Objective To assess the efficacy and safety of Chinese herbal medicines for chronic functional constipation. Methods We searched CNKI (1989 to November, 2009), CBM (1989 to November, 2009), VIP (1989 to November, 2009), Cochrane Library (Issue 4, 2009), PubMed (1966 to November, 2009) and EMbase (1986 to November, 2009). All randomized and quasi-randomized clinical trials of treating chronic functional constipation with Chinese herbal medicines versus untreated, placebo or western drug groups were included. Data were extracted independently by two reviewers. The methodological quality of trials was evaluated with Cochrane Handbook 5.0.2 criteria. Meta-analyses were conducted by the RevMan 5.0 software. Results Twenty-one trials involving 2 602 patients were included. The Meta-analysis results showed that: Chinese herbal medicines improved both syndromes and colonic transit function of recipients; moreover, it is superior to both gastrointestinal prokinetic agent in effective rate (RR=1.18, 95%CI 1.12 to 1.25), healing rate (RR=1.59, 95%CI 1.35 to 1.88), and cathartic in effective rate (RR=1.18, 95%CI 1.10 to 1.27), healing rate (RR=1.16, 95%CI 1.29 to 2.10). Integration of Chinese herbal medicines and gastrointestinal prokinetic agent is superior to gastrointestinal prokinetic agent in effective rate (RR=1.21 95%CI 1.09 to 1.34) and healing rate (RR=1.41, 95%CI 1.11 to 1.79). Conclusion Some Chinese herbal medicines may be effective and safe in treating chronic functional constipation, which can not be bly proved at present for lack of studies with high quality.
Objective To investigate the current status of constipation during postoperative hospitalization and the factors associated with moderate to severe constipation at discharge in lung cancer patients. Methods Lung cancer patients who underwent surgery in 6 tertiary hospitals in Sichuan Province from November 2017 to January 2020 were enrolled. The MD Anderson Symptom Scale-Lung Cancer Module was used to collect postoperative constipation scores. Unconditional logistic stepwise regression was used to analyze the related influencing factors for moderate to severe constipation on the day of discharge. Results Finally 337 patients were collected. There were 171 males and 166 females, with an average age of 55.0±10.3 years. Constipation scores of lung cancer patients increased from postoperative day 1 to day 3, and showed a decreasing trend from day 3 to day 7. Moderate to severe constipation was present in 68 (20.2%) patients at discharge. The postoperative hospital stay (OR=0.743, P<0.001) and the dose of morphine used during postoperative hospitalization (OR=1.002, P=0.015) were influencing factors for moderate to severe constipation at discharge in lung cancer patients. ConclusionLung cancer patients have the most severe constipation on postoperative day 3. Moderate to severe constipation at discharge is associated with the postoperative hospital stay and the dose of morphine used during postoperative hospitalization.
Objective To summarize the short-term efficacy， surgery complications， and relative experiences in the management of severe functional constipation （SFC） under laparoscopy-assisted subtotal colectomy combined modified Duhamel procedure. Methods All the data of 15 patients underwent laparoscopy-assisted subtotal colectomy combined modified Duhamel procedure from March 2010 to August 2011 were collected retrospectively， all the patients were diagnosed as SFC and failed to conservative therapy. The postoperative short-term efficacy， complications of surgery， score of gastrointestinal living condition， and improvement degree of defecation were analyzed. Results All 15 procedures achieved success， the operation time was （247.33±55.10） min， the intraoperative blood loss volume was （107.33±45.59） ml， the incision length was （8.40±2.41） cm， the postoperative out of bed activity time was （2.27±1.28） d，the postoperative passage of gas by anus time was （2.60±1.89） d， the postoperative defecation time was （2.87±2.50） d，the postoperative foods taken per oral time was （3.07±1.16） d， the hospital stay was （12.64±2.37） d. Approximately on day 3-4 after operation， 10 patients presented with postoperative diarrhea but were all under control with antidiarrheals efficiently. One patient presented with incomplete bowel obstruction on day 8 after operation and one patient with stomal leakage complicated with deep infection on day 9 after operation， who both recovered under conservative therapy. The scoreof gastrointestinal living quality on month 1 after operation was significantly higher than that on day 1 before operation （121.80±4.72 versus 90.80±7.24， P=0.000）， and the improvement degree of defecation was （0.81±0.56）%. Conclusions From the limited case informations， the laparoscopy-assisted subtotal colectomy combined modified Duhamel procedure has a certain short-term curative effect in treatment for SFC with the advantages of faster recovery， less bleeding， shorter hospital stay， and fewer complications.
