2020年10月20日星期二

hemorrhoids or anal cancer,Traditional Chinese Medicine Science Series-Constipation

    Traditional Chinese Medicine Science Series

    The Third Hospital of Chaoyang District, Beijing

    Beijing Chaoyang District Mental Disease Prevention and Control Center

    Editor in chief

    Ma Liang Third Hospital of Chaoyang District, Beijing

    consultant

    Wang Yanheng, Beijing Anding Hospital, Capital Medical University

    Tang Qisheng Third Affiliated Hospital of Beijing University of Chinese Medicine

    Editorial board

    Ma Liang Third Hospital of Chaoyang District, Beijing

    Kang Yuchun Third Hospital of Chaoyang District, Beijing

    Zhang Xiaogang Third Hospital of Chaoyang District, Beijing

    Feng Ping Third Hospital of Chaoyang District, Beijing

    Dong Shuo Third Hospital of Chaoyang District, Beijing

    Duan Shuo Third Hospital of Chaoyang District, Beijing

    Chen Yanhui Third Hospital of Chaoyang District, Beijing

    Zhang Jing, Beijing Chaoyang District Mental Disease Control and Prevention Center

    Preface

    Constipation is not only a disease, but also a clinically most common gastrointestinal symptom. For different people, constipation has different meanings. The most common symptoms are abdominal distension, abdominal pain, and a significant decrease in the frequency of bowel movements, once every 2-3 days or longer, irregular, dry stool, and difficulty in passing out. With the increase of age and the acceleration of the pace of modern life, the prevalence has also increased. Most people think that constipation is not a disease and does not need to be treated, but in fact, constipation is very harmful and will bring a lot of harm to physical and mental health.

    Dry stools can easily cause anal fissure, excessive anorectal congestion, hemorrhoids over time, and serious diseases such as intestinal obstruction. Feces stay in the intestines for a long time, produce harmful toxins after abnormal fermentation and corruption, make the abdomen full, belching, stomach acid, tasteless diet, easy to cause rough skin, itching, facial pigmentation, acne, rash, etc. Many patients also experience symptoms such as dizziness, palpitations, fatigue, anxiety, irritability, insomnia, or even memory loss, distraction, and slow thinking, which can cause sexual disorders, infertility, and seriously affect the quality of life.

    Constipation can cause intestinal ecological balance imbalance due to the inability to excrete harmful substances produced in the body, and increase the risk of colorectal cancer. For patients with high blood pressure and coronary heart disease, forced defecation during constipation can cause myocardial ischemia and cerebral ischemia, light dizziness and brain swelling, light head and feet, palpitations, shortness of breath, and sudden death in severe cases. Patients with liver cirrhosis and constipation can cause massive gastrointestinal bleeding due to rupture of the fundus veins of the esophagus. Therefore, actively preventing constipation is an important part of health that people cannot ignore in today's society.

    The general incidence of chronic constipation is about 2%-10%. Domestic research shows that in chronic constipation, functional diseases (without organic diseases but characterized by functional changes) account for 57.1%. A Chinese study found that the prevalence of constipation increased significantly with age, and the number of people over 60 increased significantly. A survey of elderly people over 60 years old in Beijing urban districts and suburban villages found that the prevalence rate was 20.39%. Constipation is closely related to gender. Females are a high-risk group, and the adult male to female prevalence ratio is 1:4.59. It can be seen that constipation is a common problem, and it occurs more frequently in the elderly.

    The cause of constipation is extremely complex, and its treatment should be based on the clear cause, and targeted measures should be taken. If the primary disease can be determined, the primary disease should be corrected first. When the primary disease is difficult to find or before the primary disease cannot be effectively treated, the dietary structure and lifestyle should be adjusted, and appropriate drugs should be given to relieve the symptoms of constipation.

    Traditional Chinese medicine believes that there are many causes of constipation, which are related to factors such as improper diet, emotional imbalance, old age and physical weakness, and feelings of external evil. , Maintain a happy mood, correct bad habits, adjust the diet, prevent constipation. Patients who are already suffering from constipation can use drugs reasonably and correctly to help defecate and prevent other diseases under the guidance of a doctor.

    1. Definition and diagnosis of constipation

    (1) The definition of constipation

    Constipation is a common clinical symptom, which refers to reduced stool frequency, reduced stool volume, dry stool, and laborious stool. The stool is not hard. Although the stool is intended, the stool is not smooth. If more than 6 months is chronic constipation.

