目的 探讨麻仁丸联合琥珀酸普芦卡必利片治疗老年慢性便秘的临床疗效。方法 选取2017年5月-2018年5月在重庆市大足区人民医院治疗的老年慢性便秘患者98例，根据住院号分为对照组（49例）和治疗组（49例）。对照组口服琥珀酸普芦卡必利片，60~65岁者，2 mg/次，1次/d，大于65岁者，起始1 mg/次，1次/d，若有需要可增至2 mg/次，1次/d；治疗组在对照组基础上口服麻仁丸，9 g/次，2次/d。两组均治疗7 d。观察两组患者临床疗效，同时比较治疗前后两组患者临床症状评分、血清P物质（SP）和血管活性肽（VIP）水平及结肠传输试验和PAC-QOL积分。结果 治疗后，对照组临床有效率为81.63%，显著低于治疗组的95.92%，两组比较差异有统计学意义（P<0.05）。经治疗，两组患者大便性状、排便困难程度、排便时间、排便频率及腹部不适积分均显著降低（P<0.05），且治疗组临床症状评分明显低于对照组（P<0.05）。经治疗，两组患者SP水平显著升高（P<0.05），而VIP水平明显降低（P<0.05），且治疗组血清SP、VIP水平明显好于对照组（P<0.05）。经治疗，两组结肠传输试验积分、PAC-QOL积分均明显降低（P<0.05），且治疗组结肠传输试验和PAC-QOL积分明显低于对照组（P<0.05）。结论 麻仁丸联合琥珀酸普芦卡必利片治疗老年慢性便秘可有效改善患者临床症状，改善血清SP、VIP水平，促进生活质量改善。

Objective To explore the clinical efficacy of Maren Pills combined with srucalopride succinate in treatment of senile chronic constipation. Methods Patients (98 cases) with chronic constipation in Dazu District People's Hospital of Chongqing from May 2017 to May 2018 were divided into control (186 cases) and treatment (186 cases) groups according to registration numbers. Patients in the control group were po administered with Prucalopride Succinate Tablets, 2 mg/time for 60-65 years old,once daily, the initial dose 1 mg/time for more than 65 years old, and increased to 2 mg/time if necessary, once daily. Patients in the treatment group were po administered with Maren Pills on the basis of the control group, 9 g/time, twice daily. Patients in two groups were treated for 7 d. After treatment, the clinical efficacy was evaluated, and the clinical symptom scores, the serum SP and VIP levels, the colonic transit test scores and PAC-QOL scores in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control group was 81.63%, which was significantly lower than 95.92% in the treatment group, and there were differences between two groups (P<0.05). After treatment, the stool, difficulty of defecation, defecation time, defecation frequency, and abdominal discomfort scores in two groups were significantly decreased (P<0.05), and these scores in the treatment group were significantly better than those in the control group (P<0.05). After treatment, the serum SP levels in two groups were significantly increased (P<0.05), but VIP levels were significantly decreased (P<0.05), and the serum SP and VIP levels in the treatment group were significantly better than those in the control group (P<0.05). After treatment, the colonic transit test scores and PAC-QOL scores in two groups were significantly decreased (P<0.05), and the scores in the treatment group were significantly lower than those in the control group (P<0.05). Conclusion Maren Pills combined with srucalopride succinate in treatment of senile chronic constipation can effectively improve the clinical symptoms, improve the serum SP and VIP levels, and the quality of life.

重庆市卫生计生委中医药科技计划项目（ZY201703062）