Objective: To compare the effect of acupuncture at Huiyin (CV 1) and oral administration of western medication in treatment of chronic severe functional constipation (CSFC).
Methods: A total of 64 patients with CSFC were randomly divided into an acupuncture group (32 cases, 5 cases dropped off) and a western medication group (32 cases, 4 cases dropped off). Both groups were given routine basic treatment. The acupuncture group was treated by directly puncture of 20-30 mm at Huiyin (CV 1), once a day for the first 4 weeks, 5 times a week, once every other day for the next 4 weeks, 3 times a week, totally for 8 weeks. The western medication group was treated with 2 mg prucalopride succinate tablets orally before breakfast every day for 8 weeks. The average number of weekly spontaneous bowel movement (SBM) of the two groups were observed before treatment and 1-8 weeks into treatment. The constipation symptom score before and after treatment, and in follow-up of 1 month after treatment, as well as quality of life [patient assessment of constipation quality of life questionnaire (PAC-QOL) score and the proportion of patients of PAC-QOL score difference before and after treatment≥1] before and after treatment were compared in the two groups. The clinical effects of the two groups were evaluated after treatment and in follow-up.
Results: Compared before treatment, the average number of weekly SBM in the two groups was increased 1-8 weeks into treatment (P<0.05). The average number of weekly SBM in the acupuncture group was less than that in the western medication group 1 week into treatment (P<0.05), and the average number of weekly SBM in the observation group was more than that in the western medication group 4-8 weeks into treatment (P<0.05). The scores of constipation symptom after treatment and in follow-up and scores of PAC-QOL after-treatment in the two groups were lower than those before treatment (P<0.05), and those in the acupuncture group were lower than the western medication group (P<0.05). The proportion of patients of PAC-QOL score difference before and after treatment≥1 in the acupuncture group was higher than that in the west medication group (P<0.05). The total effective rates after treatment and in follow-up in the acupuncture group were 81.5% (22/27) and 78.3% (18/23), respectively, which were better than 42.9% (12/28) and 43.5% (10/23) in the western medication group (P<0.05).
Conclusion: Acupuncture at Huiyin (CV 1) can effectively increase the number of spontaneous defecation in patients with CSFC, reduce constipation symptoms, improve the quality of life, and the effect after treatment and in follow-up is better than oral western medication.
目的：比较针刺会阴与口服西药治疗严重慢性功能性便秘（CSFC）的临床疗效。方法：将64例CSFC患者随机分为针刺组（32例，脱落5例）与西药组（32例，脱落4例）。两组均予常规基础治疗。针刺组予直刺会阴20~30 mm，前4周每日1次，每周5次；后4周隔日1次，每周3次，共治疗8周。西药组于每日早饭前口服琥珀酸普芦卡必利片2 mg，治疗8周。观察两组患者治疗前及治疗第1~8周周平均自主排便（SBM）次数，治疗前后及治疗后1个月随访时便秘症状评分，治疗前后生活质量[便秘生活质量自评量表（PAC-QOL）评分及治疗前后PAC-QOL评分差值≥1分者占比]，并于治疗后及随访时评定两组临床疗效。结果：与治疗前比较，两组患者治疗第1~8周周平均SBM次数增加（P<0.05）；针刺组治疗第1周周平均SBM次数少于西药组（P<0.05），治疗第4~8周周平均SBM次数多于西药组（P<0.05）。两组治疗后、随访时便秘症状评分及治疗后PAC-QOL评分较治疗前降低（P<0.05），且针刺组低于西药组（P<0.05）；针刺组治疗前后PAC-QOL评分差值≥1分者占比高于西药组（P<0.05）。针刺组治疗后及随访总有效率分别为81.5%（22/27）和78.3%（18/23），均优于西药组的42.9%（12/28）和43.5%（10/23，P<0.05）。结论：针刺会阴可有效增加CSFC患者自主排便次数，减轻便秘症状，提高生活质量，治疗后及随访时疗效均优于口服西药。.
Keywords: Point CV 1 (Huiyin); acupuncture; chronic severe functional constipation; quality of life; randomized controlled trial (RCT).