    The diagnosis must be based on the characteristics of the stool, my usual bowel habits and the difficulty of defecation to make a judgment on whether there is constipation. It is normal to have stool once a day, soft stools or banana stools, intentional defecation, and effortless defecation. Some people 1-2 times a day, or once a day, if there is no pain, it can not be regarded as constipation. Different individuals have different understandings of the term "constipation", and cultural and geographical differences will also cause differences in understanding. At present, there is still no widely accepted definition of constipation.

    (2) Diagnosis of constipation

    Constipation has a high prevalence rate in both Western countries and China, but because of the inconsistent diagnostic criteria. The more recognized diagnosis is the diagnostic criteria of Rome IV, as follows:

    The diagnostic criteria for chronic functional constipation (adults) are set as: at least 3 months in the past 6 months with 2 or more of the following symptoms: ①Defecation effort; ②Draining hard stool; ③Insufficient bowel movement; ④ A sense of blockage in the anus and rectum during defecation; ⑤Need manual defecation assistance; ⑥Defecation frequency (less than three bowel movements per week). (The above symptoms are not less than 1/4 of the time). During the evaluation, cellulose supplements and defecation-influencing drugs should be stopped. The number of constipation is the number of spontaneous bowel movements; there is no loose stool, and the diagnostic criteria for irritable bowel syndrome are not met.

    (3) Overview of Traditional Chinese Medicine for Constipation

    In his "Treatise on Febrile and Miscellaneous Diseases," the famous Eastern Han physician Zhang Zhongjing described constipation as "hard stool", "no bowel movement", "spleen appointment", "no dressing", "dry feces", "yang knot", and "yin". "Knot", "closed", "stool hard" and so on. Traditional Chinese medicine believes that constipation is always a failure of large intestine conduction and is related to the dysfunction of the spleen, stomach, lungs and kidneys, among which there are real and weak. Or the diet is unregulated, the overeating is spicy, fat and sweet, and the food accumulates in the stomach, causing gastrointestinal fever; or the poisonous drugs are incorporated into the stomach and directly damage Yangming, and the evil heat acts on Zhongzhou, which consumes body fluid and damages the body. Qi machine; or emotional disorder, stagnation of Qi machine, unable to communicate, abnormal flow and lowering; or weak body, deficiency of both qi and blood, deficiency of qi leads to weak transmission of the large intestine, and deficiency of blood leads to loss of fluid and intestinal tract, and the intestine becomes more Stagnation is hard to do. Common types are: intestinal dryness and heat, body fluid and stool; heat accumulation in the stomach and intestines, insufficiency of qi in the organs, upset stomach fire; internal accumulation of phlegm, food, dampness and heat, unfavorable Qi mechanism; insufficient stomach yin, loss of nourishment of the stomach; deficiency of Qi Lack of Jin, weak conduction, etc.

    2. Causes of constipation

    (1) Bad eating habits

    The food is too fine and lack of food containing dietary fiber and fat, which reduces the volume of feces, increases viscosity, slows down movement in the intestines, and over-absorbs water and causes constipation. Or due to a small amount of food, the gastrointestinal transit time is slowed, which can also cause constipation.

    (2) Bad emotions

    Insufficient sleep, persistent high mental stress, etc., can cause bowel motility and spastic contraction to cause constipation. Bad emotions such as Alzheimer's disease or severe mental depression can easily cause conditioned reflex to be impaired, gastrointestinal motility disorders, and constipation.

    (3) Irregular bowel habits

    Changes in living habits, improper defecation posture, failure to develop the habit of regular defecation, and often neglect of normal defecation intentions, resulting in suppression of defecation reflex and constipation. Constipation can also be easily caused by changes in lifestyle and environment, fatigue from long-distance travel, and failure to defecate in time.

    (4) Reduction in activities

    The elderly, long-term sick or obese people, due to significantly reduced physical activity, abdominal and pelvic floor muscle weakness, weakened internal and external anal sphincter muscle strength, weakened intestinal reflex, lack of exercise stimulation to promote the movement of feces, are often prone to constipation.

    (5) Drug-derived (drugs of abuse)

    Frequent use of strong laxatives and enema, etc. can cause the rectal reflex to decrease, so that although stool enters, it is not enough to cause effective nerve impulse, so that the defecation reflex cannot be produced and cause constipation. Other drugs that cause constipation include opioid analgesics, antipsychotics, anticholinergics, antihistamines, antidepressants, calcium antagonists, diuretics, etc.

