control group （P<0.05）; at the same time， the observation group's overall effective rate was better than the control group （P<0.05）; SP increased in observation group， VIP and NO decreased， compared with control group， it was better than control group （P<0.05）. Conclusion The self-made Buqi Tongmi Recipe has a significant effect on the treatment of constipation due to deficiency of both Qi and Yin in the elderly. It can increase serum SP， decrease VIP and NO， and effectively relieve patients with unsmooth defecation， sweating and asthma after stool， dry stool and abdominal distension and abdominal pain Such symptoms have certain clinical value.

Key：words：Elderly Constipation; Self-made Replenishing Qi Tong Mi Recipe; Qi and Yin Deficiency; Clinical Observation

便秘是临床常见的疾病，本病的发病广泛分布于各个年龄段，长期便秘使粪便长时间在肠道内停留导致宿便的过度分解，产生各种毒素被肠道吸收而危害健康，长期大量粪便的积累又具有形成巨结肠和粪石的风险[1]。研究[2]表明长期不良的饮食和生活习惯及作息方式等是本病的主要诱因，其中老年患者也是本病的高发人群，且临床以大便干结或干硬排出不畅而腹胀腹痛，老年患者往往因体质虚弱，中气不足而伴有便后汗出气喘等气虚症状。中医将本病分为多个证型，老年患者气阴两虚证便秘也较常见，但老年患者气阴两虚证便秘往往呈现出本虚标实之证，以大便干结，腹胀腹痛等为主要表现，但同时还伴随中气不足、津液匮乏等症状，以大便用力努挣，便后汗出气喘等气阴虚的症候为主，因此对于老年患者不可直接采用峻猛攻下之方，而需要标本同治，补气养阴，调节阴阳平衡，改善临床症状。……