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1.上海中医药大学 附属龙华医院,上海 200032
2.福建中医药大学 附属第二人民医院, 福州 350003
3.上海中医药大学 中西医结合学院,上海 201203
Received:22 September 2025,
Revised:2025-12-11,
Accepted:15 December 2025,
Online First:18 December 2025,
Published:05 June 2026
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何友成,单静怡,蒋风茹等.益气养阴活血方治疗泻药性结肠的疗效观察及病情影响因素分析[J].中国实验方剂学杂志,2026,32(11):173-184.
HE Youcheng,SHAN Jingyi,JIANG Fengru,et al.Clinical Efficacy of Yiqi Yangyin Huoxue Prescription in Treatment of Cathartic Colon and Analysis of Influencing Factors of Disease Severity[J].Chinese Journal of Experimental Traditional Medical Formulae,2026,32(11):173-184.
何友成,单静怡,蒋风茹等.益气养阴活血方治疗泻药性结肠的疗效观察及病情影响因素分析[J].中国实验方剂学杂志,2026,32(11):173-184. DOI: 10.13422/j.cnki.syfjx.20251718.
HE Youcheng,SHAN Jingyi,JIANG Fengru,et al.Clinical Efficacy of Yiqi Yangyin Huoxue Prescription in Treatment of Cathartic Colon and Analysis of Influencing Factors of Disease Severity[J].Chinese Journal of Experimental Traditional Medical Formulae,2026,32(11):173-184. DOI: 10.13422/j.cnki.syfjx.20251718.
目的
2
观察益气养阴活血方(YYHP)治疗泻药性结肠(CC)的临床疗效及其对粪便短链脂肪酸(SCFAs)的影响,并探究CC病情严重程度之间及与病史的相关性。
方法
2
根据纳排标准,将符合气阴两虚兼血瘀证CC中西医诊断标准的98例患者随机分为观察组与对照组,分别予YYHP颗粒剂和乳果糖。两药均2次/d,每次1袋,于早晚餐后半小时服用,疗程均为8周。观测治疗前后及治疗结束后第8周两组患者的便秘主要症状评分、生活质量(PAC-QOL)评分和中医证候评分;评估两组的临床总有效率、疗效衰减指数和程度;气相色谱-质谱联用(GC-MS)法检测粪便SCFAs含量;Spearman相关性探究CC患者病情严重程度之间及与病史的相关性。
结果
2
观察组临床总有效率(95.83%)明显高于对照组(78.72%)(
P<
0.05)。治疗后两组便秘主要症状总分、PAC-QOL总分和中医证候总分均降低(
P
<
0.05),且观察组降低水平更为明显(
P
<
0.05)。两组各项便秘主要症状程度均明显减轻(
P
<
0.05),且在“过度用力排便及排便困难”“肛门下坠、排便不尽、胀感”“腹胀”“排便频率”上,观察组的疗效明显优于对照组(
P
<
0.05)。两组PAC-QOL四个维度积分和中医证候主、次证积分和程度均降低和减轻(
P
<
0.05),且观察组积分和程度降低更为明显(
P
<
0.05)。治疗后观察组乙酸、丙酸、丁酸和总SCFAs明显升高(
P
<
0.05)。观察组疗效衰减指数和程度均明显低于对照组(
P
<
0.05)。两组均未出现严重不良反应,不良反应发生率差异无统计学意义。CC患者的便秘主要症状总分、PAC-QOL总分和中医证候总分之间及与刺激性泻药服用史、病程和年龄之间存在不同程度的正相关关系。
结论
2
YYHP可有效缓解CC患者的便秘主要症状,提高生活质量,改善CC患者的中医证候,安全性好,且撤药后具有反弹程度小的优势,其机制可能与增加粪便SCFAs含量有关。长期滥用刺激性泻药可能加重CC的病情程度、延长CC病程。
Objective
2
To observe the clinical efficacy of the Yiqi Yangyin Huoxue prescription (YYHP) in the treatment of cathartic colon (CC) and its effects on fecal short-chain fatty acids (SCFAs), and to explore the correlations among CC severity indicators and between these indicators and patient history.
Methods
2
According to the inclusion and exclusion criteria, 98 patients meeting the diagnostic criteria of both traditional Chinese and Western medicine for CC with the syndrome of Qi-Yin deficiency complicated by blood stasis were randomly assigned to an observation group and a control group. The observation group received YYHP granules, while the control group received lactulose. Both medications were administered twice daily, one sachet each time, half an hour after breakfast and dinner, with a treatment course of 8 wee
ks. The primary constipation symptom score, Patient Assessment of Constipation Quality of Life (PAC-QOL) score, and TCM syndrome score were assessed before and after treatment and at the 8
th
week after the end of treatment. The overall clinical effective rate, as well as the efficacy attenuation index and degree, were evaluated. Fecal SCFA levels were measured using gas chromatography-mass spectrometry (GC-MS). Spearman correlation analysis was performed to explore the correlations among CC severity indicators and between these indicators and patient history.
Results
2
The overall clinical effective rate in the observation group (95.83%) was higher than that in the control group (78.72%) (
P
<
0.05). After treatment, the total scores for primary constipation symptoms, PAC-QOL, and TCM syndromes decreased in both groups (
P
<
0.05), with more significant reductions in the observation group (
P
<
0.05). The severity of all primary constipation symptoms was alleviated in both groups (
P
<
0.05). In terms of "excessive straining and difficult defecation", "anal heaviness, incomplete evacuation, and bloating sensation", "abdominal distension", and "defecation frequency", the observation group showed better efficacy than the control group (
P
<
0.05). Scores of the four PAC-QOL dimensions and the scores and severity of primary and secondary TCM symptoms were reduced in both groups (
P
<
0.05), with more significant reductions in the observation group (
P
<
0.05). After treatment, acetic acid, propionic acid, butyric acid, and total SCFAs in the observation group increased significantly (
P
<
0.05). The efficacy attenuation index and degree in the observation group were lower than those in the control group (
P
<
0.05). No severe adverse reactions occurred in either group, and there was no statistically significant difference in t
he incidence of adverse reactions between the two groups. Positive correlations of varying degrees were observed among the total scores of primary constipation symptoms, PAC-QOL, and TCM syndromes, as well as between these scores and the history of stimulant laxative use, disease duration, and age.
Conclusion
2
YYHP can effectively alleviate the primary constipation symptoms in CC patients, improve quality of life, and ameliorate TCM syndromes, with good safety. It also has the advantage of a lower rebound degree after drug withdrawal, and its mechanism may be related to increasing fecal SCFA levels. Long-term abuse of stimulant laxatives may aggravate the severity of CC and prolong the disease course.
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