六磨湯治療慢性機能性便秘之研究

Evaluation of ＂Liu Mo Tang＂ for Chronic Functional Constipation

慢性機能性便祕是臨床診療上最常見的愁訴之一。28例經過檢查確定為慢性機能性便秘之病人，隨機分成實驗組 16 例及對照組 12 例。實驗組給予中藥六磨湯每次四公克，一天早晚二次服用；對照組給予生藥製劑 Eucarbon 每次二粒，一天早晚二次服用；兩組乏治療程各為八週。比較其排便次數(frequency)、糞便硬度(consistance)及症狀改善之情形。一共有 17 位病人在治療前口服食用色素測其全部胃腸道傳送時間(local boweltransil tim)，平均時間為 76.1 土 4.8 小時。本研究 28 例慢性機能性便祕病人中女性佔 26 例，男性只 2 例。兩組手齡十均各為 35.3 士 2.5 歲及 32.0 土 4.5 歲。實驗組排便次數由治療前平均每週 1.56 士 0.1l 次，治療後改善為平均每天 1.31 土 0.09 次；對照組治療前乎均每週 1.83 士 0.17 次，而治療後改善為平均每天 1.22 土 0.99 次；對排便次數之改善，兩組皆有明顯之效果，但兩組間無統計學上之差異。關於排便硬度，實驗組與對照組在治療前為石頭樣硬糞者各為 81.3%(13/16)及 91.6 仍(11/12)，經治療後大都改善為成形軟糞各為75.0%(l2/16及66.7%(8/l2)。病人裡急後重、頭暈等症狀，兩組皆有明顯之改善；而腹脹痛、噯氣、胸悶及食慾不振在實驗組則明顯比對照組有較好之作用(p<0.05)。治療後出現腹絞痛、食慾不振及胸悶之副作同在對照組則明顯比實驗組多(4:l)。經過治療後達痊癒者，實驗組有 3 人，對照組 1 人；顯效者實驗組有 7 人，對照組 5 人；好轉者實驗組有 6 人，對照組 6 人；而無效者則兩組均無。由以上之結果顯示六磨湯比 Eucarbon 對慢性機能性便秘具有較好之療效。本研究認為六磨湯對於慢性機能性便祕是一有效的處方。

Twenty eight chronic functional constipation subjects were prospectively randomized into experimental group (herb group, n=16, mean age=35.3 ± 2.5) and control group (n=12, mean age=32.0 ± 4.5) at division of gastroenterology, China Medical College Hospital from July 1991 to September 1992. Females were predominant in both groups, only 2 of 28 subjects were male in this study. The herb group was treated with 'Liu Mo Tang' (L.M.T.),4 g twice daily for 8 weeks, and control group was treated with Eucarbon 2 tablets twice daily for 8 weeks. Parameters for evaluation included fecal frequency, fecal consistency and the symptoms of consitpation. Before treatment, 17 out 28 subjects were evaluated with total bowel transit time (TBTT). The mean TBTT was 76.1 ± 4.8 hours. The result of this study indicated that the fecal frequency had increased from 1.56 ± 0.11 per week to 1.31 ± 0.09 per day after treatment in berb group and from 1.83 ± 0.17 per week to 1.22 ± 0.09 per day in control group. In addition, the fecal consitency were changed from stony hard 81.3% (13/16) to soft 75% (12/16) in herb group and 91.6% (11/12) to 66.7% (8/12) in control group. Significant improvement (p<0.05) of tenesmus and dizziness in both group was noted. Improve went in abdominal pain, fullness, belching, chest tightness, and anorexia in the experimental group showed that the herbal treatment was significantly more effective. The frequency of adverse effects including abdominal cramping, anorexia and chest tightness was 1/16 in herb group and 4/12 in control gorup. Complete recovery from functional constipation was 3/16 in herb gtoup and 1/12 in control group. Excellent response were 7/16 vs 5/12 and partial response were 6/16 vs 6/12 in herb group and control group respectively. Our results indicated that L.M.T. was better than Eucarbon in treatment of chronic functional constipation.