1. Zhitongtong oral liquid
1-2 tablets each time, 3 times a day. It has the function of invigorating the temperature and yang to relieve constipation, and is used for senile constipation
2 Maren Runchang Pill < P > has the function of relaxing bowels and relieving constipation, and is used for treating constipation due to intestinal dryness, puerperal constipation, habitual constipation, hemorrhoid constipation and hemorrhoid bleeding, which belong to gastrointestinal dryness and heat.
3. Tongyou Runchang Pill
has the function of moistening intestines and relaxing bowels, and is used to treat constipation caused by deficiency of law and blood in the elderly and after illness
4. Binglang Sixiao Pill is an agent for regulating qi and promoting digestion. Can be used for treating constipation caused by stagnation of qi, food stagnation, water stoppage and stagnation.
5. Gengyi Pill can purge fire and relieve constipation, and it is also helpful for constipation caused by damp heat.
6. Semi-sulfur pill is used for cold secret, that is, senile constipation due to yang deficiency.
(2) Acupuncture
1. Body acupuncture is mainly selected from back Shu point, abdominal point and Xiahe point; Excess syndrome should be diarrhea, deficiency syndrome should be tonic, and cold syndrome plus moxibustion. Take Dachangshu, Tian Shu, Zhigou and Fengliong. Hot secret plus Hegu and Quchi; Qi stagnation is added to the intermediate people's court and between the lines, and the acupuncture purgation method is used: deficiency of qi and blood is added to spleen and stomach; For those with cold excess and yang deficiency plus moxibustion at Shenque, acupuncture is used once a day, and the needle is kept for 15-2 minutes. Seven days is a course of treatment, and the interval of treatment is 2-3 days.
2. Ear acupuncture takes the lower segment of large intestine, stomach and rectum, once every other day or once a day, and electroacupuncture or needle embedding can be added, rotating once every five days.
(3) Cupping
Take Dachangshu, Xiaochangshu, Zusanli and the positive reaction parts. Methods: cupping the positive reaction parts of left abdomen, buttocks and back thighs for 1~15 minutes.
(4) Massage
1. Massage the abdomen from the lower right abdomen along the direction of the colon, and massage it up, left and down repeatedly until it stops when defecating.
2. Gently pressing perineum is the meeting of all yin, which can help defecation, or tapping cauda sacrum can also promote defecation.
(5) External treatment
1. Pig bile guide method
Take juice from one pig bile, add a little vinegar, and pour it through the anus, which is suitable for people with fluid deficiency and heat accumulation.
2. honey frying method
Take 14ml of honey, put it in a bronze vessel and simmer it with low fire, stir it frequently, and do not boil it until it is as thick as caramel. Take it out and twist it into a spindle shape, with a sharp head as big as a finger, about 3mm long, and add a little bit of ground saponin to it, and then take it into human anus by heat.
3. For external application, 1g of rhubarb powder and 4g of mirabilite are used, the navel is adjusted with appropriate amount of yellow wine, covered with gauze, fixed with adhesive tape, and then hot-pressed with hot water bottle for about 1 minutes, so that the stool can be discharged.
4. enema can be used for patients with acute occasional constipation.
2g of rhubarb (lower back), 15g of mirabilite (washed), 2g of immature bitter orange, and 15g of magnolia officinalis are decocted with water to 2ml, and enema is reserved once or twice a day.
(6) Hospital preparation
1 Dahuang capsule, 2-3 capsules each time, 1-3 times a day. It has the function of clearing away heat, purging and detoxicating, and is used for the secret of excess heat.
2 Changyanqing capsules, 4 capsules each time, 3 times a day. It has the functions of invigorating qi, strengthening spleen, promoting qi circulation and relaxing bowels, and can be used for treating deficiency and secret.
iii. western medicine treatment
in selecting laxatives, attention should be paid to the efficacy, safety and drug dependence. It is advocated to choose bulking agent (such as wheat bran, psyllium, etc.) and osmotic laxative (such as polyethylene glycol 4 lactulose). For slow transit constipation, intestinal prokinetic can be added when necessary. Long-term application or abuse of irritant laxatives should be avoided.
(1) Diet and life conditioning
1. Drink plenty of boiled water, and 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 to develop good defecation habits.
3. strengthen the exercise of defecation (anal sphincter retraction-release) and abdominal muscle exercise, especially for those who are weak and have little activity.
(II) Application of laxatives
1. Expandable laxatives
are suitable for patients with functional constipation who eat less residue. Such laxatives can increase intestinal volume and cause intestinal peristalsis.
(1) salt laxatives, magnesium sulfate 1~2g/ time; Magnesium oxide 1~3g/ time, 3 times a day. In the case of magnesium emulsion, 15ml each time.
(2) hypertonic laxative, sorbitol 5~1g/ time, 2~3 times a day; 6% lactulose 1~ -3ml, 2~3 times a day.
(3) Expansive laxative with mild effect, agar 15~3ml, twice a day; 1.5-5g/day of methyl cellulose.
2. a lubricating laxative, which is not easy to be absorbed after taking, lubricates the intestinal wall, and the liquid paraffin is 15~3ml, which can hinder the absorption of fat-soluble vitamins, calcium and phosphorus if taken before going to bed for a long time.
3. Irritating laxatives, which stimulate intestinal peristalsis, are helpful to the failure or lack of defecation power, but they are not suitable for long-term administration and are only suitable for temporary treatment because of their non-physiological effects. ① Phenolphthalein .5~.2g, taken before going to bed; ② castor oil 15~3ml, taken before going to bed; ③ Rhamnus bosch skin .3~.6g/ time; ④ Rhubarb soda tablets 2 tablets/time; ⑤ Glycerol suppository is taken into anus once per time; ⑥ Open the bottle one at a time and squeeze the liquid medicine into the rectum.
4. Wettable laxatives, which make water seep into human feces, soften, expand and discharge. For example, sodium tetrabutyl sulfonate, 5~2mg orally every day, is suitable for hard feces and weak defecation.
5. Intestinal peristalsis promoter, which stimulates intestinal nerve or muscle layer to cause increased peristalsis and defecation. ① bisacodyl (stool stop): 5~1ng times, once a day; ② Cisapride: 1mg/ time, once to three times a day; ③ Mosapride: 5mg/ time, once to three times a day.
(3) biofeedback therapy
includes balloon biofeedback method and electromyography biofeedback method. It has good curative effect on constipation of outlet stem yang type.
(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 anorectal myotomy with medicine is better for outlet obstructive constipation.