生物反馈联合莫沙必利治疗对老年功能性便秘临床症状和血清胃肠激素水平的影响

Effects of biofeedback combined with moxapride on clinical symptoms and serum gastrointestinal hormone level in elderly pa-tients with functional constipation

中文关键词: 老年  功能性便秘  生物反馈  莫沙必利  血清胃肠激素  肠道菌群

英文关键词: elderly  functional constipation  biofeedback  mosapride  serum gastrointestinal hormone  intestinal flora

中文摘要:

      目的 观察生物反馈(BF)联合莫沙必利治疗老年功能性便秘(FC)患者的临床症状和对血清胃肠激素水平的影响.方法 回顾性分析2023年4月—2024年5月于青岛市胶州中心医院治疗的120例老年FC患者临床资料,根据治疗方式不同分为莫沙必利组(n=58)和联合组(n=62).莫沙必利组患者给予莫沙必利治疗,联合组患者给予BF联合莫沙必利治疗.评估并比较2组治疗前后临床症状(参照《中国慢性便秘专家共识意见》进行症状评分);比较2组患者治疗前后血清胃肠激素及脑肠肽[血清胃动素(MTL)、血清胃泌素(GAS)、血清P物质(SP)、5-羟色胺(5-HT)、神经肽Y(NPY)、血管活性肠肽(VIP)]水平、肠道菌群(乳杆菌、双歧杆菌和大肠埃希菌)数量;观察并比较2组治疗期间不良反应发生情况.结果 治疗后,2组患者便秘症状量化积分、肠道大肠埃希菌数、NPY、VIP水平均降低(P＜0.05),乳杆菌、双歧杆菌数及血清MTL、GAS、SP、5-HT升高(P＜0.05),且联合组患者便秘症状量化积分、肠道大肠埃希菌数、NPY、VIP水平均低于较莫沙必利组(P＜0.05),乳杆菌、双歧杆菌数及血清MTL、GAS、SP、5-HT水平均高于莫沙必利组(P＜0.05).2组患者不良反应发生率差异无统计学意义(P＞0.05).结论 BF联合莫沙必利治疗老年FC可有效缓解患者临床症状,纠正肠道菌群紊乱,调节胃肠激素及脑肠肽水平,安全性良好,具有一定临床应用价值.

英文摘要:

      Objective To observe the effects of biofeedback(BF)combined with moxapride on clinical symptoms and serum gastrointestinal hormone level in elderly patients with functional constipation(FC).Methods The clinical data of 120 elderly FC patients treated in Jiaozhou Central Hospital from April 2023 to May 2024 were retrospectively analyzed.They were divided into mosapride group(n=58)and combined group(n=62)according to different treatment methods.The mosapride group was treated with mosapride,while the combined group was treated with BF combined with mosapride.The clinical symp-toms(symptom scoring criteria from the Chinese Expert Consensus Opinion on Chronic Constipation)of the two groups were evaluated and compared before and after treatment.The levels of gastrointestinal hormones and brain-gut peptides[motilin(MTL),gastrin(GAS),substance P(SP),5-hydroxytryptamine(5-HT),neuropeptide Y(NPY),and vasoactive intestinal peptide(VIP)]and intestinal flora(Lactobacillus,Bifidobacterium and Escherichia coli)were compared between the two groups before and after treatment.The adverse reactions during treatment were recorded and compared between the two groups.Results After treatment,the quantitative scores of constipation symptoms,intestinal Escherichia coli count and levels of NPY and VIP in both groups significantly decreased,while Lactobacillus count,Bifidobacterium count and levels of serum MTL,GAS,SP and 5-HT significantly increased(P＜0.05).The quantitative score of constipation symptoms,intestinal Escherichia coli count and levels of NPY and VIP in the combined group were lower than those in the mosapride group,while Lactobacillus count,Bifidobacterium count and levels of serum MTL,GAS,SP and 5-HT were higher than those in the mosapride group(P＜0.05).There were no significant differences in the incidence of adverse reactions between the two groups(P＞0.05).Conclusion The combination of BF and mosapride can effectively alleviate clinical symptoms in elderly FC patients,correct the disorder of intestinal flora,regulates the levels of gastrointestinal hormones and brain-gut peptide.It has good safety and certain clinical application value.