国医大师李辅仁治疗73例老年性便秘用药特点的回顾性探析
摘要
[目的]通过对国医大师李辅仁治疗老年性便秘病历的收集整理分析,总结归纳出国医大师李辅仁在治疗老年性便秘中的用药特点。
[方法]采用门诊病历收集、录入与系统分析结合的方法。
1.门诊病历收集：通过北京医院门诊病历库,对李老诊治的门诊患者的诊疗记录进行拍照记录,采集有效门诊信息。
2.数据标准化项目录入：通过《中医药防治重大疾病临床个体化诊疗信息采集系统》录入了73例国医大师李辅仁治疗便秘的病历,实现了对病历的临床信息多元化、准确、基本完整的结构化收集。将门诊诊疗过程中的望闻问切四诊摘要、中医诊断、西医诊断、辨证分型、治法方药等统一转换成可供分析的数据,便于分析国医大师李辅仁治疗老年性便秘的经验。通过人工分析和统计学软件互补,共同进行数据分析,参照后得出结论。
3.结果分析：将人工数据分析与系统所得分析结果相对应,互相参考,得出最后的统计结果与结论,交与李老及其弟子,寻求他们的认可。[结果]数据分析与手工统计结合分析结果：73份门诊病历中中医证候最主要为阴虚便秘(34%),气滞便秘(27%),脾虚便秘(14%)和肾虚便秘(14%)。治疗便秘处方中最常用的药物：瓜蒌(52次),火麻仁(52次),肉苁蓉(28次),炒枳实(25次),生地黄(24次),苏梗(22次),白术(21次),茯神(21次),大黄炭(20次),厚朴(20次),木香(17次),炒决明子(16次),沙参(14次)及砂仁(13次)。阴虚便秘证型中最常用的药物前14味为火麻仁、瓜蒌、麦冬、甘草、枸杞子、生地黄、丹参、大黄炭、炒枳实、党参、黄芪、石斛、茯神、沙参。气滞便秘证型中最常用的药物为：瓜蒌、火麻仁、甘草、苏梗、炒枳实、厚朴、木香、肉苁蓉、丹参、枸杞子、焦神曲、砂仁大黄炭。脾虚便秘证型中最常用的药物为：瓜蒌、火麻仁、甘草、白术、党参、茯神、苏梗、炒枳实、麦冬、厚朴、黄芪、焦神曲、砂仁。肾虚便秘证型中最常用的药物为：火麻仁、瓜蒌、肉苁蓉、生地、猪苓、枸杞子、丹参、党参、麦冬、山药、甘草、熟地黄、桑寄生、石斛。所有药物均为常见药物,用量均在药典规定范围。分析李老治疗老年便秘的经验特点。
[结论]将病历采集整理体会与系统分析结果互相验证,将两者相结合,请国医大师李辅仁弟子张剑主任医师核实,得出以下结论：
国医大师李辅仁治疗老年便秘用药特点为以下4点：扶正固本为基本治则；滋补润下为基本治法；活血化瘀为辅,标本同治；用药平和,慎用峻猛攻伐之品。
Objective:Summarized characteristics of State Hospital Master Li Furen medication in the treatment of constipation in the elderly, through collected the State Hospital Master Li Furen patient Outpatient medical records, and finishing,and analysis of medical records.
Methods:Outpat ien t medical records by collecting, recording and integration of systems analysis methods.
1. Outpatient medical record collection:diagnosis and treatment by Li Lao patients had out-patient medical records and related checks to take pictures, collect patient's information.
2. Standardized input data:a "pharmaceutical prevention of major diseases in clinical treatment of individual information gathering system" entry of73cases of State Hospital Master Li Furen medical treatment of elderly constipation. To achieve clinical information on cases, dynamic, diversified, and the basic structure of the complete collection. So that the process of out-patient clinics in the four diagnostic information, the Western diagnosis, TCM, therapy, prescription, doctor's orders, nursing and so on, converted into a unified analysis of the data. To further tap the experience of State Hospital Master Li Furen. After the analysis required by the background data analysis, conclusion.
3. Combinat ion of analysis:the experience and background analysis of medical records order results were compared with each other validation, add, draw final conclusions, for Li Lao recognition.
