Suav Cov Kws Tshaj Lij Pom Zoo Rau Kev Ntsuam Xyuas Kev Ntsuas Thiab Kev Tswj Xyuas Kev Kho Mob Ntawm Slow Transit Constipation (2023 Edition)Ⅱ
Jan 05, 2024
Kev kuaj mob STC
(1) Kev tshawb nrhiav keeb kwm kho mob
Rau cov neeg mob uas xav tias STC, cov ncauj lus kom ntxaws txog kev kho mob yuav tsum raug nug kom nkag siab tus neeg mob txoj kev noj zaub mov, keeb kwm tshuaj, thiab kev ua tau zoo. Qhov no yuav pab txheeb xyuas qhov ua rau cem quav, kab mob evolution, thiab kev txiav txim siab ua ntej, los xaiv cov kev kuaj mob hauv lub hom phiaj [13-14]. Cov keeb kwm kho mob tag nrho yuav tsum suav nrog cov yam ntxwv ntawm cov quav, lub sijhawm xav tau rau kev tso tseg, ntau zaus ntawm kev tso quav, txawm tias muaj kev xav tias qhov quav tsis tiav thiab tsis muaj zog, txawm tias yuav tsum tau siv zog ntxiv rau kev tshem tawm, seb puas muaj cov tsos mob plab xws li plab hnyuv thiab mob plab, thiab seb puas muaj qhov quav los yog mob thaum lub sij hawm defecation. Los ntshav, seb cov tshuaj puas xav tau los pab tshem tawm, seb puas muaj cov pob hauv lub qhov quav, thiab seb koj puas tau noj tshuaj uas cuam tshuam rau kev tso quav, thiab lwm yam.
Cov lus pom zoo 2: Cov ntaub ntawv keeb kwm kho mob ntxaws ntxaws yuav tsum tau sau ua ntej kev kuaj mob STC, tsom mus rau qhov hnyav ntawm cov tsos mob thiab cov txiaj ntsig ntawm kev kho tshuaj. (Cov pov thawj zoo: nruab nrab, qib pom zoo: muaj zog)
(2) Kev kuaj lub cev
Thaum kuaj pom tus neeg mob STC thawj zaug, yuav tsum tau kuaj xyuas lub cev kom zoo, suav nrog kev kuaj mob plab los ntsuam xyuas qhov kev sib tw, muaj palpable masses, thiab lub plab phab ntsa thiab inguinal hernias. Rau cov neeg mob feem ntau, kev kuaj xyuas perineal yuav tsum tau ua nyob rau sab laug sab laug decubitus los yog txoj hauj lwm nquag, thiab kev kuaj mob digital yuav tsum tau ua los txiav txim siab txog cov kab mob hauv lub qhov quav thiab cov kab mob perianal (xws li cov qog nqaij hlav hauv plab) thiab soj ntsuam rau cov kab mob hauv lub plab los yog rectocele. degree thiab qhov quav sphincter muaj nuj nqi.
Cov lus pom zoo 3: Yuav tsum muaj kev ntsuam xyuas lub cev tag nrho thaum kuaj STC, thiab kev kuaj mob digital anorectal yog qhov tseem ceeb rau kev kuaj mob thiab kev kuaj mob sib txawv. (Cov pov thawj zoo: nruab nrab, qib pom zoo: muaj zog)
(3) Kev soj ntsuam xyuas
Cov txheej txheem kev kuaj mob ntsig txog yuav tsum tau siv rau kev kuaj mob sib txawv kom tsis suav nrog cov kab mob organic, thiab kev txawv txav ntawm lub cev, thiab ntsuas cov kev hloov pauv pathophysiological ntawm qhov hluav taws xob thaiv qhov hluav taws xob.
1. Colonic transit test: It is a valuable examination method for diagnosing STC. It can determine whether there is delayed colon transit. The X-ray opaque marker method is the most commonly used in clinical applications [15-16]. It is worth noting that drugs, foods, and health products that slow down or accelerate colonic transit should be stopped 2 to 3 days before the transit test. The X-ray opaque marker method can be divided into Hinton method [17] and Metcalf method [18]. The former requires taking capsules containing 24 radiopaque markers. If the abdominal X-ray taken 3 days later shows that more than 5 markers remain in the colon, it indicates that colonic transit has slowed down [17]. The latter takes 20 capsules with a total of 60 X-ray opaque markers on days 1, 2, and 3 respectively. When tested on day 4, if the remaining markers total 60, it is meaningful for diagnosing slowed colonic transit. [18]. The general number of X-ray opaque markers swallowed in China is 20. If the number of residual markers is >20% thaum kuaj rau hnub thib peb, nws tau txiav txim siab tias muaj kev thauj mus los qeeb qeeb [16]. X-ray opaque markers tuaj yeem xa mus rau thaj tsam ileocecal 6 teev tom qab tswj qhov ncauj. Yog li, txoj kev no kuj tseem siv tau los ntsuas qhov kev sib kis ntawm lub plab thiab cov hnyuv [1].
