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.

Acupuncture Therapy ; Adult ; Aged ; Cerebral Infarction ; complications ; Combined Modality Therapy ; Constipation ; drug therapy ; etiology ; therapy ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Male ; Middle Aged

PURPOSE: This study was done to identify effects of carbonated water intake on constipation in elders who have experienced a cerebrovascular accident (CVA) and are bed-ridden. METHODS: Forty elderly patients with CVA were randomly assigned to one of two groups in a double-blind study. Patients in the experimental group drank carbonated water and those in the control group drank tap water for two weeks. Six patients dropped out during the study period. Data were analyzed by repeated measured ANCOVA and the covariance was the dose of laxatives used for the two weeks. RESULTS: Frequency of defecation increased significantly and symptoms of constipation decreased significantly for patients in the experimental group. CONCLUSION: The study results suggest that the intake of carbonated water is an effective method for the intervention of constipation in elderly patients with CVA.
Aged ; Analysis of Variance ; Carbonates/*therapeutic use ; Constipation/complications/*drug therapy ; Double-Blind Method ; Female ; Humans ; Laxatives/therapeutic use ; Male ; Middle Aged ; Stroke/*complications

OBJECTIVETo compare the difference among the combined method of oral administration of forlaxand acupoint embedding therapy, the simple acupoint embedding therapy and the simple oral administration of for-lax in the clinical efficacy on diabetic constipation.

METHODSOne hundred and fifty patients were randomized intoa comprehensive group, an acupoint embedding group and a forlax group, 50 cases in each one. In the acupointembedding group, the embedding therapy was applied to bilateral Tianshu (ST 25), Daheng (SP 15), Shangjuxu(ST 37) and Dachangshu (BL 25), once a week. In the forlax group, forlax (polyethylene glycol) was prescribedfor oral administration, once a day, 10 g each time. In the comprehensive group, the acupoint embedding therapyand forlax were combined and the methods were the same as the first two groups. The treatment for 4 weeks wasas one session, and 2 sessions were required in the three groups. Separately, in 4 weeks, 8 weeks of treatment and2 months after treatment, the constipation symptom scores were compared among the three groups. At the end of2 sessions of treatment, the clinical efficacy and adverse reactions were compared among the three groups. In2 months after treatment, the recurrence rate was compared among the three groups.

RESULTSThe total effectiverate was 98. 0% (49/50) in the comprehensive group, better than 86. 0% (43/50) in the acupoint embeddinggroup and 78. 0% (11/50) in the forlax group (both P<0. 01). In the 4 weeks and 8 weeks of treatment, the con-stipation symptom scores were reduced significantly as compared with those before treatment in the three groups(all P<0. 05). The results in the comprehensive group were lower than those in the other two groups (all P<0. 05). In the 4 weeks of treatment, the scores were not different significantly between the acupoint embedding group and the forlax group (P>0.05). In 8 weeks of treatment and 2 months after treatment, the scores in the acupoint embedding group were better tan those in the forlax group (all p<0.05). There were 2 cases of drug adverse reaction in the comprehensive group, 6 cases in the forlax group and 0 case in the acupoint embedding group. The recurrence rate was 8.1% (4/49) in the comprehensive group, lower than 32.6% (14/43) in the acupoint embedding group and 59.0% (23/39) in the forlax group (both P<0.01).

CONCLUSIONthe combined therapy of acupoint embedding and forlax achieves the better clinical efficacy on diabetic constipation and constipation symptom scores as compared with the simple acupoint embedding therapy and the oral administration of forlax the short-term efficacy of the simple acupoint embedding therapy is not different significantly from the simple forlax medication, but the long-term efficacy and safety are better than those of simple forlax medicaiton.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Aged ; Combined Modality Therapy ; Constipation ; drug therapy ; etiology ; physiopathology ; therapy ; Defecation ; Diabetes Complications ; complications ; physiopathology ; Female ; Humans ; Laxatives ; administration & dosage ; Male ; Middle Aged ; Polyethylene Glycols ; administration & dosage ; Treatment Outcome

OBJECTIVETo investigate the efficacy and safety of polyethylene glycol 4000 on adult patients with functional constipation due to posttraumatic confinement to bed.

METHODSA total of 201 posttraumatic bedridden patients were studied in this prospective, open-labeled, single-group study. Polyethylene glycol 4000 was administered orally for 14 days and the dosage was adjusted according to the Bristol stool types. Demographic characteristics, disease status, treatment period and factors affecting clinical outcome, especially the concomitant medications, were recorded.

RESULTSAfter administration of polyethylene glycol 4000, 194 cases (96.52%) showed remission of constipation, including 153 (76.12%) persistent remission. The average defecation frequency increased significantly after treatment and the percentage of patients with stools of normal types (Bristol types 3-5) increased as well. Genders, ages and concomitant medications showed no significant influence on the persistent remission rate. After consecutive treatment for two weeks, patients with slight movement showed a significantly higher remission rate than those without movement (95% vs 80%). At the end of treatment, most accompanying symptoms were relieved obviously. Patients with a medical history of constipation or ever taking laxatives showed a lower remission rate. Sixty cases (29.85%) developed diarrhea during the observational period, among whom 6 (10%) withdrew from the clinical observation voluntarily at the first onset of diarrhea. Two cases suffered from abdominal pain.

