防風通聖散與大腸生理迴饋對慢性便秘患者之臨床研究

The Evaluation of Therapeutic Effects of Fang Feng Tong Sheng Powder and Colon Biofeedback on Chronic Constipation

慢性便秘約佔所有人口的5%左右，在臨床工作上常常會遇到此類患者的求診。此病症的原因很多，是困擾著人類久遠的疾病之一，中醫傳統的辨証分型加上中藥方劑對便秘的治療，雖然對症狀的改善有不錯的成績，但在根治方面亦與西藥一樣沒有很高的治癒率。本研究針對經確定診斷為慢性便秘患者 47 例，經 SITZMARK 測其大腸之傳送時間屬大腸蠕動不良型佔 25.55%及末端蠕動不良型佔 74.44%；而中醫的分類則分為熱結型佔 42.55%，氣滯型佔23.40%，氣虛型佔 10.63%，血虛型佔 6.38%，陰虛型佔8.51%，陽虛型佔14.80%。所有患者經防風通聖散治療，並以 Wilcoxon Signed Pank Test 等進行統計分析其大腸蠕改變情形，結果為有意義的改善，改善率為 82.7%；但中藥治療後若停藥則其症狀又復發，停藥兩週後其便秘復發率為 75%，這與目前大部份的中藥或西藥治療便秘情形相同，但經防風通聖散治療後，若再接受大腸生理迴饋控制，其便秘復發率只有 15%，故利甪防風通聖散加上大腸生理迴饋之訓練對於性便秘之治療是一有效之方法。

The incidence of chronic constipation is approximately 5% of the total population. There are many patients in the clinic seeking treatment. The causes of chronic constipation are multiple, and its pathophysiology is also very complex. It is one of the diseases that have long troubled mankind. Although the diagnosis and herbal formula treatment of Traditional Chinese medicine for chronic constipation has achieved reasonably good results, permanent benefits have not been achieved as in Western Medicine. The present study first used accurate methods to acertain the diagnosis of chronic constipation. Then the large intestine transit time was measured according to SITEMARKS. Based to the anatomic classification of Western Medicine. The malfunction of peristalsis of the entire large intestine is 26% and that of the terminal portion of large intestine is 74%. Based on the functional classification of Traditional Chinese Medicine, Heat bind 42.55%, qi stagnation 23.40%, qi vacuity 10.63%, blood vacuity 6.38%,yin vacuity 8.51% and yang vacuity 14.8%. The changes in peristalsis was studied before and after treatment used to determine the significance of the results according to Wilcoxon Signed Rank Test in all patients. It showed that the treated group exhibited beneficial effects. However, patients treated with the Chinese herbal formula showed recurrence when medication was discontinued. The recurrence is similar whether receiving Western medication or not. However, after therapy with herbal formula, if patients receive BIOFEEDBACK of colon, the recurrence rate of chronic constipation was 15%. This significant in the treatment of chronic constipation is very important.