1. Zhitongtong oral liquid
65438+ 0~2 tablets each time, 3 times a day. Has effect in invigorating qi, invigorate yang, moistening intestine and relaxing bowels, and can be use for treating senile constipation.
2 Maren Runchang Pills
Has the effects of moistening intestine and relaxing bowels, and can be used for treating constipation due to intestinal dryness, postpartum constipation, habitual constipation, hemorrhoid constipation, asthenia and hemorrhoid bleeding in the elderly.
3. Tongyou Runchang Pill
It has the function of moistening intestine and relaxing bowels, and can be used to treat constipation caused by blood deficiency and law deficiency in the elderly and after illness.
4. Betel nut Xiao Si pill is a qi regulating agent. Can be used for treating constipation caused by qi stagnation, food stagnation, water stoppage and stagnation.
5. Geng Yi Pill can purge fire and relieve constipation, and it is also helpful for constipation caused by damp heat.
6. Semi-sulfur pills are used for cold secret, that is, constipation due to yang deficiency in the elderly.
(2) Acupuncture
1. Body acupuncture is mainly selected from Beishu Point, Abdominal Mofu Point and Xiahe Point; Excess syndrome should be diarrhea, deficiency syndrome should be tonic, and cold syndrome plus moxibustion. Take Da Zhangshu, Shu Tian, Zhigou and Hong Long for example. Hot secret plus Hegu and Quchi; Qi stagnation is added to the intermediate people's court, between the lines, and acupuncture is used to lower the method: deficiency of qi and blood plus spleen and stomach; For those with cold excess and yang deficiency, moxibustion at Shenque point is added, with acupuncture as the auxiliary method, and the needle is kept for 1 time every day for 5-20 minutes, with 1 course of treatment for 7 days, and the interval of treatment is 2-3 days.
2. Ear acupuncture takes the lower segment of large intestine, stomach and rectum every other day 1 time or every day 1 time. Electroacupuncture or needle embedding can be added, with rotation/kloc-0 every 5 days.
(3) Cupping
Take Dachangshu, Xiaochangshu, Zusanli and positive reaction sites. Methods: Cupping the positive reaction parts of the left abdomen, buttocks and back thighs for 10~ 15 minutes.
(4) Massage
1. Massage the abdomen up, left and down from the lower right abdomen along the direction of colon, and repeat it until it stops when defecating.
2. Gently pressing the perineum and perineum is the intersection of all yin qi, which can help defecation, or patting the sacrococcygeal region can also promote defecation.
(5) External treatment
1. Pig bile guiding method
Take pig bile 1 block, add a little vinegar, and pour it through anus. Suitable for people with insufficient body fluid and heat accumulation.
2. Honey decocting method
Take honey 140ml, put it in bronze ware, simmer with low fire, stir it frequently, don't cook it, cook it until it is as thick as caramel, take it out and twist it into a spindle shape with a tip as big as a finger, about 30mm long, add a little powder of Gleditsia sinensis, and heat it to take it into the anus.
3. External application method: adjust the navel with rhubarb powder 10g and mirabilite 40g, cover it with gauze, fix it with adhesive tape, and then hot compress it with hot water bottle for about10min, then it can be discharged.
4. Enema can be used for patients with acute occasional constipation.
20g of rhubarb (lower back), mirabilite (washed) 15g, 20g of immature bitter orange, and magnolia officinalis 15g. Decoct in water to 200ml, and keep enema, 1~2 times a day.
(6) Hospital preparation
1 rhubarb capsules, 2-3 capsules each time, 1-3 times a day. It has the function of clearing heat, purging fire and detoxifying, and is used for the secret of excess heat.
2 Changyanqing capsules, 4 capsules each time, 3 times a day. Has the effects of invigorating qi, invigorating spleen, promoting qi circulation and relaxing bowels, and can be used for treating deficiency and secret.
Third, western medicine treatment.
When choosing laxatives, we should pay attention to the efficacy, safety and drug dependence. It is recommended to choose fillers (such as wheat bran and plantain seeds). ) and osmotic laxatives (such as polyethylene glycol 4000 lactulose). For slow transit constipation, intestinal prokinetic drugs can be added when necessary. Long-term application or abuse of irritant laxatives should be avoided.
(A) diet and life conditioning
1. Drink plenty of boiled water. You can drink 1 cup of warm boiled water or salted boiled water every morning. Eat more fruits, vegetables and dregs, such as bamboo shoots, bran and standard flour.
2. Exercise regularly and develop good defecation habits.
3. Strengthen defecation exercise (anal sphincter retraction-release) and abdominal muscle exercise, especially for people who are weak and have little activity.
(2) Application of laxatives
1. Expansive laxatives
Suitable for people with less residue diet and functional constipation. This kind of laxative can increase intestinal volume and cause intestinal peristalsis.
(1) salt laxative, magnesium sulfate 10~20g/ time; Magnesium oxide 1~3g/ time, 3 times a day. In case of magnesium emulsion, each time 15ml.
(2) hypertonic laxative, sorbitol 5~ 10g/ time, 2~3 times a day; 60% lactulose 10~ -30ml, 2~3 times a day.
(3) A mild expansive laxative, agar 1.5 ~ 30 ml, twice a day; Methyl cellulose 1.5~5g/ day.
2. Lubricating laxatives, which are not easy to be absorbed after taking and lubricate the intestinal wall. Liquid paraffin 15~30ml will hinder the absorption of fat-soluble vitamins, calcium and phosphorus when taken before going to bed.
3. Irritating laxatives are laxatives, which stimulate intestinal peristalsis and contribute to the failure or deficiency of defecation motivation. However, due to non-physiological effects, it is not suitable for long-term use and only suitable for temporary treatment. ① Phenolphthalein 0.05~0.2g, taken before going to bed; ② castor oil 15~30ml, taken before going to bed; ③ Rhamnus rhamnoides bark 0.3~0.6g/ time; ④ Rhubarb soda tablets 2 tablets/time; ⑤ Glycerol suppository 1 granule/time; ⑥ Every time 1 kaiselu, squeeze the liquid medicine into rectum.
4. Wettable laxatives make water permeate human feces, soften, swell and discharge. For example, sodium tetrabutyl sulfonate, 50~200mg orally every day, is suitable for hard defecation and weak defecation.
5. Intestinal peristalsis promoter, which stimulates intestinal nerve or muscle layer to cause peristalsis and increase defecation. ① bisacodyl (stopping defecation): 5~ 10ng times, daily 1 time; ② Cisapride: 10mg/ time, 1~3 times a day; ③ Mosapride 5mg/ time, 1~3 times/day.
(3) biofeedback therapy
Include balloon biofeedback method and electromyography biofeedback method. It has a good curative effect on dry yang constipation at the exit.
(4) Surgical treatment
For severe chronic constipation, surgical treatment can be considered. Total colectomy plus enterorectal anastomosis is an important method to treat chronic constipation, and drug anorectal myotomy has a better effect on outlet obstructive constipation.