Tsis tas li ntawd, cov txheej txheem siv los ntsuas kev thauj mus los hauv lub cev muaj xws li cov qauv nuclide, hydrogen breath method [19], capsule endoscopy, thiab scintillation fluorescence imaging technology [20], thiab lwm yam, tab sis lawv tsis tau siv dav hauv Suav teb.
Cov Lus Pom Zoo 4: Kev kuaj mob colonic transit test yog ib txoj hauv kev uas siv los ntsuam xyuas kev ua haujlwm colonic transit. (Cov pov thawj zoo: nruab nrab, qib pom zoo: muaj zog)
2. Colonoscopy: Colonoscopy is of great value in excluding organic colorectal lesions. It is recommended that patients aged >40 xyoo uas tau kuaj pom tshiab STC, tshwj xeeb tshaj yog cov neeg uas muaj cov cim ceeb toom lossis cov cim ceeb toom thaum rov qab los, tau txais kev tsom mus rau colonoscopy [21]. Cov cim ceeb toom muaj xws li cov ntshav hauv cov quav, kuaj ntshav fecal occult zoo, ua npaws, ntshav ntshav, poob phaus, mob plab, plab plab, nce ntshav carcinoembryonic antigen, keeb kwm ntawm mob plab adenoma, thiab tsev neeg keeb kwm ntawm cov qog nqaij hlav hauv plab. Tsis tas li ntawd, colonoscopy tuaj yeem kuaj pom cov kab mob ulcerative colitis, Crohn's kab mob, mob plab melanosis, thiab lwm yam kab mob [22]. Rau cov neeg uas xav tias muaj cov qog nqaij hlav hauv plab tab sis tsis kam lossis tsis tuaj yeem ua rau mob qog noj ntshav, barium enema, quav DNA, lossis kuaj cov protein tuaj yeem siv rau kev tshuaj ntsuam [23-26].
Kev pom zoo 5: Colonoscopy yog qhov muaj txiaj ntsig zoo hauv kev tsis suav nrog cov kab mob hauv plab hnyuv loj uas tshwm sim los ntawm cov kab mob plab hnyuv loj. (Cov pov thawj zoo: siab, qib pom zoo: muaj zog)
3. Kev kuaj Barium enema: Ntxiv rau kev ntsuam xyuas seb qhov anatomical ntawm txoj hnyuv loj yog qhov txawv txav, kev kuaj barium enema kuj tuaj yeem siv los nkag siab seb STC puas muaj cov nyuv ntev lossis megacolon, thiab lwm yam, uas yog ib qho tseem ceeb hauv kev kuaj mob sib txawv. ntawm STC. Rau cov neeg mob uas muaj tus kab mob Hirschsprung, barium enema tuaj yeem qhia meej qhov chaw thiab qhov ntev ntawm cov stenotic ntu thiab cov kab mob sib kis. Rau cov neeg mob uas tsis tuaj yeem tiv thaiv kab mob colonoscopy, kev tshuaj xyuas barium enema tuaj yeem raug xaiv los txiav txim cov kab mob hauv plab hnyuv.
Kev pom zoo 6: Barium enema tuaj yeem soj ntsuam cov kab mob hauv lub cev anatomical abnormalities thiab tsis suav nrog cov kab mob organic. (Cov pov thawj zoo: nruab nrab, qib pom zoo: muaj zog)
4. Kev kuaj mob plab CT: Qhov kev ntsuam xyuas no tuaj yeem siv los txiav txim cov kab mob hauv plab hnyuv, xws li mob plab, retroperitoneal, thiab plab hnyuv. Tsis tas li ntawd, CT colonography (CTC) tuaj yeem ntsuas qhov ntev ntawm txoj hnyuv loj hauv peb qhov ntev, uas muaj qee qhov kev siv tus nqi rau kev ntsuas qhov muaj cov nyuv ntev thiab megacolon. Kev tshawb fawb nyob rau hauv xyoo tas los no tau pom tias qhov rhiab heev ntawm CTC hauv kev kuaj pom cov kab mob hauv cov hnyuv (mob qog noj ntshav lossis cov plab hnyuv loj) yog siab dua li ntawm barium enema [27-28]; nws yog sib npaug rau colonoscopy [28]. Yog li, CTC tuaj yeem siv los ua ib txoj hauv kev ntxiv rau kev kuaj mob ntawm cov neeg mob STC, tab sis tseem yuav tsum tau kuaj colonoscopy ntxiv thaum kuaj pom qhov txhab.