    (6) Gastrointestinal diseases

    Suffering or potential gastrointestinal diseases may be the cause of constipation, so constipation or changes in bowel regularity are also signs and signs of many diseases.

    There are many reasons for constipation. In addition to the above-mentioned reasons, Chinese medicine believes that physical fitness is also a factor that affects defecation. Among them, qi deficiency, yang deficiency, yin deficiency, and damp-heat are prone to constipation.

    (7) Other system diseases

    Endocrine or metabolic diseases such as diabetes, hypothyroidism, parathyroid disease, immune system diseases, scleroderma, lupus erythematosus, neurological diseases, central brain disease, stroke, spinal cord injury and peripheral neuropathy, etc., nerves Mental disorders can also cause constipation.

    3. Self-adjustment of constipation

    (1) Develop good bowel habits

    Improving lifestyle plays an important role in the prevention and treatment of functional constipation. Develop the habit of defecation at a regular time every day, usually after getting up in the morning or after a meal, or at a time that you think is appropriate, to form a conditioned reflex and establish a good defecation rule. If you find that you have a bowel movement, don't ignore it, and defecate in time. Attention should be paid when defecation, not listening to music or reading a book or cell phone. The environment and posture for defecation should be as convenient as possible, so as not to inhibit defecation and destroy defecation habits. Avoid excessive defecation,

    (2) Reasonably arrange work and life

    Appropriate cultural and sports activities and exercises that combine work and rest and relax the mood can not only improve mood and reduce excitement, but also help improve gastrointestinal function. It is especially important for sedentary mental workers who are less active and highly concentrated. Regular diet can regulate digestion and absorption, increase stool volume and consistency, and maintain normal gastrointestinal motility and rectal emptying.

    (3) Improve mood

    Patients with severe constipation often have symptoms of anxiety or depression and other psychological factors or disorders. Cognitive therapy should be given to relieve the tension. Anti-depressant and anti-anxiety treatments should be given if necessary, and psychologists should assist in diagnosis and treatment.

    4. Sports massage for constipation

    (1) Appropriate exercise

    Sit less and go more, slow for 20 minutes after a meal, and perform appropriate physical exercises according to your physical fitness to strengthen your body to increase appetite, improve colon movement, increase the contraction of defecation auxiliary muscles, and relieve symptoms of constipation. For patients who need absolute bed rest due to illness or lack of physical activity, they should passively move their limbs every day to promote bowel movements and prevent constipation.

    (2) Self-massage

    First abdomen luck. Lie supine or semi-recumbent, flex your feet slightly, relax your abdomen, close your mouth slightly, lick your upper jaw with your tongue, aim at the umbilicus, and breathe deeply for 3 minutes in a calm abdominal position. Exhale 6 times per minute, the larger the abdominal breathing, the better the effect.

    Then go around the umbilical massage. On the basis of abdomen luck, continue to take deep abdominal breathing while overlapping your hands, with your right palm down, apply even force, and relax supine. Starting from the right lower abdomen-up-to the left-and then down, massage the abdomen in a clockwise direction (that is, along Follow the sequence of ascending colon, transverse colon and descending colon-sigmoid colon. The depth is generally 3-5 cm. It is better to touch the intestines. Generally, take 1 breath around the umbilical for 1 week, massage for 5 minutes and then luck for 2 minutes, 2-3 times a day, 15-20 minutes each time, or massage 200 times each time, 14 days is a course of treatment. It can also be done 20 minutes before the toilet or 2 hours after the meal.

    (3) Abdominal shaking method

    On the premise of ensuring the correct bowel posture, shake your stomach. Because the intestine is located in the abdomen, shaking the stomach can increase the fluidity of the intestinal material, thereby promoting defecation. It can be shaken in the front, back, left, and right directions or up and down. It can also vibrate at a fast frequency, usually within a few minutes, can produce strong bowel movements.

    (4) Prevention and treatment of habitual constipation

    Habitual constipation prevention and treatment exercises are mainly based on abdominal exercises. Persistent exercises can strengthen abdominal muscles, promote gastrointestinal peristalsis, correct habitual constipation, and keep stool smooth.

    ①Bend the legs in the supine position, bend the knees at the same time and lift them to make the thighs close to the abdomen, and then restore. Repeat 15 times.

    ②Lift your legs in the supine position, raise your legs at the same time, and then slowly lower them. Repeat 15 times.

