OBJECTIVETo explore the optimal therapy for constipation of excess fu syndrome due to phlegm heat in acute cerebral infarction.

METHODSOne hundred and sixty cases were randomized into acupuncture plus herbal medicine group, Chinese herbal medicine group, acupuncture group and Glycerine Enema group, 40 cases in each one. All the patients of 4 groups had received the conventional management in neurological internal medicine department and acupuncture according to the theory of SHI's regaining consciousness. Additionally, in acupuncture plus herbal medicine group, acupuncture and oral administration of Chinese herbal medicine were adopted. Acupuncture was applied to Shaoshang (LU 11), Shangyang (LI 1), Fenglong (ST 40), Tianshu (ST 25), Zhigou (TE 6), etc. Chinese herbal medicine was composed of Jinyinhua (Lonicera Japonica), Liangqiao (Fructus Forysthiae; Weeping Forsythia), Huangqin (Radix Scutellariae), Zhizi (Gardenia jasminoides Ellis; Cape Jasmine), Dannanxing (Rhizoma Arisaematis Cum Bile), Quangualou (Fructus Trichosanthis), etc. In acupuncture group, acupuncture was used simply. In Chinese herbal medicine group, only Chinese herbal medicine was administered orally. In Glycerine Enema group, Glycerine Enema was adopted. The interval time of defecation, stool quality, efficacy on constipation and nerve function score in 7 days and 21 days after treatment were compared among groups.

RESULTSAfter 7 days treatment of constipation, the total effective rate was 97.5% (39/40) in acupuncture plus herbal medicine group, which was superior apparently to 87.5% (35/40) in Chinese herbal medicine group, 82.5% (33/40) in acupuncture group and 80.0% (32/40) in Glycerine Enema group (all P < 0.05). After 21 days treatment, the total effective rate of constipation was 92.5% (37/40) in acupuncture plus herbal medicine group, which was superior apparently to 82.5% (33/40) in Chinese herbal medicine group. 80.5% (32/40) in acupuncture group and 67.5% (27/40) in Glycerine Enema group (all P < 0.01). The differences in the interval time of defection, stool quality and nerve function score after 7 days and 21 days treatment were significant statistically in comparison among 4 groups (P < 0.05, P < 0.01). The results in acupuncture plus herbal medicine group were superior apparently to the other groups.

CONCLUSIONThe integrated acupuncture and herbal medicine is effective definitely on constipation in acute cerebral infarction. Additionally, this therapy may improve the clinical efficacy of cerebral infarction and suggest the coordination between acupuncture-moxibustion and Chinese herbal medicine.