Kev Pom Zoo 7: Abdominal CT thiab CT colonography tuaj yeem siv los tshawb xyuas cov kab mob hauv plab hauv plab thiab tshuaj xyuas cov kab mob plab hnyuv loj thiab qhov chaw nyob qhov chaw. (Cov pov thawj zoo: nruab nrab, qib pom zoo: tsis muaj zog)
5. Defecography: Defecography siv X-ray los yog MRI los simulate cov dej num ntawm lub qhov quav thiab lub plab mog thaum lub sij hawm defecation, thiab soj ntsuam cov morphological thiab structural abnormalities ntawm lub qhov quav thiab qhov quav kwj dej (xws li rectocele, rectal prolapse, plab hnyuv hernia, megacolon, thiab lwm yam) thiab pelvic pem teb morphological thiab kev ua haujlwm txawv txav (xws li puborectalis spasm, pelvic floor laxity, pelvic floor hernia, etc.), haum rau kev soj ntsuam seb STC puas ua ke nrog lub plab hauv plab pelvic morphological thiab kev ua haujlwm txawv txav thiab OOC. Feem ntau siv cov txheej txheem defecography muaj xws li barium X-ray defecography (BD) thiab magnetic resonance defecography (MRD). BD yog ib qho yooj yim thiab yooj yim rau kev siv thiab yog ib qho kev kuaj xyuas seb puas yog STC koom nrog OOC. BD ua ke nrog pelvic, qhov chaw mos, lossis cystography tuaj yeem ua kom pom qhov txawv txav ntawm cov ntaub so ntswg thiab cov kabmob hauv plab thaum lub sijhawm defecation. MRD muaj kev daws teeb meem zoo dua rau cov ntaub so ntswg thiab tuaj yeem siv los ntsuas seb STC puas ua ke nrog qhov txawv txav ntawm lub qhov quav thiab lub plab hauv plab morphology thiab cov qauv [29-30].
Kev Pom Zoo 8: Defecography tuaj yeem siv los ntsuas qhov txawv txav ntawm lub qhov quav ntawm qhov quav thiab lub plab hauv plab morphology thiab kev ua haujlwm, thiab txheeb xyuas seb puas muaj qhov hluav taws xob thaiv. (Cov pov thawj zoo: nruab nrab, qib pom zoo: muaj zog)
6. Anorectal manometry (ARM): Nws yog feem ntau siv los ntsuas qhov motility thiab sensory muaj nuj nqi ntawm lub anorectum. Nws muaj qee tus nqi hauv kev txiav txim siab seb STC puas koom nrog OOC thiab hauv kev kuaj mob sib txawv ntawm megacolon. ARM tuaj yeem txiav txim siab seb puas muaj qhov tsis sib haum xeeb ntawm lub qhov quav sphincter lossis cov leeg hauv plab hauv plab, qhov quav qhov quav, thiab tsis muaj qhov tsis txaus ntseeg ntawm anorectal inhibitory reflex [31-32]. Qhov kev kuaj pom txawv txav ntawm ARM feem ntau suav nrog kev poob ntawm recto-anal inhibitory reflex, txo lub qhov quav thiab contractility, txawv txav ntawm qhov quav, thiab sphincter coordination disorder [33]. High-resolution ARM tuaj yeem cuam tshuam txog kev hloov pauv ntawm lub qhov quav sphincter thiab muab cov ntaub ntawv raug siv ntau dua rau kev kuaj mob anorectal [34]. Tsis tas li ntawd, tseem muaj cov kev tshawb fawb qhia tias cov tshuaj ntsiav ntse yog siv rau hauv txoj hnyuv manometry, uas tuaj yeem muab cov ntaub ntawv siv rau kev xaiv STC txoj kev phais [35]. Txawm li cas los xij, vim tsis muaj cov ntaub ntawv kho mob ntau dua thiab cov ntaub ntawv tshawb fawb ntau qhov chaw txhawb nqa, nws tuaj yeem siv tau xaiv.
Kev pom zoo 9: Anorectal manometry tuaj yeem siv los ntsuas qhov kev xav ntawm lub cev thiab lub cev muaj zog. (Cov pov thawj zoo: nruab nrab, qib pom zoo: muaj zog)
7. Balloon expulsion test: Nws tuaj yeem siv rau kev kuaj mob sib txawv ntawm STC thiab OOC. Qhov kev ntsuam xyuas no tuaj yeem cuam tshuam ncaj qha rau lub peev xwm ntawm lub cev kom tshem tawm lub zais pa (feem ntau yog lub hnab dej lossis lub hnab airbag). Cov neeg noj qab haus huv tuaj yeem tshem lub zais pa hauv 1 mus rau 2 feeb. Sac[36-37]. Txawm li cas los xij, vim tias qee tus neeg mob uas tsis muaj kev sib koom ua ke ntawm lub plab hauv plab cov leeg tseem tuaj yeem tshem tawm lub zais pa ib txwm thaum lub zais pa tshem tawm, cov txiaj ntsig zoo ntawm ib qho kev tshem tawm lub zais pa tsis tuaj yeem txiav txim siab txog qhov tsis muaj kev sib koom ua ke ntawm cov leeg hauv plab. Xav tau kev pab. Kev tshuaj xyuas zoo raws li lwm yam kev xeem tau [38]. Clinically, qhov kev ntsuam xyuas no feem ntau yog siv ua ke nrog anorectal manometry.