    ③Being in the supine position on a bicycle, the legs take turns in flexion and extension, imitating the exercise of pedaling a bicycle. The movements should be fast and flexible, and the range of flexion and extension should be as large as possible. Do it for 20-30 seconds.

    ④Sit-ups: Sit up from the supine position, lean your upper body forward after sitting up, and touch your toes with both hands for 8-10 times.

    (5) Anal and perineum exercise method

    Anus-perineum exercise is also called anal contraction exercise, which is a method of exercise under the control of active consciousness to contract and relax-contract the anus and perineum. Anus-perineum exercises can enhance the voluntary relaxation and contraction functions of the external anal sphincter, puborectalis, and levator ani muscle, thereby increasing the power of defecation and smooth defecation, which is beneficial to the prevention and treatment of constipation. The following specific methods are commonly used.

    1. Randomly contract the anus and perineum for 5 seconds, then relax for 5 seconds, continue for 5 minutes, usually practice 2-3 times a day. When practicing, pay attention to inhale and hold your breath slightly when retracting the anus.

    2. Lie on your back, bend your knees, raise your head, stretch your right hand to your left knee, then relax and recover; then bend your knees, raise your head, stretch your left hand to your right knee, relax and recover. Repeat this exercise 10-15 times, usually 1-2 times a day.

    3. Lie on your back, contract your abdomen inward, and tighten your buttocks for 5 seconds, then put it down, and repeat for 5 minutes, usually 2-3 times a day.

    4. Sitting deep breathing method, tighten the buttocks and anus when you breathe deeply, and relax when you exhale. Do this 10-30 times continuously with the deep breath; you can also stand up to contract the anus, relax, and then contract the anus, repeat the practice 10-30 Times; or deliberately doing anal contraction exercises while walking.

    5. Acupoint treatment for constipation

    (1) Ear-point pressing beans

    Sterilize the auricles with 75% ethanol, place the Wangbuliuxing seeds (or magnetic beads) in the center of a round tape with a diameter of 4-5 mm, and paste them on both ear points (large intestine, rectum, triple burnt, endocrine, sympathetic, lung, etc.) On the spleen, place the thumb and index finger on the front and back of the auricle for 1-2 minutes, with the degree of local acid, numbness, heat, swelling, and pain, 3-5 times/day, change every 5 days Once Wang did not leave the seeds, the treatment was continued for 15 days.

    (2) Umbilical application

    The medicine is directly applied to the umbilical area and absorbed through the umbilical area, acting on the intestinal tract, reconciling qi and blood, and stimulating the conduction of the intestinal tract to achieve the purpose of defecation.

    ① Take 100 grams of fresh scallion white, mash and press it into a cake and stick it on the belly button, cover it with gauze, and place a hot water bottle on it for 20-30 minutes.

    ②Grind Glauber's salt into powder, use 2-3 ml of safflower oil to make a paste, fill the umbilical fossa, cover with gauze, fix with tape, change the dressing once every 2-3 days, and 5 times as a course of treatment;

    ③ 5-10 grams of rhubarb powder, mixed with 50-60℃ white wine into a paste, applied to Shenjue acupoint, covered with external dressing, fixed with tape (bandage for tape allergy), and 50-60℃ white wine for topical use about 5ml Warm up, once a day, dressing once every 3 days, 5 times as a course of treatment.

    ④ 100g aloe powder, add 150ml of 70% ethanol and stir to make a paste, place the aloe paste in the umbilicus and fill it up (about 5 grams), press gently, and fix it in a cross shape with a wide tape. Do not let the paste leak out, 1 per day Times.

    Prescription 1 is suitable for people with mild constipation symptoms and weak physique. Recipes 2, 3, and 4 are suitable for people with severe constipation and who are usually strong.

    (3) Shiatsu therapy

    Shiatsu therapy, also known as pointer method, is a treatment method in which fingers are pressed tightly at acupoints. During operation, generally use the thumb and index fingers to pinch the distal segment of the middle finger and press and rub the acupoints with the tip of the middle finger. The finger strength is light to heavy, and there is a sense of qi in the local area.

    Fang 1 Chize, Weizhong points (both sides).

    Method Use acupressure method to force the upper acupoints for 5 minutes. If necessary, it can be repeated once more, or bloodletting after pressing.

    Fang 2 Quze, Weizhong points (both sides).

    Method Use acupressure and pricking blood to force the upper point for 1.5-3 minutes per point. The operation can be repeated after a five-minute rest.