CONCLUSIONSPolyethylene glycol 4000 has efficacy on functional constipation in posttraumatic bedridden patients. Furthermore, patients with milder symptoms, more movement in bed, and longer duration of treatment but without accompanying symptoms can achieve a higher remission rate.

Adolescent ; Adult ; Aged ; Bed Rest ; Constipation ; drug therapy ; etiology ; Female ; Humans ; Male ; Middle Aged ; Polyethylene Glycols ; adverse effects ; therapeutic use ; Prospective Studies ; Wounds and Injuries ; complications

Adult ; Aged ; Constipation ; drug therapy ; etiology ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Phytotherapy ; Stroke ; complications

OBJECTIVETo determine the therapeutic efficacy and elucidate the probable pharmacological mechanism of Zhizhuwan (ZZ), a known formula for GI/Dysmotility and constipation in Traditional Chinese medicine, in managing constipating diabetes mellitus (DM).

METHODSubjects, composed of both males and females, ranged from 55 to 76 years of age, and had constipating DM. Subjects with severe colon, rectum, heart, renal, or hepatic disease, obesity and those on medications known to alter gastrointestinal motility were excluded. 28 healthy subjects were also recruited. The study group (n = 28) received 90 g per day of ZZ and the control group (n = 28) received 30 mg per day of cisapride for a 1 month period. Conservative therapy was similar in both groups and administered by a person blinded to randomization code. Patients were assessed pre-treatment and post-treatment by a blinded interviewer. A constipation visual analogue scale (CVAS) was constructed to evaluate the patients' constipation status. To analyze neuropeptides motilin (MTL), vasoactive intestinal polypeptide (VIP), substance P (SP) levels in plasma, a radioimmunoassay technique was adopted. Data were analyzed for treatment effects using the "t" test.

RESULTBase line characteristics were similar in both treatment groups. There were significant effects on symptom relief, increases in serum SP level, and decreases in VIP level in both groups (P < 0.05). ZZ was significantly more effective than cisapride in ameliorating patients' subjective symptoms of defecating and stool frequency, and increasing serum SP level (P < 0.05).

CONCLUSIONZZ is beneficial in constipating DM via increasing SP levels and decreasing VIP levels of serum.

Aged ; Constipation ; blood ; drug therapy ; etiology ; Diabetes Mellitus, Type 2 ; complications ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Gastrointestinal Diseases ; blood ; drug therapy ; etiology ; Gastrointestinal Hormones ; blood ; Gastrointestinal Motility ; drug effects ; Humans ; Male ; Middle Aged ; Substance P ; blood

OBJECTIVETo study the effect of Simotang oral liquid and glycerin enema on the patients' bowel sound (BS) restoration and anal exhaust after abdominal gynecological operation.

METHODNinety patients with benign tumor who had undergone gynecological operation were randomly divided into the Simotang group, treated after operation with Simotang oral liquid; the enema group, treated with glycerin enema, and the control group, non-treated. The restoration time of BS and anal exhaust were observed.

RESULTSCompared with the control group, the restoration time of BS and anus exhaust were both significantly shorter in the Simotang group and the enema group, showing statistical significance (P < 0.05); but the difference between the two treated groups was insignificant (P > 0.05).

CONCLUSIONSimotang oral liquid and glycerine enema both could benefit the restoration of anal exhaust and BS after abdominal operation.

Abdomen ; Administration, Oral ; Adolescent ; Adult ; Aged ; Constipation ; drug therapy ; etiology ; Drugs, Chinese Herbal ; administration & dosage ; Enema ; Female ; Gastrointestinal Motility ; drug effects ; Glycerol ; administration & dosage ; Humans ; Middle Aged ; Myoma ; surgery ; Postoperative Complications ; drug therapy ; Pregnancy ; Pregnancy, Ectopic ; surgery ; Uterine Neoplasms ; surgery

OBJECTIVETo observe the efficacy and the influence on quality of life (QOL) of syndrome differentiation treatment with Chinese medicine (CM) for opioid-induced constipation as well as the safety and influence on analgesic effect of opioids.

METHODSTotally 406 cases enrolled from 53 collaborating medical centers were randomly assigned to a CM group and a control group. The CM group were treated with CM decoction based on syndrome differentiation, and the control group were treated with Phenolphthalein Tablet. Both groups were treated for 14 days. Cleveland constipation score (CCS), numerical rating scale (NRS) of pain and Chinese version of European Organisation for Research and Treatment of Cancer, Quality of Life Questionnaire-C30 V3.0 (EORTC QLQ-C30 V3.0) were used to evaluate the efficacy, pain controlled and QOL status.