Daim Ntawv Pom Zoo 10: Kev kuaj lub zais pa tuaj yeem siv los ntsuas qhov kev sib koom tes ntawm cov leeg hauv plab hauv plab. (Cov pov thawj zoo: qis, qib pom zoo: tsis muaj zog)
Ntuj Herbal Tshuaj Rau Relieving cem quav-Cistanche
Cistanche yog ib tug genus ntawm parasitic nroj tsuag uas belongs rau tsev neeg Orobanchaceae. Cov nroj tsuag no paub txog lawv cov khoom siv tshuaj thiab tau siv hauv Cov Tshuaj Suav Tshuaj (TCM) rau ntau pua xyoo. Hom Cistanche feem ntau pom nyob rau hauv thaj chaw qhuav thiab suab puam ntawm Tuam Tshoj, Mongolia, thiab Central Asia. Cistanche nroj tsuag yog tus cwj pwm los ntawm lawv cov nqaij tawv, yellowish stems thiab muaj nuj nqis heev rau lawv cov txiaj ntsig kev noj qab haus huv. Hauv TCM, Cistanche ntseeg tau tias muaj cov khoom siv tonic thiab feem ntau yog siv los kho lub raum, txhim kho qhov tseem ceeb, thiab txhawb kev ua haujlwm ntawm kev sib deev. Nws kuj yog siv los daws cov teeb meem ntsig txog kev laus, qaug zog, thiab kev noj qab haus huv tag nrho. Thaum Cistanche muaj keeb kwm ntev ntawm kev siv tshuaj ib txwm siv, kev tshawb fawb tshawb fawb txog nws txoj kev ua tau zoo thiab kev nyab xeeb yog tsis tu ncua thiab txwv. Txawm li cas los xij, nws paub tias muaj ntau yam bioactive tebchaw xws li phenylethanoid glycosides, iridoids, lignans, thiab polysaccharides, uas tuaj yeem ua rau nws cov teebmeem tshuaj.
Wecistanche covcistanche hmoov, cistanche ntsiav tshuaj, cistanche capsules,thiab lwm yam khoom tsim los sivsuab puamcistancheraws li cov khoom siv raw, txhua yam muaj txiaj ntsig zoo rau kev tshem tawm cem quav. Cov txheej txheem tshwj xeeb yog raws li hauv qab no: Cistanche ntseeg tau tias muaj cov txiaj ntsig zoo rau kev tshem tawm cem quav raws li nws cov kev siv ib txwm siv thiab qee cov tshuaj uas nws muaj. Txawm hais tias kev tshawb fawb tshawb fawb tshwj xeeb ntawm Cistanche qhov cuam tshuam rau cem quav yog txwv, nws tau xav tias muaj ntau lub tswv yim uas yuav ua rau nws muaj peev xwm txo tau cem quav. Laxative nyhuv:Cistanchetau ntev tau siv nyob rau hauv tsoos suav tshuaj raws li ib tug tshuaj rau cem quav. Nws ntseeg tau tias muaj cov nyhuv laxative me me, uas tuaj yeem pab txhawb kev zom zaub mov thiab ua rau cem quav. Cov nyhuv no tuaj yeem raug ntaus nqi rau ntau lub tebchaw nyob hauv Cistanche, xws li phenylethanoid glycosides thiab polysaccharides. Moistening cov hnyuv: Raws li kev siv ib txwm siv, Cistanche suav hais tias muaj cov khoom siv moisturizing, tshwj xeeb yog tsom rau cov hnyuv. Txhawb nqa dej thiab lubrication ntawm cov hnyuv yuav pab tau cov cuab yeej soften thiab yooj yim dua, yog li no relieving cem quav. Anti-inflammatory Effect: cem quav tej zaum yuav txuam nrog o nyob rau hauv lub plab zom mov. Cistanche muaj qee qhov sib txuas, suav nrog phenylethanoid glycosides thiab lignans, uas ntseeg tau tias muaj cov tshuaj tiv thaiv kab mob. Los ntawm kev txo cov kab mob hauv cov hnyuv, nws tuaj yeem pab txhim kho kev zom zaub mov tsis tu ncua thiab txo qhov cem quav.