    Fang 3 Zusanli (double), Tianshu (double), Zhongwan, Qihai points.

    Methods Using acupressure method, use both thumbs to press the above acupoints in sequence, 3-5 minutes per acupoint, once a day.

    (4) Foot bath

    Through warm water stimulation, the blood circulation in the reflection areas of the small intestine, colon, and anus of the feet is active, thereby strengthening the functions of these organs and promoting intestinal peristalsis. It is more effective if it can be pressed with the plantar reflex area.

    Six, diet therapy for constipation

    The diet therapy for constipation, also known as the diet promotion method, is mainly suitable for young people and friends with mild constipation. You can eat more fruits, vegetables, and crude fiber foods, such as sweet potatoes, celery, carrots, leeks, kiwi, etc.

    (1) Adjust diet

    1. Increase the crude cellulose content in food.

    Adopt a multi-residue diet, including cellulose-rich vegetables, fruits, whole grains and fresh vegetables and fruits. If necessary, add some agar (Gelidium agar) to use their water absorption to expand and increase intestinal contents. And as a nutrient for intestinal bacteria, it increases the intestinal flora, produces gas, stimulates intestinal peristalsis, thereby shortening colon transit time, reducing intestinal pressure, and softening stool.

    2. Use more gas-producing foods.

    For example, raw onions, raw garlic, honey, raw cucumbers, raw radishes, etc., use their fermentation in the intestines to produce gas, promote bowel movements, and facilitate defecation.

    3. Drink plenty of water.

    Drink at least 6 cups of 250 ml (1-2 liters) of water daily. Drink 1 cup of warm water on an empty stomach every morning to stimulate gastrointestinal peristalsis, soften stool, and stimulate bowel movements. You should pay attention to drinking skills: sip a large amount, drink 300ml-400ml of warm water on an empty stomach in the morning, and drink it in 2-3 times.

    4. Correct the partial eclipse habits.

    Use less refined foods and more coarse grains, beans and their products to increase the intake of vitamin B. Avoid irritating foods, such as strong tea, coffee, peppers, etc., and do not drink alcohol or beverages that contain a lot of caffeine.

    5. Eat more oily foods.

    For patients with normal weight and low blood lipids, instruct them to eat more oily foods and eat more foods that lubricate the intestines such as black sesame, walnut, honey and vegetable oil.

    6. Yogurt.

    If possible, drinking 1-2 cups of yogurt a day can promote digestion and have a laxative effect.

    (2) Convenient diet test prescription

    The diet therapy for constipation, also known as diet promotion method, is mainly suitable for young people and friends with mild constipation. Some people mention bananas, but bananas are not suitable for people with qi deficiency, which will make the stool more dry. You can eat more fruits, vegetables, and crude fiber foods, such as sweet potatoes, celery, leeks, kiwi, etc.

    1. Vinegar and Egg Therapy

    1 egg, 180 ml rice vinegar. Put the eggs in the vinegar for 2 days and nights, break the shells and stir them evenly, and then take them after 4 days. Take 15 ml twice a day. Generally, it is effective in 1 day and gets better in 1 week.

    2. Senna egg soup

    5-10g senna leaves, 1 egg, a little spinach, salt and MSG. Stir the eggs in a bowl for later use, fry the senna leaves in water, remove the residue and leave the juice, pour in the eggs, add spinach, salt, monosodium glutamate, and boil and serve. This soup has the effect of reducing heat and conducting stagnation. Excess heat constipation is its indication. Do not eat too hot.

    3. Yellow and white radish noodles

    Rhubarb 3g, raw rehmannia 10g, cabbage 100g, carrot 100g, flour 200g, sugar, salt, monosodium glutamate, sesame oil. Wash the cabbage and carrots and shred them for later use. Fry rhubarb in water, raw ground, remove the residue and leave the juice, add a little sugar to taste. When it cools, combine the noodles with concoction and cut into noodles in the usual way. Add clean water to the pot, bring it to a boil, boil the noodles, add cabbage, shredded radish and some salt after boiling, continue to cook, add a little MSG, sesame oil and serve. People who experience heat, constipation and dry mouth and tongue and body fluid consumption should use this diet to relieve heat, nourish yin, and relax bowel movements.