Results:Combination of manual data analysis and statistical analysis:73cases of elderly patients with constipation medicine syndrome type declared major reduction of yin deficiency(34%), qi stagnation (27%), spleen deficiency (14%) and kidney deficiency (14%). The most common drug in the treatment of constipation prescription:Trichosanthes (52), hemp seed (52), Cistanche (28), fried citrus aurantium (25), Rehmanniae (24), the Soviet Union stems (22), Atractylodes (21), Fu Shen (21), rhubarb carbon (20), Magnolia (20), woody (17), fried cassia (16), Radix (14) and Amomum (13). Yin deficiency syndrome type most commonly used drugs before the14flavor of hemp seed, Trichosanthes, Radix,licorice root, wolfberry fruit, dried rehmannia root, red sage root, rhubarb charcoal, fried citrus aurantium, Codonopsis, Astragalus, Dendrobium, Fu Shen The, Shashen. Qi stagnation the constipation card type most commonly used drugs:Trichosanthes, hemp seed, licorice root, the Soviet Union stems, fried citrus aurantium, Magnolia, woody, Cistanche, red sage root, wolfberry fruit, coke Divine Comedy, Amomum, rhubarb charcoal. The most commonly used drugs in the spleen deficiency card type:Trichosanthes, hemp seed, licorice root, Atractylodes, Codonopsis, Fu Shen, the Soviet Union stems, fried citrus aurantium, Ophiopogon, Magnolia, Astragalus, coke Divine Comedy, Amomum. The most commonly used drugs in the kidney deficiency card type:hemp seed, Trichosanthes, Cistanche, habitat, Polyporus, wolfberry fruit, red sage root, Codonopsis, Radix, Chinese yam, licorice, rehmannia, mistletoe, Dendrobium. All the drugs are common drugs with a volumein the range of pharmacopoeia. Analyzed in the treatment of constipation in the elderly among all the drugs and the relationship between two corresponding frequency.
Conclusion:medical records collected finishing to realize mutual authentication with the results of systems analysis, will be a combination of both, the State Hospital Master Li, Fu Ren Catholic disciple of Zhang Jian, director of physician to verify the following conclusions:
State Medical Master Li Fu Ren Catholic treatment of senile constipation medication is characterized by the following four points:the basic principles is supporting healthy energy; the basic method of treatment is invigoration and purgation by drugs of lubricant nature; blood circulation, specimens of Tong zhi; Medication peaceful,caution Jun the onslaught cutting products.
[方法]采用门诊病历收集、录入与系统分析结合的方法。
1.门诊病历收集：通过北京医院门诊病历库,对李老诊治的门诊患者的诊疗记录进行拍照记录,采集有效门诊信息。
2.数据标准化项目录入：通过《中医药防治重大疾病临床个体化诊疗信息采集系统》录入了73例国医大师李辅仁治疗便秘的病历,实现了对病历的临床信息多元化、准确、基本完整的结构化收集。将门诊诊疗过程中的望闻问切四诊摘要、中医诊断、西医诊断、辨证分型、治法方药等统一转换成可供分析的数据,便于分析国医大师李辅仁治疗老年性便秘的经验。通过人工分析和统计学软件互补,共同进行数据分析,参照后得出结论。
3.结果分析：将人工数据分析与系统所得分析结果相对应,互相参考,得出最后的统计结果与结论,交与李老及其弟子,寻求他们的认可。[结果]数据分析与手工统计结合分析结果：73份门诊病历中中医证候最主要为阴虚便秘(34%),气滞便秘(27%),脾虚便秘(14%)和肾虚便秘(14%)。治疗便秘处方中最常用的药物：瓜蒌(52次),火麻仁(52次),肉苁蓉(28次),炒枳实(25次),生地黄(24次),苏梗(22次),白术(21次),茯神(21次),大黄炭(20次),厚朴(20次),木香(17次),炒决明子(16次),沙参(14次)及砂仁(13次)。阴虚便秘证型中最常用的药物前14味为火麻仁、瓜蒌、麦冬、甘草、枸杞子、生地黄、丹参、大黄炭、炒枳实、党参、黄芪、石斛、茯神、沙参。气滞便秘证型中最常用的药物为：瓜蒌、火麻仁、甘草、苏梗、炒枳实、厚朴、木香、肉苁蓉、丹参、枸杞子、焦神曲、砂仁大黄炭。脾虚便秘证型中最常用的药物为：瓜蒌、火麻仁、甘草、白术、党参、茯神、苏梗、炒枳实、麦冬、厚朴、黄芪、焦神曲、砂仁。肾虚便秘证型中最常用的药物为：火麻仁、瓜蒌、肉苁蓉、生地、猪苓、枸杞子、丹参、党参、麦冬、山药、甘草、熟地黄、桑寄生、石斛。所有药物均为常见药物,用量均在药典规定范围。分析李老治疗老年便秘的经验特点。
[结论]将病历采集整理体会与系统分析结果互相验证,将两者相结合,请国医大师李辅仁弟子张剑主任医师核实,得出以下结论：
国医大师李辅仁治疗老年便秘用药特点为以下4点：扶正固本为基本治则；滋补润下为基本治法；活血化瘀为辅,标本同治；用药平和,慎用峻猛攻伐之品。
Objective:Summarized characteristics of State Hospital Master Li Furen medication in the treatment of constipation in the elderly, through collected the State Hospital Master Li Furen patient Outpatient medical records, and finishing,and analysis of medical records.
Methods:Outpat ien t medical records by collecting, recording and integration of systems analysis methods.
1. Outpatient medical record collection:diagnosis and treatment by Li Lao patients had out-patient medical records and related checks to take pictures, collect patient's information.