ObjectiveTo systematically evaluate the related factors of constipation in patients with stroke. MethodsCochrane Library, PubMed, Web of Science, Embase, CNKI, VIP, Wanfang and China Biomedical Literature Database were searched by computer, and the retrieval time was set to May 2022. Case-control studies, cohort studies and cross-sectional studies on stroke and constipation were selected. Meta-analysis was performed using RevMan 5.3 software. ResultsA total of 13 studies involving 2 834 patients were included. Meta-analysis showed that age [odds ratio (OR) =2.54, 95% confidence interval (CI) (1.36, 3.73), P<0.001], lesion location [OR=1.98, 95%CI (1.27, 3.11), P=0.003], National Institutes of HealthStroke Scale score [OR=0.40, 95%CI (0.10, 0.70), P=0.010], hemiplegia [OR=4.31, 95%CI (2.59, 7.17), P<0.001], dysphagia [OR=2.32, 95%CI (1.27, 4.25), P=0.006], antidepressants [OR=2.33, 95%CI (1.62, 3.34), P<0.001], BI score [OR=−17.08, 95%CI (−33.07, −1.08), P=0.04], eating pattern [OR=4.18, 95%CI (1.16, 15.09), P=0.030], drinking water volume ≥800 mL [OR=0.30, 95%CI (0.19, 0.46), P<0.001] might be the influencing factors of constipation in patients after stroke. The results of sensitivity analysis showed that age, education level, diabetes, smoking, stroke type, lesion location, diuretic and BI score might be the influencing factors of constipation after stroke (P<0.05). The results of bias analysis suggest that publication bias is less likely. Conclusions There are many risk factors for constipation in patients with stroke. Current evidence shows that age, diabetes, smoking and other 11 factors may be risk factors for stroke constipation, while high education level and drinking water ≥800 mL may be protective factors, and the other influencing factors have not been determined and need further study.
ObjectiveTo investigate changes in anal dynamics and anorectal sensory function in patients with irritable bowel syndrome with constipation (IBS-C) and detect its status of basin’s myoelectric pressure. MethodsThirty-six patients with IBS-C (IBS-C group) and 28 healthy volunteers (control group) were collected. The rectal-anal canal pressure and the change of the basin’s myoelectric status were detected by the ZJ-D3 gastrointestinal motility tester and bio-stimulus feedback instrument, respectively. The anal canal resting pressure, rectal resting pressure, anorectal pressure difference, length of anal canal high pressure area, rectal sensation threshold, rectal compliance, and basin’s myoelectric voltage were compared between these two groups. ResultsThere were no significant differences in the rectal resting pressure and anal canal resting pressure between the IBS-C group and the control group (t=–2.312, P=0.851; t=–5.464, P=0.283), but the difference value of anorectal pressure of the IBS-C group was significantly higher than that of the control group (t=4.371, P=0.017), and the length of the anal canal hypertension area in the IBS-C group was significantly longer than that of the control group (t=6.180, P=0.042). The maximal and minimum basin’s myoelectric voltage and frequency of the basin’s myoelectric voltage in the IBS-C group were significantly higher than those in the control group (t=3.386, P=0.031; t=5.763, P=0.042; t=8.410, P<0.001). ConclusionAnorectal dynamics and rectal sensory dysfunction are one of important causes of IBS-C, it might be existed abnormal changes in basin’s myoelectric voltage.