    4. Champagne porridge

    Woody 5g, betel nut 5g, japonica rice 100g, rock sugar right amount. Method: Fry the muxiang and betel nut in water, remove the residue and leave the juice, add the japonica rice to cook the porridge. Add an appropriate amount of rock sugar to the porridge, fry for a while, and serve. The function is smooth and stagnant, suitable for people with qi stagnation and constipation. This medicated diet can be eaten in 2 times.

    5. Spicy ginseng stewed large intestine

    Woody 10g, Dalbergia 5g, Sea cucumber 10g, 1 pig large intestine, salt, soy sauce, green onion, ginger, and MSG. Soak the sea cucumber, wash and slice it. Wash the large intestine and chop finely. Dalbergia and woody incense are put into gauze bags. Add appropriate amount of water to the pot, add the large intestine, boil to defoam, add green onions and ginger, cook until the intestines are almost cooked, put the sea cucumber and medicine bag, cook until the large intestine is very soft, add appropriate amount of salt, monosodium glutamate, soy sauce, and cook for a while. This medicated diet has the effects of promoting qi, nourishing blood, and laxative. It is especially suitable for people with qi stagnation and fluid deficiency and constipation.

    6, Polygonum multiflorum boiled eggs

    Polygonum multiflorum 50g, 2 eggs. Boil Polygonum multiflorum and eggs with water. After the eggs are cooked, remove the shells and boil them for a while, eat the eggs and drink the soup. This medicated diet is designed for people with blood deficiency and constipation. Polygonum multiflorum replenishes essence and blood, moisturizes the intestines and laxative, and eggs nourishes qi and blood.

    7, raw ground stewed bananas

    20g of raw land, 2 bananas, appropriate amount of rock sugar. Fry the ground in water, remove the residue and leave the juice, peel the banana, cut into sections, put it in the pot, add rock sugar and cook. The original place nourishes yin and clears away heat, and the banana nourishes the intestines. This medicated diet is suitable for constipation with yin deficiency and internal heat, 2 times a day.

    9. Guilai honey cream

    20 grams each of Angelica and Scutellaria, 200 grams of honey. Make an ointment according to routine, 50 grams per serving. 2 times a day. After 2 days of medication, the effective rate was 94.17%.

    9, fried sweet potato leaves

    500 grams of fresh sweet potato leaves, appropriate amount of hemp oil. Stir-fry with salt, and serve once. 2 times a day. It is generally smooth after 7 days of consumption.

    10. Sweet potato and jujube porridge

    200g sweet potatoes, 30g jujube. Wash the sweet potatoes, peel them, cut into small pieces, put them in a pot with the jujubes, add about 500 ml of water, boil them on a high fire to 200 ml, and then add appropriate amount of honey to eat, 1-2 times a day, treatment habits Sexual constipation.

    (3) Fruit

    Fruits contain a lot of pectin, cellulose, and vitamins, which are of great benefit to the human body, but not all fruits are good for laxative, so it is not generally recommended. For example, the commonly used bananas are sweet in taste and cold in nature. They have the properties of clearing away heat, moisturizing the intestines, and detoxifying. However, they are not suitable for patients with physical weakness, menstruation, renal insufficiency, and diabetes. Bananas in the mainland are mostly ripening and contain a lot of tannic acid. It will aggravate constipation.

    1. Apple

    Apple is rich in dietary fiber-pectin, which protects the intestinal wall, activates useful bacteria in the intestine, and adjusts gastrointestinal function, so it can effectively clean the intestine. Apple can play a two-way regulatory role in laxative problems. When constipation occurs, eating more apples can play a laxative effect. The pectin in the apple can absorb 2.5 times the water of its own volume, which makes the stool soft and easy to discharge, which can relieve the worry of constipation. When diarrhea occurs, pectin can absorb the water in the feces to make loose stools thicker, thus playing an antidiarrheal effect. Apple's two-way adjustment is very gentle, especially suitable for the elderly and infants. You can eat one in the morning and evening on an empty stomach.

    2. Kiwi

    Kiwifruit contains more dietary fiber, oligosaccharides, and proteolytic enzymes, which can quickly remove harmful metabolites accumulated in the body and prevent constipation. It can also prevent colon cancer. Kiwi fruit is rich in vitamin C, which improves immunity and softens blood vessels. Take 1 to 2 on an empty stomach every morning, and then eat normally after 1 hour.

    3.Citrus

    Citrus is rich in dietary fiber, which promotes gastrointestinal motility and digestion, but cannot lower blood fat and blood pressure. It is fine to eat 2 or 3 a day. If it is too much, some people may get angry easily. The white meridian silk on the orange flesh can be eaten.

