OBJECTIVETo compare the efficacy between acupuncture with smoothing liver and regulatingand lactulose for post-stroke slow transit constipation(STC) and to explore the mechanism.

METHODSSixty patients were randomized into an acupuncture group and a medication group,30 cases in each one. Based on the comprehensive stroke unit care,acupuncture with smoothing liver and regulatingwas used at Danzhong(CV 17),Qihai(CV 6),Tianshu(ST 25),Neiguan(PC 6),Gongsun(SP 4) and Taichong(LR 3) in the acupuncture group,once a day. Lactulose oral liquid was taken at a draught in the morning in the medication group,20 to 30 mL a time,once a day. The study period was 11 weeks,including 1-week baseline evaluation,6-week treatment and 4-week follow-up. We recorded the time of the first independent defecation,constipation symptom score,and gastrointestinal hormone level,including somatostatin(SS),motilin(MTL),P substance(SP) and vasoactive intestinal peptide(VIP). Also,the side effects were recorded at any time.

RESULTSThe time of the first independent defecation was (30.18±16.14) h in the acupuncture group,which was significantly different from (43.22±28.42) h in the medication group(<0.05). The constipation scores after 6-week treatment and at follow-up were lower than those before treatment in the two groups (all<0.05),with better results in the acupuncture group(both<0.05). MTL and SP increased,as well as SS and VIP decreased after treatment in the two groups(all<0.05). The changes were better in the acupuncture group(all<0.05). The side effect was not observed in the two groups.

CONCLUSIONSAcupuncture with smoothing liver and regulatingachieves better effect than lactulose for post-stroke STC in terms of efficacy onset,extent,and long term. The mechanism may relate to increasing excitatory regulatory peptide and reducing inhibitory regulatory peptide.