ObjectiveTo evaluate the functional outcomes and quality of life in patients with surgery for slow transit constipation (STC).MethodsFrom March 2013 to July 2017, 29 patients undergoing total or subtotal colectomy for STC in our department were analyzed prospectively. Their preoperative and postoperative 1-year follow-up details were analyzed. Evacuation function of all patients was assessed by bowel movements, abdominal pain, bloating, straining, laxative, enema use and the Wexner constipation scales. Quality of life was evaluated by the Gastrointestinal Quality of Life Index (GIQLI) and the short-form (SF)-36 survey.ResultsA high number of patients (93.1%, 27/29) in STC stated that surgery received benefits to their health. Compared with that before operation, the number of bowel movements per week during a 1-year follow-up increased significantly (31.6±19.9 vs. 1.21±0.6, P<0.05). Significant trends toward improvement of bloating, straining, laxative and enema use were noted 1-year following surgery (P<0.05). The Wexner constipation scales scores during a 1-year follow-up decreased significantly (5.69±3.4 vs. 20.34±0.6, P<0.05). The GIQLI scores during a 1-year follow-up increased significantly (120.7±20.4 vs. 78.6±17.3, P<0.05). Moreover, results of SF-36 showed significant improvements in 7 spheres (role physical, role emotional, physical pain, vitality, mental health, social function and general health) during a 1-year follow-up compared with those before operation (P<0.05).ConclusionTotal or subtotal colectomy for STC did not only alleviate constipation symptoms dramatically, but also received significant improvements in the patients’ quality of life.
Objective To study the neuropathological changes of gastrin and substance P(SP) in the intermuscular and submucous nerve plexus of the colonic walls in patients with delayed motor constipation(DMC).MethodsGastrin and rabbit SP polyclonal antibiotics were used to make an immunohistochemical staining of the samples of different segments obtained from 10 patients with DMC and 8 normal subjects(control group) for a comparative observation as well as a relative semi-quantitative analysis.Results The immune positive nerve cells of gastrin and SP in the intermuscular nerve plexus of colon with DMC were markedly reduced; no differences in the immune response of gastrin and SP in the mucous nerve plexus were found between the two groups(P＜0.01). With routine HE staining, focal inflammation occurred in the mucous membrane of DMC colon and that the neuronal vacuolus of the intermuscular nerve plexus degenerated, reduced and even disappeared. Conclusion The abnormal changes of the neural structure in the immune reponse of gastrin and SP in the intermuscular nerve plexus of colon with DMC might be related to reduction of gastrin and SP peptide neuron or dysfunctional.
Objective To investigate the express of ERβ protein in female slow transit constipation (STC) patients. Methods Immunohistochemistry and Western blot technique were used to detect the distribution and expression of estrogen receptor β (ERβ) protein of 20 patients with STC and 20 aged-matched controls. Results ERβ expressions were detected in mucous layer, myenteric nerve plexus and submucous nerve plexus in two groups. In comparison with the control group, the expression of ERβ protein of STC group was much lower (Plt;0.01). The expression of ERβ protein of sigmoid colon in STC group was significantly lower than that in control group (Plt;0.05). Conclusion The expression of ERβ protein decreased in myenteric and submucous nerve plexus of sigmoid colon tissues may involve in the pathogenesis of STC.
ObjectiveTo explore the clinical effect of healthy education on functional constipation caused by unhealthy lifestyle, and to analyze the disadvantages affecting the curative effect. MethodsA total of 167 cases of functional constipation from February 2009 to February 2012 were included. All of the patients were followed up for one year. We collected clinical data of curative effect and influencing factors, determined the clinical value of healthy education, and analyzed the influence of different factors on the curative effect of healthy education. ResultsThe total curative effect after one-year follow-up was 84.4%. The curative effect in elderly patients was significantly higher than that in middle-aged ones (P<0.05). The curative effect in urban patients was remarkably higher than that in rural ones (P<0.05). And the curative effect of patients with college degree wass much higher than that in patients with education background of primary school or below (P<0.05). ConclusionHealthy education has important value on releasing and eliminating functional constipation caused by unhealthy lifestyle. And it needs individual education aimed at patients with different age, education degree, and domicile.
ObjectiveTo explore etiopathogenesis of slow transit constipation(STC). MethodsThe model of rat with “cathartic colon” was established, and the changes of colonic electromyography of the rat was examined. ResultsThe frequency and amplitude of slow wave in vivo of rats with cathartic colon was decreased markedly. Postmeal spike potential and duration was decreased, showing that gastrocolonic reflex of rats colon was decreased.ConclusionLong term abuse of stimulant laxuatives could damage enteric nervous system and accelerate the pathological changes of STC.