    4. Grapefruit

    Grapefruit tastes sweet and sour, with cold nature. It is rich in protein, organic acids, vitamins, calcium, phosphorus, magnesium, sodium and other essential elements for the human body. It contains pectin and insulin-like ingredients. It has the ability to regulate qi, relieve phlegm, nourish the lungs and clear the intestines. Nourishes blood and invigorates the spleen. It can help digestion, eliminate phlegm and quench thirst, regulate qi and dispel stagnation, and moisturize the intestines.

    5. Pear

    Pear contains a lot of water, it moisturizes the intestines, relaxes the bowels, diuresis and lowers blood pressure, and is also good for pharyngitis. Eat 1 to 2 a day.

    6, peaches

    Peach pulp contains more protein, fat, sugar, calcium, iron, vitamin B, C and other nutrients needed by the human body, which can promote blood circulation, remove blood stasis, and moisturize the bowel.

    7, strawberry

    Strawberry is not only rich in vitamins and minerals, but also high in dietary fiber, which moisturizes dryness and promotes body fluids, and regulates the intestines and stomach. Eating a few more will not catch cold or get angry. It is a good fruit for all ages.

    8. Pineapple

    Pineapple has a cleansing and detoxifying effect. Bromelain can effectively decompose protein in food and increase gastrointestinal motility. Peel the pineapple and cut it into small pieces, stir in a blender, pour out the juice and mix it with honey and lemon juice before drinking.

    9, dragon fruit

    Pitaya is a tropical fruit with low energy. It not only tastes sweet, but also has high nutritional value and unique functions. It is rich in vitamin C and has a laxative function. The rich fiber also has the function of preventing constipation, and it can be consumed by people with or without constipation.

    10. Persimmon

    Persimmon is sweet, astringent and cold in nature. It has the functions of clearing heat and removing dryness, moisturizing the lungs and resolving phlegm, softening firmness, quenching thirst and promoting fluid, strengthening the spleen, curing dysentery, and stopping bleeding. It can relieve dry stool, pain or bleeding from hemorrhoids, dry cough, sore throat, Hypertension and other diseases. Persimmon is rich in pectin, which has a good effect of moisturizing the bowel and laxative. It has a good effect on correcting constipation and maintaining the growth of normal intestinal flora. However, it is important to note that persimmons must be cooked thoroughly. Persimmon skins should not be eaten, and should not be eaten on an empty stomach. Do not eat them with high-protein crabs, fish, shrimps and other foods. People with diabetes should use them with caution.

    Seven, drug treatment of constipation

    Those who are still ineffective after high-fiber diet and training bowel habits or those with intractable constipation may consider medication, including western medicine and traditional Chinese medicine. The choice of drugs should be based on the principles of low toxicity, low side effects, and low drug dependence, such as laxatives and Chinese patent medicines; for severe constipation, glycerin enema can be used; for slow transit constipation, an accelerator can be added; for intractable constipation You should go to the hospital for professional treatment.

    There are many commonly used Chinese and Western medicines, it is recommended to use under the guidance of a doctor:

    (1) Volumetric laxatives: mainly include soluble cellulose (pectin, oat bran, etc.) and insoluble fiber (plant fiber, lignin, etc.). It has a slow onset and small side effects and is safe, so it has a good effect on pregnancy constipation or mild constipation, but it is not suitable for rapid laxative treatment of temporary constipation. Some health products contain such drugs.

    (2) Lubricating laxative: It can lubricate the intestinal wall, soften the stool, make the stool easy to pass, and is convenient to use, such as glycerin enema (Kaisailu), mineral oil or liquid paraffin. Take Kaisailu as an example. First cut off the top to make it smooth, squeeze out a small amount of liquid to lubricate Kaisailu's head, lie on the left side, gently insert it into the anus, and slowly inject the liquid into the rectum. After the injection, Pull out the injection tube slowly, and then use a clean cotton ball to hold the anus for 1-2 minutes, usually 5-15 minutes to defecate.

    (3) Salt laxatives: such as magnesium sulfate and magnesia milk, these drugs can cause serious adverse reactions and should be used with caution in clinical practice.

    (4) Osmotic laxatives: commonly used drugs include lactulose, sorbitol, polyethylene glycol 4000, polyethylene glycol (PEG) and so on. It is suitable for fecal impaction or as a temporary treatment for chronic constipation. It is a better choice for constipation patients with poor curative effect of volumetric laxatives.

