The concept of constipation] Drossman and others believe that any person who defecates more than 25% of the normal time or/and defecates 2 times a week or less can be regarded as constipated. But in fact, due to diet, life, defecation habits and food composition of different, defecation interval is a big difference. Although the time of defecation is long, but as long as smooth, and no discomfort, can not be generalized as constipation. Therefore, it is generally believed that constipation refers to constipation, prolonged defecation time, or although the intention to defecate but difficult to defecate, or after defecation, there is a sense of incompleteness or discomfort, or accompanied by abdominal fullness and bloating and even other discomforts. If you have the above symptoms, even if you have one or more bowel movements per day, you should be considered constipated. The danger of constipation] Long-term constipation, the harmful substances produced by the body can not be discharged in a timely manner, is the income of blood, resulting in poor taste, nausea, belching, bitter breath, bad breath, irritability, mouth and tongue sores, swollen gums, eye redness and pain, mouth and nose bleeding, acne, and dizziness and fatigue, mental frenzy or indifference, depression, a series of symptoms of poisoning such as weird personality. Some even trigger anemia, malnutrition, fecalithiasis, fecal impaction, anal fissure, hemorrhoids, colorectal ulcers, induced rectal cancer, but also asthma, emphysema, pulmonary heart disease, hypertension, coronary heart disease, gastrointestinal disease and other geriatric or chronic disease aggravation, and even defecation sudden death. Constipation makes intestinal toxin retention and absorption, but also promote premature aging or aging. Constipation also leads to hair loss and breast disease. [Classification of constipation] Constipation with outlet obstruction Organic constipation with outlet obstruction Functional constipation with outlet obstruction Anterior rectal protrusion Puborectal myelopathy Prolapse of the rectum/Internal condylomata Descending perineum syndrome Colonic constipation Organic colon constipation Functional colon constipation Colonic constipation Colonic redundancy Colonic paralysis (colon slow transmission disease) Reduced neurological activity Thinning of intestinal muscles Mixed constipation [Manifestations of constipation] Outlet obstruction Constipation Colonic constipation Mixed constipation 【Diagnosis of constipation】 Detailed history Fecography Colonic transport test Barium enema Electromyography Rectal manometry 【Treatment of constipation】 Conservative treatment Increased exercise Drinking water Dietary therapy Medications Western medicine: dilatation laxatives, the main role is to increase intestinal contents to promote intestinal peristalsis. Commonly used are slow special diarrhea (Metamucil), agar, Yi speed diarrhea (Isogel), methyl cellulose and so on. Stimulant laxatives, commonly used such as phenolphthalein, anthraquinones such as rhubarb, Senokot, the standard preparation of senna, and Boshi’s rhamnosus bark (Cascara). These drugs are absorbed in the small intestine and broken down in the body into the active substance rhubarbine excreted into the colon, which stimulates the intestinal myenteric plexus to cause intestinal peristalsis. Castor oil after oral administration by pancreatic lipase, hydrolyzed to ricinoleic acid and glycerol, the former has a stimulating effect on the mucosa of the small intestine, causing intestinal reflex peristalsis enhancement. Salt laxatives, such as magnesium sulfate, sodium sulfate and other services in the intestinal tract is not absorbed, three hours to act.) Stool softeners, such as dioctyl sodium sulfosuccinate (Di-octyl sodium sulphasuccinate; DSS) is a surfactant that softens the stool and reduces the surface tension of the stool, which in turn allows water to seep into the stool. Lactulose is a synthetic disaccharide that ferments in the colon to produce soft stools, with the side effect of gas production causing abdominal distension, often dose-related. Polyoxyethylene propylene, Poloxalkal can be used alone or in combination with stimulant laxatives. Rectal colonics are commonly used with glycerin suppositories and bisacodyl (Beog-ex), the latter of which produces CO2 gas in the rectum, which distends the lumen of the bowel leading to defecation. However, whether lubricating laxatives such as liquid paraffin, olive oil, glycerin, or stimulating laxatives such as phenolphthalein, rhubarb, or swelling laxatives such as agar, methylcellulose, etc., have the side effect of interfering with the normal activity of the intestinal tract and absorption, and the long-term use of the intestinal wall neuroreceptor cell reactivity can be reduced, even if there is a sufficient amount of feces in the intestines do not produce normal peristalsis and defecation reflexes, so that not to take laxatives or enemas on the