Chronic constipation, a common clinical chronic digestive disorder, is a chronic, primary, functional condition with various causes of intestinal motility dysfunction and delayed transmission of intestinal contents. The main clinical manifestation is a longer period of reduced stool frequency, no bowel movement, or involuntary bowel movement. The majority of patients have abdominal distension and nappiness. The prevalence in Western countries is 2%-27%, with more women than men.
China’s Beijing, Tianjin and Xi’an over 60 years of age people with chronic constipation up to 15-20%. Has become a difficult disease that endangers society. At present, Western medicine mainly uses a variety of laxatives such as liquid paraffin oil, sulfates, etc., although the momentary effect can be achieved, but the long-term use of side effects, but also easy to produce drug-dependent type, some can cause colonic melanosis, colonic ganglion cell damage, and even induce serious complications such as gastrointestinal tumors. In recent years, we use double work to regulate intestinal pill treatment of chronic constipation, the efficacy is more significant, summarized as follows.
1.Data and methods
1.1 Clinical data According to the Rome III diagnostic criteria, at least two or more of the following criteria are met (at least 25% of defecation has struggle; at least 25% of defecation is hard stool; at least 25% of defecation has incomplete emptying; at least 25% of defecation has anorectal obstruction; at least 25% of defecation needs manual assistance (such as finger defecation, supporting the pelvic floor)
①Stressful defecation;
②Lumpy/hard stools;
③Sense of incomplete evacuation of stool;
④Anorectal obstruction or blockage;
(⑤) Manual assistance for defecation;
(6) Defecation less than 3 times per week;
(⑦) Thin stools are rare in patients who do not use laxatives;
⑧ Not enough to diagnose IBS;
⑨ Symptoms should have been present for 6 months prior to diagnosis, and symptoms in the last 3 months must meet the diagnostic criteria. 1125 patients, all of whom met the criteria. Clinical data were complete, 428 men and 697 women, age 20-84 years, average age 49 years, duration of disease 2 months-35 years, average duration of disease 12 years, patients were outpatients of Linyi City Hospital of Traditional Chinese Medicine from 2005-2008.
1.3 Treatment method: Shanshu Yunyunwan (Lu Pharmaceutical System Z1420030028): the main ingredients are: Atractylodes macrocephala 30g, Shengdi 30g, Yam 30g, Chenpi 9g, Angelica sinensis 15g, He Shouwu 15g, etc. Oral administration: 9g once, 3 times a day, served with warm water. The shortest course of oral treatment was two weeks and the longest was 1.5 years in the above cases.
1.4 Criteria for judging the efficacy: according to the Interim Criteria for the Diagnosis and Treatment of Constipation formulated by the Seminar on the Diagnosis and Treatment of Constipation held by the Editorial Committee of the Chinese Medical Journal in November 1990.
①Cure: frequency of defecation is 1 time every 1~3d, soft and shaped, defecation time is not more than 5 min, and colon transport test shows that 80% or more of the markers are excreted within 72 hours.
②Improved: the frequency and duration of defecation improved, and the number of markers excreted within 72 h improved in the colonic transport test.
③Not effective: no improvement in the frequency and duration of defecation. The colonic transport test showed no improvement in the number of excreted markers within 72 h.
2.Results
1125 patients were treated with oral Shanzhu Yunyun intestinal pill, 1013 cases (90.04%) were cured; 68 cases (6.04%) were improved; 44 cases (3.91%) were invalid, and the total effective rate was 96.09%. The total effective rate was 96.09%. The treatment effect was remarkable.
3.Discussion
Chronic constipation is also known as idiopathic constipation, habitual constipation, functional constipation. “Chronic” refers to a history of more than 2 years, or the onset of the disease at a young age; “idiopathic” indicates that the causes of constipation and epidemiological understanding is still incomplete; “persistent” means that the general drug The term “recalcitrant” means that constipation is difficult to be treated by general medications and non-surgical methods and often requires surgery.
Constipation is one of the most common clinical symptoms, surpassing other GI symptoms. The prevalence of constipation in the population is 3-4%. Epidemiological surveys have confirmed that constipation is associated with age, gender, diet, occupation, genetics, medications, education, family income, area of residence, as well as race, marriage, and personality.
The clinical manifestations of chronic constipation are reduced natural stool >2-3 times/week, dry and hard stool, difficulty in discharge with anal drop, perineal distension, incomplete defecation, thinning of stool, obstruction, and abdominal distension and pain.
The spleen is the main organ of transportation, if the spleen is deficient in transportation, and the dregs are stagnant, the large intestine will lose the function of conduction; the lung and the large intestine are adjacent to each other, if the lung is hot and dry, the lung will move down to the large intestine, and the intestine will be dry and dry; the liver is the main organ of qi, if the liver is depressed and stagnant, the internal qi will be blocked, and the qi will not work; the kidney is responsible for the two stools, if the kidney is deficient in yin, the intestine will not be moistened, and the stool will be dry. If the kidney yin is insufficient, the bowel will be deprived of moistening, and the stool will be dry. In response to the causes of constipation, we developed the special medicine “Shan Zhu Yun Yin Wan”.
In this formula, yam enters the spleen and kidney, strengthens the spleen and nourishes the kidney; Atractylodes macrocephala strengthens the spleen and benefits the qi; Angelica sinensis nourishes the blood and invigorates the blood, moistens the bowels and opens the bowels; Chen Pi moves the qi and strengthens the spleen; Sheng Di nourishes the yin and nourishes the kidney; He Shou Wu nourishes the blood and nourishes the kidney. Its action is not to directly pass stools, but to regulate the function of the internal organs related to the function of the large intestine to promote the recovery of the function of the large intestine to normalize the stools. This is fundamentally different from the previous “laxative” therapy. Clinical results show that this preparation has significant efficacy in treating blood deficiency, qi deficiency and blood heat constipation.