2. Standardized input data:a "pharmaceutical prevention of major diseases in clinical treatment of individual information gathering system" entry of73cases of State Hospital Master Li Furen medical treatment of elderly constipation. To achieve clinical information on cases, dynamic, diversified, and the basic structure of the complete collection. So that the process of out-patient clinics in the four diagnostic information, the Western diagnosis, TCM, therapy, prescription, doctor's orders, nursing and so on, converted into a unified analysis of the data. To further tap the experience of State Hospital Master Li Furen. After the analysis required by the background data analysis, conclusion.
3. Combinat ion of analysis:the experience and background analysis of medical records order results were compared with each other validation, add, draw final conclusions, for Li Lao recognition.
Results:Combination of manual data analysis and statistical analysis:73cases of elderly patients with constipation medicine syndrome type declared major reduction of yin deficiency(34%), qi stagnation (27%), spleen deficiency (14%) and kidney deficiency (14%). The most common drug in the treatment of constipation prescription:Trichosanthes (52), hemp seed (52), Cistanche (28), fried citrus aurantium (25), Rehmanniae (24), the Soviet Union stems (22), Atractylodes (21), Fu Shen (21), rhubarb carbon (20), Magnolia (20), woody (17), fried cassia (16), Radix (14) and Amomum (13). Yin deficiency syndrome type most commonly used drugs before the14flavor of hemp seed, Trichosanthes, Radix,licorice root, wolfberry fruit, dried rehmannia root, red sage root, rhubarb charcoal, fried citrus aurantium, Codonopsis, Astragalus, Dendrobium, Fu Shen The, Shashen. Qi stagnation the constipation card type most commonly used drugs:Trichosanthes, hemp seed, licorice root, the Soviet Union stems, fried citrus aurantium, Magnolia, woody, Cistanche, red sage root, wolfberry fruit, coke Divine Comedy, Amomum, rhubarb charcoal. The most commonly used drugs in the spleen deficiency card type:Trichosanthes, hemp seed, licorice root, Atractylodes, Codonopsis, Fu Shen, the Soviet Union stems, fried citrus aurantium, Ophiopogon, Magnolia, Astragalus, coke Divine Comedy, Amomum. The most commonly used drugs in the kidney deficiency card type:hemp seed, Trichosanthes, Cistanche, habitat, Polyporus, wolfberry fruit, red sage root, Codonopsis, Radix, Chinese yam, licorice, rehmannia, mistletoe, Dendrobium. All the drugs are common drugs with a volumein the range of pharmacopoeia. Analyzed in the treatment of constipation in the elderly among all the drugs and the relationship between two corresponding frequency.
Conclusion:medical records collected finishing to realize mutual authentication with the results of systems analysis, will be a combination of both, the State Hospital Master Li, Fu Ren Catholic disciple of Zhang Jian, director of physician to verify the following conclusions:
State Medical Master Li Fu Ren Catholic treatment of senile constipation medication is characterized by the following four points:the basic principles is supporting healthy energy; the basic method of treatment is invigoration and purgation by drugs of lubricant nature; blood circulation, specimens of Tong zhi; Medication peaceful,caution Jun the onslaught cutting products.
引文
[1]程静,黄谷.浅谈《黄帝内经》中的养生观点[M].北京：第四届世界养生大会论文集,2007：340-341.
[2]陈利平,吴整军.老年病的中医特点及其防治[M].北京：第六届全军保健医学学术研讨会暨保健医学进展学习班论文汇编,2009：62-63.
[3]尹东辉,郭丽娃.《寿世保元》对中医老年医学的贡献[J].上海中医药杂志,2007,41(4)：62-63.
[4]王发渭,郝爱真,王治宽.试论老年人疾病特点和中医用药原则[J].中华中医药杂志,2006,21(4)：203-206.
[5]朱振铎,宋文杰,张恭新,张宁.中医对老年病的认识[J].山东中医药大学学报,2000,24(5)：334-335.
[6]林孝正.老年病从虚、痰、瘀论治[J].衰老与养生,2005,28(5)：51-52.
[7]田德禄,张伯礼.中医内科学[M].北京：中国中医药出版社,2005：278。
[8]蔡德光.宣肺润肠汤治疗老年性便秘100例临床观察[J].山西医药杂志,2010,39(5)：453-454.
[9]喻海农.白术调肠饮治疗老年便秘的临床研究[J].临床论著,2008,5(4)：50-51.
[10]金玲肖,龙惠珍,王唯.补肾活血法治疗老年性便秘[J].浙江中西医结合杂志,2010,20(1)：33-34.
[11]雷耀晨.老年性便秘从瘀论治的经验体会[J].光明中医杂志,2005,20(6)：51-53.
[12]余在先.自拟必通汤治疗气滞型便秘150例疗效观察[J].山西中医学院学报,2011,12(1)：32-33.
[13]徐洪洁,卢昕.中药敷脐神灯照射治疗老年虚寒型便秘的临床观察[J].中国老年保健医学,2008,6(1)：19-20.