difficult to defecate, make the It is addictive and forms stubborn constipation dependent on laxatives. Long-term use of bisacodyl can lead to liver dysfunction; long-term use of liquid paraffin can impede fat-soluble vitamins A, D and K and calcium, phosphorus absorption, and the risk of causing lipoid pneumonia; laxative stimulation can also be reflexively caused by pelvic organ congestion, so that women have excessive menstruation, pregnant women miscarriage. Traditional Chinese medicine believes that often take rhubarb, senna, petunia seeds, hemp pill, niu huang detoxification tablets, on the clear pill and other bitter cold laxatives, will hurt the gas loss Tsu, the more diarrhea the more constipation. Chinese medicine treatment of constipation] identification and treatment of constipation is generally divided into two categories, always to regulate the qi, moisturize the intestines for the treatment of the law. Solid constipation: mostly seen in new diseases or temporary intestinal peristalsis dysfunction. The patient’s body is strong and solid people, the duration of the disease is short, the treatment is mainly diarrhea. Appropriate identification, often rubbing hands and healing. However, diarrhea bitter cold, easy to hurt the stomach gas, so need to stop the disease, not under the long time under the harsh. Surface and inside the same disease: is the gastrointestinal heat blazing and surface evidence. The main evidence of constipation, irritation and thirst, red face and burnt lips, chest and diaphragm heat, body heat, slightly sick of wind and cold. The tongue is red, the moss is yellow or white, and the pulse is floating. The treatment is to remove the fire and pass the bowel movement, so as to solve the problem of both the surface and the inside of the body. The formula uses cool diaphragm scattered addition and subtraction: raw rhubarb 6g, manganite 12g, gardenia 12g, scutellaria baicalensis 12g, silver buckthorn 15g, peppermint 10g, bamboo leaf 10g, licorice 3g. dry and hot internal knot: the main symptom sees the dry and knotty stool, short and red urine, abdominal distension and disease, dry and bad taste of the mouth, body heat and irritability. The tongue is red, the moss is yellow and dry, and the pulse is smooth and solid. The treatment is to clear heat and moisten the intestines. Use hemp seed kernel pill plus and minus: hemp seed kernel 18g, raw rhubarb 6g, white peony 12g, thick park 12g, almonds 12g, citrus aurantium 12g. injury to fluid add XuanShenGen, raw land, etc. in order to nourish yin and promote the production of fluids; if the liver fire is strong, and the eyes are red and easy to onion, add gentian herb or more pill (aloe vera, ZhuSiSi) in order to dredge the liver and pass the bowel movement. Yangming Viscera: constipation of stools, or purely foul water, abdominal distension, hard pain, body heat does not subside. The tongue is red, the moss is yellow and dry, and the pulse is solid. The treatment is to attack the cushion. With the adjustment of stomach Chengqi Tang plus reduction: raw rhubarb 12g, manganese nitrate 15g, licorice 6g. If the yangming viscera solid, the attack on the head and eyes, hot flashes and bizarre language, can be used in a small Chengqi Tang, raw rhubarb 12g, Citrus aurantium 12g, thick Park 6g in order to drain down the hot knots. Tongue dryness and heat is worse, delirium, eyes and eyes, can be used in Dachengqi Tang, raw rhubarb 12g, Houpu 15g, Citrus aurantium 15g, manganese nitrate 12g in order to precipitate down the hot knots. Yangming viscera real, Jin injury is more serious, with dry mouth and lips, tongue coating, can be used to adjust the stomach Chengqi Tang plus XuanShen 15g, ShengDi 15g, MaDong 15g to attack the lower drain heat, produce Jin nourishing liquid. Qi and Jin two parts, with dry mouth and throat, fatigue, moss yellow or burnt black, weak pulse, can be used to increase the liquid Cheng Qi Tang plus flavor: raw rhubarb 6g, 10g of nitrous oxide, licorice 6g, XuanShen 15g, the raw land, maitake, sea cucumber 15g, ginseng 10g, (or Codonopsis pilosulae 30g) in order to pass through the internal organs and drain the heat, and benefit the qi to produce fluids. If the yangming viscera real, with urine yellow red dribbling astringent pain, body heat and thirst, can be used to adjust the stomach Cheng Qi Tang plus raw land 15g, red peony 10g, Huanglian 6g, Bianzhu 10g, in order to diuretic diuresis and gonorrhea. Cold solid internal knot: inability to pass stool, abdominal pain or pain under the hypochondrium, or accompanied by chills and fever. The tongue is white or sticky, and the pulse is tight and stringy. The treatment is to warm the Yang to pass the stool, dispel cold and relieve pain, with the addition and subtraction of Wen Spleen Tang: 12g of sliced epiphyllum, raw rhubarb, thick park, dry ginger, cinnamon stick 10g each, 3g of fine pungent, 5g of licorice, and for the frail, add Codonopsis pilosulae and Angelica sinensis to nourish