Clinical Efficacy of Modified Zhishi Daozhiwan on Slow Transit Constipation / 中国实验方剂学杂志

ABSTRACT

Objective::To observe the clinical efficacy of modified Zhishi Daozhiwan on slow transit constipation (STC) and the effect on gastrointestinal hormones and intestinal flora. Method::One hundred and sixty patients were randomly divided into control group and observation group by random number table. Patients in control group got Maren Wan, 1-2 pills/time, 2 times/days, and mosapride citrate tablets, 1 piece/time, 3 times/days. Patients in observation group got modified Zhishi Daozhiwan, 1 dose/day. A course of treatment was 4 weeks. Before and after treatment, the main symptoms of constipation and patient assessment of constipation symptoms (PAC-SYM) were scored. And times of spontaneous complete bowel movement (SCBM) and colonic transmission test were recorded. And levels of intestinal flora and motilin (MTL), vasoactive intestinal peptide (VIP), substance P (SP) and gastrin (GAS) were detected. The 12-week follow-up of patients (SCBM≥3) was recorded, and the relapse of disease was calculated. Result::According to rank sum test analysis, the clinical efficacy in observation group was better than that in control group (Z=2.275, P<0.05). After treatment, scores of the main symptoms of constipation, PAC-SYM, and the total score of PAC-SYM were all lower than those in control group (P<0.01). At the second, third and fourth weeks after treatment, the times of SCBM were more than those in control group (P<0.01). Ratio of residual marker at 24, 48 and 72 h was lower than that in control group (P<0.01). Count of enterococcus and enterobacter were lower than those in control group (P<0.01), while counts of bifidobacterium and lactobacillus were higher than in control group (P<0.01). Levels of GAS, MTL and SP were higher than those in control group, whereas level of VIP was lower than that in control group (P<0.01). And relapse rate in observation group was 33.85%, which was lower than 57.69% in control group (χ2=6.653, P<0.05). Conclusion::Modified Zhishi Daozhiwan can alleviate constipation and other symptoms, increase the number of SCBM, regulate gastrointestinal hormones and intestinal flora, and improve colonic transit function, with a good clinical efficacy and low recurrence rate, so it is worth clinical application.