[14]吴晓丹,杨勇,张林,白晶,王煦.王绵之教授治疗便秘经验总结[J].中医药信息,2010,27(5)：37-39.
[15]陈绍强,马建宁.老年人便秘虚实辨[J].光明中医,2001,16(93)：13-1 5.
[16]莫健平.补中益气汤治疗老年性便秘27例[J].实用中医内科杂志,2003,17(3)：190-191.
[17]何祥毅.补中益气汤加味治疗老年习惯性便秘45例疗效分析[J].中外医学研究,2010,8(8)：44.
[18]马俊勇.补中益气汤治疗老年性便秘42例[J].光明中医,2006,21(5)：51-52.
[19]张杰.参术麻仁汤治疗老年性便秘80例[J].中国乡村医药杂志,2006,13(10)：52.
[20]刘明,李茁然,黄树明.黄芪汤加减治疗老年性便秘的临床观察[J].中医药信息,2010,27(4)：64-65.
[21]吴良淑,吴朝华.黄芪汤加味配合按摩治疗老年便秘30例[J].世界中医药,2007,2(4)：228-229.
[22]曾耀明,祝梅君.养血通便方治疗老年性便秘[J].吉林中医药,2002,22(5)：35.
[23]骆红,魏学军.四物汤加味治疗老年性便秘47例[J].浙江中医杂志,2007,42(3)：157.
[24]李忠卓,刘理,关新林,田树成,陈兆东,赵仑.养荣润肠舒治疗中老年便秘68例[J].辽宁中医杂志,2004,31(12)：1012.
[25]钱弘泉.加味四逆散治疗慢性功能性便秘94例[J].浙江中西医结合杂志,2007,17(8)：494-495.
[26]王耀.中医辨证治疗老年性便秘68例[J].安徽中医临床杂志,2003,15(3)：204.
[27]黄峰.自拟行气通便汤治疗老年功能性便秘疗效观察[J].中国民族民间医药,2010,17(5)：122.
[28]陈良献.自拟养阴润肠方治疗便秘55例--附果导片治疗48例对照[J].浙江中医杂志,2003,38(6)：245.
[29]潘家利.麻仁增液汤治疗老年性便秘[J].光明中医,2011,26(1)：172.
[30]徐俊林.增液汤加减治疗老年性便秘40例临床观察[J].中医药导报,2010,16(12)：41-42.
[31]罗颖,章浩军,范文东.从阴结论治老年性便秘60例[J].江西中医药,2006,(8)：28.
[32]朱晓红.温脾汤加味治疗老年性便秘30例[J].河北中医,2003,25(7)：522.
[33]杨金才.闪光勋导师运用附子为君药治疗老年功能性便秘35例[J].云南中医中药杂志,2010,31(12)：24-25.
[34]王德钢,张扬,顾宇.温肾润肠汤治疗老年便秘72例疗效观察[J].实用中医内科杂志,2008,22(5)：89-90.
[35]钟文华.自拟补肾通便汤治疗老年便秘40例[J].中国中医药科技,2008,15(3)：205.
[36]黄彬.温肾缩尿法治疗老年肾阳虚便秘66例[J].四川中医,2000,18(9)：31.
[37]谢东宇.益肺润肠方治疗老年功能性便秘临床观察[J].山西中医,2010,26(7)：17-18.
[38]彭国英.宣肺润肠方治疗老年性便秘60例[J].河南中医,2008,28(7)：71.
[39]易献春.清燥救肺汤治疗老年便秘36例[J].江西中医,2008,18(4)：48.
[40]景建中,刘运磊.益气健脾法治疗老年习惯性便秘150例[J].陕西中医,2005,26(9)：925-926.
[41]韩偎偎.李乾构教授健脾润肠法治疗老年习惯性便秘经验[J].中医研究,2007,20(1)：44-45.
[42]黄煦霞.老年便秘从脾阴虚论治[J].南京中医药大学学报,2007,23(6)：405.
[43]郭素芬.天王补心丸治疗冠心病PCI术后老年便秘[J].中国社区医师-医学专业,2010,12(32)：113.
[44]张仲起,任喜洁,韦倩.理论有新见证治创新法-师从任继学教授诊治老年便秘体会[J].吉林中医药,2008,28(7)：482-483.
[45]蔡屏江.一贯煎加味治疗老年性便秘56例[J].云南中医中药杂志,2002,23(3)：12-13.
[46]陈启石,吴孝华.老年便秘从肝论治[J].浙江中医杂志,1991,15(10)：435-436.
[47]陈凤仙.穴位按摩干预治疗老年性便秘护理体会[J].福建中医药,2010,41(6)：58-59.
[48]奚翠云,曾柳芳.穴位注射治疗老年人便秘疗效观察[J].护理实践与研究,2010,7(15)：29-30.
[49]张学娟.指针法防治老年便秘[J].中华实用中西医杂志,2001,1(14)：1215.
