中医药在脊髓损伤神经源性肠道功能障碍的研究进展
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摘要
脊髓损伤(spinal cordin jury,SCI)后神经源性肠功能障碍对患者身心健康和生活质量的严重影响,目前越来越受到国际关注.但国内对此尚未普遍开展.中医理论在SCI及SCI后出现的排便异常尚未作相关总结.现有研究中医药对肠道自主神经系统已经成熟,其有效性获得国内外普遍承认,并较药物更易接受.为SCI肠功能障碍的研究打下基础.但目前国内对SCI后排便异常缺乏专业认识、项目资助和人员管理,临床研究欠规范,中医理论有待完善.现主要针对SCI神经源性肠功能障碍出现的排便异常,在中医病名、病机、主要方法、有效性、优势及存在问题作一综述.
Neurogenic bowel dysfunction after spinal cord injury (SCI) has a significant impact on both patients' physical and mental health, severely impairing their quality of life. Although this condition has attracted wide attention in the world, there have been few studies on it in China. So far, the theory of Chinese medicine for the treatment of SCI and neurogenic bowel dysfunction after SCI has not been established. Fortunately, Chinese medicine for the treatment of gastrointestinal autonomic nervous system dysfunction has been recognized. The finding that Chinese medicine is effective in the treatment of bowel dysfunction and can improve patients' quality of life lays a foundation for further studies on neurogenic bowel dysfunction. In this paper, we review recent advances in treatment of neurogenic bowel dysfunction after SCI by Chinese medicine.
Neurogenic bowel dysfunction after spinal cord injury (SCI) has a significant impact on both patients' physical and mental health, severely impairing their quality of life. Although this condition has attracted wide attention in the world, there have been few studies on it in China. So far, the theory of Chinese medicine for the treatment of SCI and neurogenic bowel dysfunction after SCI has not been established. Fortunately, Chinese medicine for the treatment of gastrointestinal autonomic nervous system dysfunction has been recognized. The finding that Chinese medicine is effective in the treatment of bowel dysfunction and can improve patients' quality of life lays a foundation for further studies on neurogenic bowel dysfunction. In this paper, we review recent advances in treatment of neurogenic bowel dysfunction after SCI by Chinese medicine.
引文
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2南京中医学院.难经校释.第1版.北京:人民卫生出版社,1979:70
3Manheimer E,Cheng K,Wieland LS,Min LS,Shen X,Berman BM,Lao L.Acupuncture for treatment of irritable bowel syndrome.Cochrane Database Syst Rev2012;5:CD005111
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5AyaS,Leblebici B,S?zay S,Bayramo?lu M,Niron EA.The effect of abdominal massage on bowel function in patients with spinal cord injury.Am J Phys Med Rehabil2006;85:951-955
6Ebert E.Gastrointestinal involvement in spinal cord injury:a clinical perspective.J Gastrointestin Liver Dis2012;21:75-82
7王红,周士枋.脊髓损伤后肠道功能障碍.中国康复理论与实践2002;8:174-177
8Moseley AM,Herbert RD,Sherrington C,Maher CG.Evidence for physiotherapy practice:a survey of the Physiotherapy Evidence Database(PEDro).Aust J Physiother2002;48:43-49
9曾宪涛,包翠萍,曹世义,刘菊英.分析系列之三:随机对照试验的质量评价工具.中国循证心血管医学杂志2012;4:183-185