RESULTSThe comparisons of CCS score reduction and QOL between the two groups after treatment suggested that the improvements of constipation and QOL in the CM group were better than that in the control group (P<0.05). The total efficiency of the CM group was better than the control group (93.5% vs. 86.4%, P<0.05). There was no significant difference in NRS scores between before and after treatment in both groups. There was no serious drug-related adverse event during the course of study.

CONCLUSIONCM decoction could effectively treat opioid-induced constipation and improve patients' QOL at the same time. It is safe and doesn't affect the analgesic effect of opioids when treating constipation.

Aged ; Analgesics, Opioid ; administration & dosage ; adverse effects ; Constipation ; chemically induced ; drug therapy ; Drugs, Chinese Herbal ; administration & dosage ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Neoplasms ; complications ; Pain, Intractable ; drug therapy ; Phenolphthalein ; administration & dosage ; Quality of Life ; Treatment Outcome

BACKGROUND/AIMS: Antispasmodic agents have been used in the management of irritable bowel syndrome. However, systematic reviews have come to different conclusions about the efficacy in irritable bowel syndrome. Fenoverine acts as a synchronizer of smooth muscle in modulating the intracellular influx of calcium. We compared fenoverine with trimebutine for the treatment of patients with IBS. METHODS: A multicenter, randomized, double-blind, non-inferiority clinical study was conducted to compared fenoverine with trimebutine. Subjects were randomized to receive either fenoverine (100 mg three times a day) or trimebutine (150 mg three times a day) for 8 weeks. A total of 197 patients were analyzed by the intention-to-treat approach. The primary endpoint was the proportion of patients who had 30% reduction in abdominal pain or discomfort measured by bowel symptom scale (BSS) score at week 8 compared to the baseline. The secondary endpoints were changes of abdominal bloating, diarrhea, constipation, overall and total scores of BSS, and overall satisfaction. RESULTS: At week 8, fenoverine was shown to be non-inferior to trimebutine (treatment difference, 1.76%; 90% CI, -10.30-13.82; p=0.81); 69.23% (54 of 78 patients) of patients taking fenoverine and 67.47% (56 of 83 patients) of patients taking trimebutine showed 30% reduction in abdominal pain or discomfort compared to the baseline. There results of the secondary endpoints were also comparable between the fenoverine group and the trimebutine group. CONCLUSIONS: Fenoverine is non-inferior to trimebutine for treating IBS in terms of both efficacy and tolerability.
Abdominal Pain/etiology ; Adult ; Constipation/etiology ; Diarrhea/etiology ; Double-Blind Method ; Drug Administration Schedule ; Female ; Humans ; Irritable Bowel Syndrome/complications/*drug therapy ; Male ; Middle Aged ; Parasympatholytics/*therapeutic use ; Phenothiazines/*therapeutic use ; Severity of Illness Index ; Treatment Outcome ; Trimebutine/*therapeutic use

INTRODUCTIONConstipation is a common poststroke complication. This study was designed to document the incidence and clinical course of poststroke constipation in a rehabilitation ward, as well as identify the factors independently associated with the condition.

METHODSThis retrospective study involved patients who were admitted to the rehabilitation ward of our institute due to an acute stroke between 1 August 2010 and 31 July 2011. The main outcome measured was the incidence of poststroke constipation, defined as the use of laxative after stroke, fulfilment of the Rome II diagnostic criteria for functional constipation and/or stool impaction. The variables examined were basic demographic data, presence of impairment, degree of disability (evaluated using the Barthel index), walking ability, medications taken and medical complications.

RESULTSOut of the 155 patients who met the inclusion criteria, 123 (79.4%) had poststroke constipation. All 123 patients used oral laxatives; 56 received additional rectal medications and 13 discontinued their use of laxatives at discharge. Patients with poststroke constipation were more likely to have major medical complications (p = 0.04). Those who used rectal medications had a higher risk of major medical complications than those who used only oral laxatives (p < 0.01). Infratentorial lesions were an independent predictor of poststroke constipation (p = 0.003). More severe disability increased the severity of constipation, as indicated by the use of rectal medication.

CONCLUSIONPoststroke constipation is a common complication during inpatient rehabilitation. Healthcare providers should be aware of the incidence of poststroke constipation. Further studies are required to establish standard guidelines for screening and managing bowel function in patients with stroke.

Age Distribution ; Aged ; Aged, 80 and over ; Cohort Studies ; Constipation ; drug therapy ; epidemiology ; etiology ; Female ; Follow-Up Studies ; Humans ; Incidence ; Laxatives ; therapeutic use ; Male ; Middle Aged ; Rehabilitation Centers ; Retrospective Studies ; Risk Assessment ; Severity of Illness Index ; Sex Distribution ; Singapore ; Stroke ; complications ; diagnosis ; Stroke Rehabilitation ; Treatment Outcome