[50]熊天惠.中药贴脐治疗老年性便秘的疗效观察及护理[J].吉林医学,2010,31(20)：3302-3303.
[51]徐利仙.生大黄穴位贴敷治疗老年便秘的效果观察[J].护理与康复,2009,8(6)：541-542.
[52]施永敏,周永香,马文芳,徐加红.薄荷油湿热敷解除老年人便秘的效果观察[J].中华现代医学与临床,2006,3(8)：45-46.
[53]胡团敏,张丽婷,黄永德.黄术灌肠液结合大肠水疗治疗老年性便秘疗效探讨[J].医学理论与实践,2010,23(1)：15-16.
[54]陈德洪,张翠华,王洪彬,饶玲.蜂蜜灌肠治疗老年性便秘的效果观察[J].当代护士,2010,20(13)：49-50.
[55]熊玲.老年便秘的饮食护理[J].中国老年保健医学,2008,6(3)：94.
[56]李兰珍.老年患者便秘的预防[J].国际护理学杂志,2006,25(1)：72-73.
[57]李锦秀,廖伯年,王惠君.老年性便秘的护理[J].中医药临床杂志,2004,16(6)：602-609.
[58]林征,林琳,赵志泉等.对慢性便秘病人进行生物反馈训练的护理[J].中华护理杂志,2002,37(4)：264-265。
[59]Drossman D A. The functional gastrointestinal disorders and the Rome Ⅱ process [J]. Gut,1999,45(suppl Ⅱ):1-5.
[60]Drossman D A. The functional gastrointestinal disorder and the Rome Ⅲ process [J]. Gastroenterology,2006,130(5):1377-1390.
[61]Dennison C, LloydA, Prasad M etal. The health—related quality of life and economic burden of cons t ipat ion [J]. Pharmacoeconomics,2005,23(5):461-476.
[62]Higgins PD, Johanson JF. Epidemiology of constipation in North America: a systematic review[J]. Am J Gastroenterol,2004,99 (4):750-759.
[63]尉秀清,陈曼湖.广州市城市居民功能性便秘的流行病学调查[J].胃肠病学和肝 病学杂志,2001,10(2)：150-155.
[64]熊理守,陈惠新,陈蔓湖.广东省社区人群的慢性便秘流行病学研究[J].中华消化杂志,2004,24(8)：448-449.
[65]刘国旗,王增强,陈香.唐山市老年人便秘现状研究及其影响因素的凋查[J].现代预防医学,2007,34(9)：1749-1750.
[66]于普林,郑宏,李增金.老年人便秘流行病学的特点初步分析[J].中华老年医学杂志,2001,20(2)：132-134.
[67]童卫东.结肠慢传输型便秘的病因和诊断[J].医学新知杂志,2007,17(1)：1-2.
[68]王学勤,朱有玲,戴菲,罗金燕,龚均.功能性出口梗阻型便秘排便动力学研究[J].西安医科大学学报,2002,23(3)：288-290.
[69]中华消化学会胃肠动力学组.我国慢性便秘的诊治指南[J].中国全科医学,2005,8(2)：119-121.
[70]Longstreth GF, Thompson W G, Chey W D. Functional Bowel Disorders. In: Drossman DA eds. Rome III:the functional gas-trointestinal disorders. Mclean: Degnon Associates,2006.487-555.
[71]于洪燕,李湘琴,苏丹.肛门直肠测压的应用与护理体会[J].现代护理,2011,8(13)：118-119.
[72]周立平,郭丽,何敏静,刘瑶,王丽,蔡文智.肛管直肠测压技术在功能性便秘患者中的应用[J].实用医学杂志,2011,27(13)：2467-2469.
[73]冯自成,张昕.排便造影诊断出口梗阻性便秘的意义[J].黑龙江医药科学,2008,31(5)：92.
[74]Roos JE, Weishaupt D, Wildermuth S, et al. Experience of 4 years with open MR defecography:pictorial review of anorectal anatomy and disease. Radiographics,2002,22:817 - 832.
[75]Hetzer FH, Andreisek G, Tsagari C, et al. MR defecography in patients with fecal incontinence:imaging findings and their effect on surgical management. Radiology,2006,240:449 - 457.
[76]屠云.糖尿病病人便秘相关因素分析及护理干预[J].护理研究,2007 21(1)：113-114。
[77]王金萍,王雅琴,苏建华.膳食纤维与糖尿病便秘[J].中华临床医学研究杂志,2008 14(8)：1204-1205。
[78]张新平,陈长香.不同饮食习惯对老年人便秘的影响及干预[J].华北煤炭医学院学报,2010 12(4)：508。
[79]李水淼.复方丹参加西沙必利与单用西沙必利治疗老年功能性便秘比较[J].中国新药与临床杂志,2009,17(5)：94-95。
[80]游红利.西沙必利的不良反应分析[J]China Health Care,2010,19(06):13-14.