the vital energy and the blood. The secret of cold solid knot, the importance of the tongue and pulse, although fever is cold solid knot, yang qi stagnation, Yingwei disorders caused by. If you see constipation and abdominal pain will be generalized cast cold down, not only the more down the more secret, fear of changes in the evidence of the bee up, so the evidence had to be carefully examined. Qi stagnation: constipation of stools, wanting to stool can not be, belching, less food, chest and abdominal plumpness, or even abdominal pain and intestinal tinnitus. Thin moss, stringy pulse. This is often due to emotional injury and disease, due to emotional fluctuations and recurrence or aggravation. The treatment is to smooth the qi, guide stagnation and pass the bowels, with the addition and subtraction of Liu Mu Tang: 6g of raw rhubarb, 10g of Citrus aurantium, 10g of betel nut, 10g of aconite, 6g of sedum, 12g of broad spices, if qi depresses and transforms into fire, with a bitter mouth and dry throat, and a stringy pulse, the addition of Gentian grass, Scutellaria baicalensis, and Dampi is recommended to clear the heat and eliminate the fire. Dampness-heat interlude: the symptoms include inability to pass stools, hardness and fullness in the abdomen, or loose stools but difficult to get out, or accompanied by pain in the anus, head distension and drowsiness, with a red tongue, yellow fur, and moistened pulse. The treatment to clear heat and dampness, guide turbid stagnation, with Xuanqing guide turbid soup plus reduction: poria, cloud ling each 12g, silkworm sand 30g, soap pods 15g, cold water stone 20g, hedge hedge apricot red each 10g. this condition is often seen in the vegetative habit of strong tea, excessive alcohol consumption. Functional outlet obstruction constipation due to spasm of the puborectal muscle or pelvic floor muscle spasm syndrome belongs to this evidence, can be added to the white peony 30g, licorice, yuan Hu, peach red 15g, in order to antispasmodic pain, blood circulation and laxative. Gastrointestinal stagnation: constipation, epigastric distension and fullness, with Hovenia Citrus Husk Guiding Stagnation Soup plus subtractions: raw rhubarb, Huanglian, Atractylodes macrocephala 10g, Hovenia Citrus Husk, Yunling, Scutellaria baicalensis 12g, Zedoaria zeylanica 6g, hawthorn qu 15g. Blood stasis: constipation and constipation of stool, abdominal distension and pain and refusal to be pressed. The tongue is purple or dark or with petechiae and the pulse is strong or astringent. Heat. This is often seen in trauma or typhoid fever that does not resolve, and the heat is transmitted to the lower jiao. Deficiency constipation: mostly seen in long-term illness or habitual constipation, to the old and weak and frail people, the course of the disease is longer, so the treatment only need to slowly collect power, do not be under the name of false, presumptuous supplementation. Yin deficiency and blood: constipation, hard to get down, lips and nails, waist and knees, dizziness, palpitations, pale tongue, fine pulse. The treatment is to nourish yin and blood, lubricate the intestines and pass stools, with the addition and subtraction of five kernel pills: cypress seed kernel, pine seed kernel, YuLiRen, wolfberry each 12g, raw land, the birth of the first 15g, Cistanches 10g, flaxseed 20g, ChenPi 10g, licorice 5g. The nature of this formula is calm and peaceful, and it can be made as a honey pill to serve long. If Qi is weak, add Astragalus 20g, Platycodon 10g. Yin deficiency and fire: constipation, dizziness, tinnitus, heartburn and heat, or hot flashes and night sweating. The tongue is red with little moss, and the pulse is fine. The treatment is to nourish the yin and lower the fire, increase the water to move the boat, with the increase of liquid soup with lily of the valley soup flavored: 30g of raw land, lily of the valley, maitong 12g, XuanShenGen 15g, white peony 10g, licorice 5g. If the stool is dry and hard, hard and astringent, plus the raw rhubarb 3g manzanite 10g. qi deficiency is not transported: to defecation is mainly not, the stool does not have to be dry and knotty. Stools for several days a solution or a day several solutions, or stool is not easy to discharge, or defecation time is prolonged, or defecation after a sense of incomplete, or day-long anal swelling, or although the intention to stool, the toilet to earn the lack of strength, to earn the sweat out of shortness of breath. The color of the face is white, and the spirit is tired and timid. The tongue is pale and the pulse is thin and weak. This is often seen in the old and weak, prolonged illness. Functional outlet obstruction constipation such as anterior rectal protrusion, rectal mucosal detachment, perineal descent syndrome, etc. mostly belongs to this type. The treatment is to strengthen the spleen and qi, lubricate the bowels and pass stool, with the addition and subtraction of tonifying zhong yi qi soup: astragalus 