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12Lam T,Eng JJ,Wolfe DL,Hsieh JT,Whittaker M,SCIRE Research Team.A systematic review of the efficacy of gait rehabilitation strategies for spinal cord injury.Top Spinal Cord Inj Rehabil2007;13:32-57
13陈泽鑫,刘慧,潘益峰,余运贤.试验性和观察性研究相关医学文献质量评价方法.中国循证医学杂志2011;11:1229-1236
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19余瑾,黄顺仪,李莉,谭进芝.隔盐隔玉灸神阙命门治疗脊髓损伤康复期便秘的疗效观察.新中医2011;43:110-112
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23王志红,王晓鹏.外伤性脊髓损伤致截瘫的中医康复治疗.中国康复2003;18:310
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25王晶,靳冬.补中益气汤化裁治疗脊髓损伤后便秘1例.中医研究2012;25:43-44
26丁光红,苟坤婷.麻子仁丸治疗脊髓损伤便秘患者疗效观察.贵阳中医学院学报2012;32:45-46
27王建伟,吴毛.“脊髓康”治疗脊髓损伤后便秘18例.实用临床医药杂志2005;9:59
28吴毛,冯骅.中西医结合治疗急性脊髓损伤后便秘48例.现代中西医结合杂志2008;17:5483-5484
29虞抟.医学正传.第1版.北京:中医古籍出版社,2002:341
30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.医学理论与实践2010;23:15-16,29
31季林香.牙皂蜂蜜煎剂灌肠治疗良性前列腺增生术后便秘205例.浙江中医杂志2001;36:348
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33Yin X,Yin Y,Cao FL,Chen YF,Peng Y,Hou WG,Sun SK,Luo ZJ.Tanshinone IIA attenuates the in-flammatory response and apoptosis after traumatic injury of the spinal cord in adult rats.PLoS One2012;7:e38381
34Chen X,Zhou C,Guo J,Sun K,Zhao N,Yang J,Sun Y,Liu X,Hibi T,Liu Z,Han J.Effects of dihydrox-ylphenyl lactic acid on inflammatory responses in spinal cord injury.Brain Res2011;1372:160-168
35刘世清,赵东明,王海斌,周华.复方丹参对大鼠脊髓损伤后细胞凋亡及诱导型一氧化氮合酶表达的影响.中国脊柱脊髓杂志2005;15:109-111
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37王远政,田晓滨,李波,孙立,韩伟,汪雷,张一.汉防己甲素对大鼠急性脊髓损伤后神经细胞凋亡和相关基因表达的影响.中华创伤杂志2012;28:460-465
38罗春山,田晓滨,汪雷,李波,彭智,周焯家,简月奎,赵伟峰.汉防己甲素干预急性损伤脊髓神经元凋亡及bcl-2和bax表达:与甲基强的松龙的比较.中国组织工程研究与临床康复2012;14:7770-7774
39陈飞波,包云光,舒小莉,顾伟忠,赵婵,姚敏华,欧弼悠,江米足.一氧化氮在慢传输型便秘大鼠中的作用及中药治疗评估.临床儿科杂志2009;27:580-584
40卢敏,郑晨果,金纯.复方白术汤对慢传输型便秘大鼠肠道肌间神经丛内NOS的影响.北京中医药2009;28:58-60
41占琼英,刘评.穴位按揉及腹部按摩对胸腰椎术后患者排便的影响.中华现代护理杂志2009;15:3052-3053
42任灵贤,黄煌.经方起源考.南京中医药大学学报2011;27:10-12
43古求知,老膺荣,范宇鹏,黄煌.黄煌教授运用经方治疗肠易激综合征经验简介.新中医2012;44:208-209
44魏玉凤,林煜,连新福.黄煌体质学说之“药人”646例临床资料相关性分析.中医杂志2012;53:1112-1115
45王天宇,孙波,李瓦里,刘世珑.复元活血汤加味治疗阳虚型胸腰椎骨折后腹胀便秘22例.中国中医骨伤科杂志2012;20:60-61
46刘红敏.中药辨证治疗脊柱、脊髓损伤后腹胀便秘.中医正骨1999;11:38
47赵淑芳,马国忠.白术当归导滞汤治疗创伤后便秘62例.实用中医药杂志1999;15:19,21
48付知勤,宋莉.疏肝活血汤加味治疗胸腰椎骨折后早期便秘46例.四川中医2004;22:83-84
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2南京中医学院.难经校释.第1版.北京:人民卫生出版社,1979:70
3Manheimer E,Cheng K,Wieland LS,Min LS,Shen X,Berman BM,Lao L.Acupuncture for treatment of irritable bowel syndrome.Cochrane Database Syst Rev2012;5:CD005111
4Feldhaus S.[Treatment of a tetraplegic patient with chronic constipation with the Tibetan remedy Pad-ma Lax--a case report].Forsch Komplementmed2006;13Suppl1:31-32
5AyaS,Leblebici B,S?zay S,Bayramo?lu M,Niron EA.The effect of abdominal massage on bowel function in patients with spinal cord injury.Am J Phys Med Rehabil2006;85:951-955
6Ebert E.Gastrointestinal involvement in spinal cord injury:a clinical perspective.J Gastrointestin Liver Dis2012;21:75-82
7王红,周士枋.脊髓损伤后肠道功能障碍.中国康复理论与实践2002;8:174-177