[81]梁乙安,杨春敏,邵波.替加色罗治疗2型糖尿病合并便秘患者的疗效和安全性研究[J].实用医学杂志,2007,23(13)：2087-2088。
[82]FDA Public Health Advisory. United States Food and Drug Administration, 30 March,2007。
[83]邵万金.泻药的副作用[J].中华中医药学会第十二次大肠肛门病学术会议,2006, 671-675。
[84]柏愚,邹多武.泻药在慢性便秘治疗中的应用[J].临床消化病杂志,2007,19(3)：142-143。
[85]XingJH, SofferEE,Adverseeffectsoflaxatives, Dis Colon Rectum 2001; 44: 1201 - 1209。
[86]PARE P, BRIDGES R, CHAMPION MC, et al. Recommendations on chronic constipation (including constipation associated with irritable bowel syndrome) treatment [J]. Can J Gastroenterol,2007,21 (Suppl B):3B.
[87]Seow Choen F. The physiology of colonic hydrotherapy [J]. Colorectal Dis, 2009,11(7):686-688.
[88]杜平,梁仲惠.结肠水疗法的临床应用[J].现代中西医结合杂志,2009,18(3)339-341。
[89]Longstreth GF, Thompson WG, Chey WD. Functional Bowel Disorders. In:Drossman DA eds. Rome Ⅲ:the functional gastrointestinal disorders. Mclean:Degnon Associates,2006.487-555.
[90]刘宝华,张连阳,张胜本.慢传输性便秘的外科治疗的疗效分析[J].第三军医大学学报,2004,26：1036-1038.
[1]史学军.李辅仁教授治疗脾胃疾病经验介绍[J].中国医刊,1999,34(6)：47-48。
[2]陈利平,吴整军.老年病的中医特点及其防治[M].北京：第六届全军保健医学学术研讨会暨保健医学进展学习班论文汇编,2009：62-63.
[3]尹东辉,郭丽娃.《寿世保元》对中医老年医学的贡献[J].上海中医药杂志,2007,41(4)：62-63.
[4]王发渭,郝爱真,王治宽.试论老年人疾病特点和中医用药原则[J].中华中医药杂志,2006,21(4)：203-206.
[5]朱振铎,宋文杰,张恭新,张宁.中医对老年病的认识[J].山东中医药大学学报,2000,24(5)：334-335.
[6]林孝正.老年病从虚、痰、瘀论治[J].衰老与养生,2005,28(5)：51-52.
[7]田德禄,张伯礼.中医内科学[M].北京：中国中医药出版社,2005：278。
[8]蔡德光.宣肺润肠汤治疗老年性便秘100例临床观察[J].山西医药杂志,2010,39(5)：453-454.
[9]喻海农.白术调肠饮治疗老年便秘的临床研究[J].临床论著,2008,5(4)：50-51.
[10]金玲肖,龙惠珍,王唯.补肾活血法治疗老年性便秘[J].浙江中西医结合杂志,2010,20(1)：33-34.
[11]雷耀晨.老年性便秘从瘀论治的经验体会[J].光明中医杂志,2005,20(6)：51-53.
[12]余在先.自拟必通汤治疗气滞型便秘150例疗效观察[J].山西中医学院学报,2011,12(1)：32-33.
[13]徐洪洁,卢昕.中药敷脐神灯照射治疗老年虚寒型便秘的临床观察[J].中国老年保健医学,2008,6(1)：19-20.
[14]吴晓丹,杨勇,张林,白晶,王煦.王绵之教授治疗便秘经验总结[J].中医药信息,2010,27(5)：37-39.
[15]陈绍强,马建宁.老年人便秘虚实辨[J].光明中医,2001,16(93)：13-1 5.
[16]莫健平.补中益气汤治疗老年性便秘27例[J].实用中医内科杂志,2003,17(3)：190-191.
[17]何祥毅.补中益气汤加味治疗老年习惯性便秘45例疗效分析[J].中外医学研究,2010,8(8)：44.
[18]马俊勇.补中益气汤治疗老年性便秘42例[J].光明中医,2006,21(5)：51-52.
[19]张杰.参术麻仁汤治疗老年性便秘80例[J].中国乡村医药杂志,2006,13(10)：52.
[20]刘明,李茁然,黄树明.黄芪汤加减治疗老年性便秘的临床观察[J].中医药信息,2010,27(4)：64-65.
[21]吴良淑,吴朝华.黄芪汤加味配合按摩治疗老年便秘30例[J].世界中医药,2007,2(4)：228-229.
[22]曾耀明,祝梅君.养血通便方治疗老年性便秘[J].吉林中医药,2002,22(5)：35.
[23]骆红,魏学军.四物汤加味治疗老年性便秘47例[J].浙江中医杂志,2007,42(3)：157.
[24]李忠卓,刘理,关新林,田树成,陈兆东,赵仑.养荣润肠舒治疗中老年便秘68例[J].辽宁中医杂志,2004,31(12)：1012.