30~60g, dang gui 30g, angelica 15~30g, tian ma, chai hu, platycodon grandiflorus, citrus aurantium, atractylodes macrocephala 10g, cistanches 20g, shen qiu 18g, licorice 6g, huo ma ren 20g, if concurrently with renal yang deficiency, accompanied by cold limbs and coldness, lumbar and knee pain, with the addition of slices of 15g, 12g of dry ginger, xin xin 3g, in order to warm and tonify the spleen and kidneys. The following is a list of the most common types of medicines. Qi deficiency and dampness obstruction: poor bowel movement, anal swelling, yellowish color, fatigue and timidity, poor appetite. White and greasy moss, thin and moist pulse. Treatment is to strengthen the spleen, dissolve dampness and pass stools, with ginseng lingbaijutsu san plus flavor: bubble ginseng, astragalus, silkworm sand, cistanches each 20g, cangbaijutsu, cloud ling, lentils, hedgehog shells, formation of the skin, apricot kernels, each 12g, coix seed 15g, sand nuts, orange root 10g, rice bran 30g. qi and yin deficiency: constipation, difficulty in defecation, or defecation is not complete. Tiredness and laziness, thirst and sweating or spontaneous sweating, dry mouth and tongue. Red tongue with little fur and thin pulse. The treatment is to benefit the qi and nourish the yin, moisten the intestines and pass the bowels, with the addition and subtraction of Si Jun Zi Tang and Zeng Yi Tang: Codonopsis pilosulae, raw Shouwu, fire Ma Ren each 20g, Atractylodes macrocephala, Radix et Rhizoma Dioscoreae 12g, Xuan Shen Maitong each 15g, licorice 5g, and for those who suffer from severe constipation, rhubarb, manganese nitrate can be added. Water-qi condensation: constipation, palpitation, chest tightness, dizziness, shortness of breath, or swelling, thirst and not much water or water into the vomit, urination is short and astringent and unfavorable, the face is green and dull, the tongue is slippery, and the pulse is heavy and stringy. The treatment is to warm the yang and transform the qi, diuresis and laxative, with five ling san plus flavor poria, poria, atractylodes 12g each, ze diarrhea 15g, gui zhi 10g, cistanche 20g. this evidence is rare, mostly due to the deficiency of the spleen and kidney yang, do not bear vaporization, so that the water and qi congealed, the fluid does not spread, the large intestine is not moist. Prof. Liu Du Zhou believes that this evidence of water disease seems to be dry, all due to the fluid is not distributed. If the mistake for dry treatment and cast the greasy Yin soft products, will help Yin cutting Yang, so that the water without control, often abdominal distension and swelling of the limbs, food and drink, gasping and death, so not be cautious! Yin cold stagnation: hard and astringent feces, long and clear urine, cold limbs, or abdominal gas distension or pain, get warm pain. The tongue is pale, and the pulse is slow and weak. In addition, the above evidence if add rice bran 30~60g effect is better. Cover rice bran is pungent, sweet and flat, enter hand, foot yangming meridian. Rich in oil, glutathione and a variety of glycerol, free fatty acids, vitamins B and E, etc., and has anti-tumor effect, “can wear down the stomach in the old accumulation also”. I experience that it has the function of opening the spleen and stomach, eliminating food stagnation, cleansing the stomach and intestines of the turbid and corrosive gas, laxative effect. [Acupuncture and moxibustion qigong single prescription for constipation] folk constipation single prescription is quite a lot, the efficacy of which there are Raw rhubarb 2 ~ 5g or senna 5 ~ 10g of boiled water soak service, the main treatment of solid constipation. Betel nut 15g, thick Park, orange leaf 9g each water decoction, the main treatment of gas constipation. Sesame oil or bee honey in appropriate amount orally, treating constipation with deficiency of yin and blood. Astragalus, flaxseed 30g each, Suzi 15g decoction, treating constipation of qi deficiency. Silver fungus daily 30g decoction with sugar, or 30g of raw Shouwu decoction; or Angelica sinensis, Cistanche 20g decoction tea. All can cure habitual constipation. Surgical treatment of constipation] Anterior rectal herniation Transvaginal repair Hodgkin’s repair Superimposed suture repair Transrectal repair Superimposed suture repair Sclerotherapy Injection PPH incision and suture Rectal endodermal detachment/internal condylomata PPH incision and suture Sclerotherapy PPH incision and suture Sclerotherapy Sclerotherapy Injection PPH incision and suture + suture Suture Mucosal incision and suture Publica recta myocardial sign Transanal dissection Transcoccygectomy Transection of caudasacral region Transection of caudasacral region Partial resection Transection of caudasacral region Inversion of encasement Colonic redundancy Partial colectomy anastomosis Colonic paralysis (slow transmission of the colon) Total colectomy Ileo-rectal anastomosis Partial colectomy Subtotal colectomy Selective colectomy anastomosis.