8Moseley AM,Herbert RD,Sherrington C,Maher CG.Evidence for physiotherapy practice:a survey of the Physiotherapy Evidence Database(PEDro).Aust J Physiother2002;48:43-49
9曾宪涛,包翠萍,曹世义,刘菊英.分析系列之三:随机对照试验的质量评价工具.中国循证心血管医学杂志2012;4:183-185
10Foley NC,Teasell RW,Bhogal SK,Speechley MR.Stroke Rehabilitation Evidence-Based Review:methodology.Top Stroke Rehabil2003;10:1-7
11Sackett DL.Evidence-based medicine and treatment choices.Lancet1997;349:570,author reply572-573
12Lam T,Eng JJ,Wolfe DL,Hsieh JT,Whittaker M,SCIRE Research Team.A systematic review of the efficacy of gait rehabilitation strategies for spinal cord injury.Top Spinal Cord Inj Rehabil2007;13:32-57
13陈泽鑫,刘慧,潘益峰,余运贤.试验性和观察性研究相关医学文献质量评价方法.中国循证医学杂志2011;11:1229-1236
14温萍,李旭方,李智,刘满芬.穴位注射疗法治疗胸腰椎骨折后腹胀便秘疗效观察.吉林中医药2006;26:38-39
15杨涛,刘志顺,刘元石.电针次髎、会阳穴治疗神经源性二便失禁30例.新中医2001;33:43
16李向红.针灸推拿治疗脊髓损伤后肠道功能紊乱.中国临床康复2005;9:30-36
17何竟,李齐寅,丁明甫,何成奇.针灸治疗脊髓损伤文献计量分析.中国康复医学杂志2010;25:1093-1094
18谢青,陆廷仁,熊键,顾琳.脊髓损伤ASIA2000神经功能评定介绍.中华物理医学与康复杂志2007;29:210-213
19余瑾,黄顺仪,李莉,谭进芝.隔盐隔玉灸神阙命门治疗脊髓损伤康复期便秘的疗效观察.新中医2011;43:110-112
20叶天士.临证指南医案.第1版.山西:山西科学技术出版社,2006:185
21覃纯初.伤科便秘的辫证治疗.湖南中医杂志1990;6:7-9
22邹崇祺.辨证治疗脊柱、脊髓损伤后腹胀便秘165例.广西中医药2000;23:36-40
23王志红,王晓鹏.外伤性脊髓损伤致截瘫的中医康复治疗.中国康复2003;18:310
24李瓦里,张建梅,古恩鹏.复元活血汤加减治疗脊椎骨折患者便秘的临床体会.天津中医药2006;23:453
25王晶,靳冬.补中益气汤化裁治疗脊髓损伤后便秘1例.中医研究2012;25:43-44
26丁光红,苟坤婷.麻子仁丸治疗脊髓损伤便秘患者疗效观察.贵阳中医学院学报2012;32:45-46
27王建伟,吴毛.“脊髓康”治疗脊髓损伤后便秘18例.实用临床医药杂志2005;9:59
28吴毛,冯骅.中西医结合治疗急性脊髓损伤后便秘48例.现代中西医结合杂志2008;17:5483-5484
29虞抟.医学正传.第1版.北京:中医古籍出版社,2002:341
30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.医学理论与实践2010;23:15-16,29
31季林香.牙皂蜂蜜煎剂灌肠治疗良性前列腺增生术后便秘205例.浙江中医杂志2001;36:348
32韩艳,马红梅,朱亚萍.中药肠毒清保留灌肠治疗老年顽固性便秘的体会.湖南中医药导报2003;9:29-30
33Yin X,Yin Y,Cao FL,Chen YF,Peng Y,Hou WG,Sun SK,Luo ZJ.Tanshinone IIA attenuates the in-flammatory response and apoptosis after traumatic injury of the spinal cord in adult rats.PLoS One2012;7:e38381
34Chen X,Zhou C,Guo J,Sun K,Zhao N,Yang J,Sun Y,Liu X,Hibi T,Liu Z,Han J.Effects of dihydrox-ylphenyl lactic acid on inflammatory responses in spinal cord injury.Brain Res2011;1372:160-168
35刘世清,赵东明,王海斌,周华.复方丹参对大鼠脊髓损伤后细胞凋亡及诱导型一氧化氮合酶表达的影响.中国脊柱脊髓杂志2005;15:109-111
36余永桂,张功礼,施永彦,邓长康,杨洪平,禹志宏,张磊,张昊,黄振华.丹参注射液椎管内局部灌注对急性脊髓损伤的保护作用.中华实验外科杂志2004;21:993-994
37王远政,田晓滨,李波,孙立,韩伟,汪雷,张一.汉防己甲素对大鼠急性脊髓损伤后神经细胞凋亡和相关基因表达的影响.中华创伤杂志2012;28:460-465
38罗春山,田晓滨,汪雷,李波,彭智,周焯家,简月奎,赵伟峰.汉防己甲素干预急性损伤脊髓神经元凋亡及bcl-2和bax表达:与甲基强的松龙的比较.中国组织工程研究与临床康复2012;14:7770-7774
39陈飞波,包云光,舒小莉,顾伟忠,赵婵,姚敏华,欧弼悠,江米足.一氧化氮在慢传输型便秘大鼠中的作用及中药治疗评估.临床儿科杂志2009;27:580-584
40卢敏,郑晨果,金纯.复方白术汤对慢传输型便秘大鼠肠道肌间神经丛内NOS的影响.北京中医药2009;28:58-60
41占琼英,刘评.穴位按揉及腹部按摩对胸腰椎术后患者排便的影响.中华现代护理杂志2009;15:3052-3053
42任灵贤,黄煌.经方起源考.南京中医药大学学报2011;27:10-12
43古求知,老膺荣,范宇鹏,黄煌.黄煌教授运用经方治疗肠易激综合征经验简介.新中医2012;44:208-209
44魏玉凤,林煜,连新福.黄煌体质学说之“药人”646例临床资料相关性分析.中医杂志2012;53:1112-1115
45王天宇,孙波,李瓦里,刘世珑.复元活血汤加味治疗阳虚型胸腰椎骨折后腹胀便秘22例.中国中医骨伤科杂志2012;20:60-61
46刘红敏.中药辨证治疗脊柱、脊髓损伤后腹胀便秘.中医正骨1999;11:38
47赵淑芳,马国忠.白术当归导滞汤治疗创伤后便秘62例.实用中医药杂志1999;15:19,21
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