[25]钱弘泉.加味四逆散治疗慢性功能性便秘94例[J].浙江中西医结合杂志,2007,17(8)：494-495.
[26]王耀.中医辨证治疗老年性便秘68例[J].安徽中医临床杂志,2003,15(3)：204.
[27]黄峰.自拟行气通便汤治疗老年功能性便秘疗效观察[J].中国民族民间医药,2010,17(5)：122.
[28]陈良献.自拟养阴润肠方治疗便秘55例--附果导片治疗48例对照[J].浙江中医杂志,2003,38(6)：245.
[29]潘家利.麻仁增液汤治疗老年性便秘[J].光明中医,2011,26(1)：172.
[30]徐俊林.增液汤加减治疗老年性便秘40例临床观察[J].中医药导报,2010,16(12)：41-42.
[31]罗颖,章浩军,范文东.从阴结论治老年性便秘60例[J].江西中医药,2006,(8)：28.
[32]朱晓红.温脾汤加味治疗老年性便秘30例[J].河北中医,2003,25(7)：522.
[33]杨金才.闪光勋导师运用附子为君药治疗老年功能性便秘35例[J].云南中医中药杂志,2010,31(12)：24-25.
[34]王德钢,张扬,顾宇.温肾润肠汤治疗老年便秘72例疗效观察[J].实用中医内科杂志,2008,22(5)：89-90.
[35]钟文华.自拟补肾通便汤治疗老年便秘40例[J].中国中医药科技,2008,15(3)：205.
[36]黄彬.温肾缩尿法治疗老年肾阳虚便秘66例[J].四川中医,2000,18(9)：31.
[37]谢东宇.益肺润肠方治疗老年功能性便秘临床观察[J].山西中医,2010,26(7)：17-18.
[38]彭国英.宣肺润肠方治疗老年性便秘60例[J].河南中医,2008,28(7)：71.
[39]易献春.清燥救肺汤治疗老年便秘36例[J].江西中医,2008,18(4)：48.
[40]景建中,刘运磊.益气健脾法治疗老年习惯性便秘150例[J].陕西中医,2005,26(9)：925-926.
[41]韩偎偎.李乾构教授健脾润肠法治疗老年习惯性便秘经验[J].中医研究,2007,20(1)：44-45.
[42]黄煦霞.老年便秘从脾阴虚论治[J].南京中医药大学学报,2007,23(6)：405.
[43]郭素芬.天王补心丸治疗冠心病PCI术后老年便秘[J].中国社区医师-医学专业,2010,12(32)：113.
[44]张仲起,任喜洁,韦倩.理论有新见证治创新法-师从任继学教授诊治老年便秘体会[J].吉林中医药,2008,28(7)：482-483.
[45]蔡屏江.一贯煎加味治疗老年性便秘56例[J].云南中医中药杂志,2002,23(3)：12-13.
[46]陈启石,吴孝华.老年便秘从肝论治[J].浙江中医杂志,1991,15(10)：435-436.
[47]陈凤仙.穴位按摩干预治疗老年性便秘护理体会[J].福建中医药,2010,41(6)：58-59.
[48]奚翠云,曾柳芳.穴位注射治疗老年人便秘疗效观察[J].护理实践与研究,2010,7(15)：29-30.
[49]张学娟.指针法防治老年便秘[J].中华实用中西医杂志,2001,1(14)：1215.
[50]熊天惠.中药贴脐治疗老年性便秘的疗效观察及护理[J].吉林医学,2010,31(20)：3302-3303.
[51]徐利仙.生大黄穴位贴敷治疗老年便秘的效果观察[J].护理与康复,2009,8(6)：541-542.
[52]施永敏,周永香,马文芳,徐加红.薄荷油湿热敷解除老年人便秘的效果观察[J].中华现代医学与临床,2006,3(8)：45-46.
[53]胡团敏,张丽婷,黄永德.黄术灌肠液结合大肠水疗治疗老年性便秘疗效探讨[J].医学理论与实践,2010,23(1)：15-16.
[54]陈德洪,张翠华,王洪彬,饶玲.蜂蜜灌肠治疗老年性便秘的效果观察[J].当代护士,2010,20(13)：49-50.
[55]熊玲.老年便秘的饮食护理[J].中国老年保健医学,2008,6(3)：94.
[56]李兰珍.老年患者便秘的预防[J].国际护理学杂志,2006,25(1)：72-73.
[57]李锦秀,廖伯年,王惠君.老年性便秘的护理[J].中医药临床杂志,2004,16(6)：602-609.
[58]林征,林琳,赵志泉等.对慢性便秘病人进行生物反馈训练的护理[J].中华护理杂志,2002,37(4)：264-265。
[59]Drossman D A. The functional gastrointestinal disorders and the Rome Ⅱ process [J]. Gut,1999,45(suppl Ⅱ):1-5.
[60]Drossman D A. The functional gastrointestinal disorder and the Rome Ⅲ process [J]. Gastroenterology,2006,130(5):1377-1390.
[61]Dennison C, LloydA, Prasad M etal. The health—related quality of life and economic burden of cons t ipat ion [J]. Pharmacoeconomics,2005,23(5):461-476.
[62]Higgins PD, Johanson JF. Epidemiology of constipation in North America: a systematic review[J]. Am J Gastroenterol,2004,99 (4):750-759.
[63]尉秀清,陈曼湖.广州市城市居民功能性便秘的流行病学调查[J].胃肠病学和肝 病学杂志,2001,10(2)：150-155.
[64]熊理守,陈惠新,陈蔓湖.广东省社区人群的慢性便秘流行病学研究[J].中华消化杂志,2004,24(8)：448-449.
[65]刘国旗,王增强,陈香.唐山市老年人便秘现状研究及其影响因素的凋查[J].现代预防医学,2007,34(9)：1749-1750.
[66]于普林,郑宏,李增金.老年人便秘流行病学的特点初步分析[J].中华老年医学杂志,2001,20(2)：132-134.
[67]童卫东.结肠慢传输型便秘的病因和诊断[J].医学新知杂志,2007,17(1)：1-2.
[68]王学勤,朱有玲,戴菲,罗金燕,龚均.功能性出口梗阻型便秘排便动力学研究[J].西安医科大学学报,2002,23(3)：288-290.
[69]中华消化学会胃肠动力学组.我国慢性便秘的诊治指南[J].中国全科医学,2005,8(2)：119-121.
[70]Longstreth GF, Thompson W G, Chey W D. Functional Bowel Disorders. In: Drossman DA eds. Rome III:the functional gas-trointestinal disorders. Mclean: Degnon Associates,2006.487-555.
[71]于洪燕,李湘琴,苏丹.肛门直肠测压的应用与护理体会[J].现代护理,2011,8(13)：118-119.
[72]周立平,郭丽,何敏静,刘瑶,王丽,蔡文智.肛管直肠测压技术在功能性便秘患者中的应用[J].实用医学杂志,2011,27(13)：2467-2469.
[73]冯自成,张昕.排便造影诊断出口梗阻性便秘的意义[J].黑龙江医药科学,2008,31(5)：92.
[74]Roos JE, Weishaupt D, Wildermuth S, et al. Experience of 4 years with open MR defecography:pictorial review of anorectal anatomy and disease. Radiographics,2002,22:817 - 832.
[75]Hetzer FH, Andreisek G, Tsagari C, et al. MR defecography in patients with fecal incontinence:imaging findings and their effect on surgical management. Radiology,2006,240:449 - 457.
[76]屠云.糖尿病病人便秘相关因素分析及护理干预[J].护理研究,2007 21(1)：113-114。
[77]王金萍,王雅琴,苏建华.膳食纤维与糖尿病便秘[J].中华临床医学研究杂志,2008 14(8)：1204-1205。
[78]张新平,陈长香.不同饮食习惯对老年人便秘的影响及干预[J].华北煤炭医学院学报,2010 12(4)：508。
[79]李水淼.复方丹参加西沙必利与单用西沙必利治疗老年功能性便秘比较[J].中国新药与临床杂志,2009,17(5)：94-95。
[80]游红利.西沙必利的不良反应分析[J]China Health Care,2010,19(06):13-14.
[81]梁乙安,杨春敏,邵波.替加色罗治疗2型糖尿病合并便秘患者的疗效和安全性研究[J].实用医学杂志,2007,23(13)：2087-2088。
[82]FDA Public Health Advisory. United States Food and Drug Administration, 30 March,2007。
[83]邵万金.泻药的副作用[J].中华中医药学会第十二次大肠肛门病学术会议,2006, 671-675。
[84]柏愚,邹多武.泻药在慢性便秘治疗中的应用[J].临床消化病杂志,2007,19(3)：142-143。
[85]XingJH, SofferEE,Adverseeffectsoflaxatives, Dis Colon Rectum 2001; 44: 1201 - 1209。
[86]PARE P, BRIDGES R, CHAMPION MC, et al. Recommendations on chronic constipation (including constipation associated with irritable bowel syndrome) treatment [J]. Can J Gastroenterol,2007,21 (Suppl B):3B.
[87]Seow Choen F. The physiology of colonic hydrotherapy [J]. Colorectal Dis, 2009,11(7):686-688.
[88]杜平,梁仲惠.结肠水疗法的临床应用[J].现代中西医结合杂志,2009,18(3)339-341。
[89]Longstreth GF, Thompson WG, Chey WD. Functional Bowel Disorders. In:Drossman DA eds. Rome Ⅲ:the functional gastrointestinal disorders. Mclean:Degnon Associates,2006.487-555.
[90]刘宝华,张连阳,张胜本.慢传输性便秘的外科治疗的疗效分析[J].第三军医大学学报,2004,26：1036-1038.
[1]史学军.李辅仁教授治疗脾胃疾病经验介绍[J].中国医刊,1999,34(6)：47-48。