    (5) Stimulant laxatives: including anthraquinone-containing botanical laxatives (rhubarb, senna, aloe), phenolphthalein, castor oil, diesterphentine, etc. Stimulant laxatives should be used when volume laxatives and salt laxatives are ineffective, and some are more intense and not suitable for long-term use. Long-term use of anthraquinone laxatives can cause melena or laxative colon, cause atrophy of smooth muscle and damage the intestinal myenteric plexus, but aggravate constipation, which can be reversed after drug withdrawal.

    (6) Prokinetic agents: Mosapride and Itopride have the effect of promoting gastrointestinal motility, and procapride can selectively act on the colon. Need to be selected under the guidance of a doctor.

    (7) Probiotics: Probiotics multiply through the intestines and produce a large amount of lactic acid and acetic acid to promote intestinal peristalsis. For example, bifidobacteria triple live bacteria preparations (Jinbiqi tablets, Pefeikang), etc., can relieve symptoms of constipation.

    (8) Vitamin B1: Vitamin B1 can be supplemented by oral administration for those who are lack of vitamin B1 due to long-term use of psychotropic drugs or drinking alcohol.

    Eight, constipation commonly used proprietary Chinese medicines

    (1) Over-the-counter drugs

    1. Three yellow films

    The function is mainly for clearing heat and laxative. Used for constipation with heat, mouth sore, toothache, upset and thirst, yellow and red urine.

    Usage and dosage: Orally, 4 tablets each time, 2 times a day.

    2. Maren Runchang Pills (capsules/soft capsules)

    The function is mainly for moistening the bowel and laxative. It is used for gastrointestinal fever, lack of body fluid, intestinal dryness and moisturization, and constipation.

    Usage and dosage: Orally, 1-2 pills each time (6g per pill), 2 times per eye.

    3. Wuren Runchang Pills

    The function is mainly to moisten the intestines to lax and resolve stagnation. It is used for chronic illness, postpartum, postoperative, old and weak blood deficiency constipation, abdominal distension and less food.

    Usage and dosage: Orally, 1 pill (9g) each time, 1 to 2 times a day.

    4. Liuwei Anxiao Capsules

    The function is mainly to invigorate the spleen and stomach, eliminate stagnation, promote blood circulation and relieve pain. Used for full stomach pain, indigestion, constipation, dysmenorrhea.

    Usage and dosage: Orally, 3-6 capsules at a time, 2-3 times a day.

    5. Betel Nut Four Elimination Pills

    The main function is to treat air conduction stagnation. Used for constipation due to stagnation of qi and food, fullness of the flanks, anorexia and anorexia.

    Usage and dosage: Orally, 6g per serving, 2 times a day.

    6. Buzhong Yiqi Pills

    The function cures the vital energy. Used for qi deficiency and difficulty in defecation, the feces are not dry and hard, fatigue and shortness of breath.

    Usage and dosage: Orally, 1 pill (9g) for honey pill each time, 6g for water pill each time, twice a day.

    7. Diyu Huaijiao Wan

    The function mainly cures wind and blood, relieves heat and moisturizes dryness. It is used for hemorrhoids, damp-heat constipation, anal swelling and pain caused by visceral heat and large intestine. The hemostatic effect is good, and the laxative power is weak.

    Usage and dosage orally. 1 pill for dami pill and 5 grams for water pill, 2 times a day.

    8. Tongbianling capsules

    The function mainly treats heat-reducing stagnation, moistening the intestines and laxative. It is used for constipation caused by heat, long-term bedridden constipation, temporary abdominal distension and constipation, habitual constipation in the elderly.

    Usage and dosage: Orally, 5-6 capsules at a time, once a day.

    9. Fangfengtongsheng pill

    The function is mainly to relieve the surface, clear away heat and detoxify. Used for external cold and internal heat, both outside and inside, aversion to cold and strong heat, headache, dry throat, short urine, constipation, scrofula, rubella and eczema.

    Usage and dosage: Orally, 1 bag (6 grams) at a time, 2 times a day.

    10. Angelica Longhui Pills

    The function is mainly to relieve fire and laxative. For liver and gallbladder fire, upset and restless, dizziness, tinnitus and deafness, flank pain, abdominal distension and pain, constipation.

    Usage and dosage: Orally, 6 grams each time, 2 times a day.

    (2) Prescription drugs

    1. Niuhuang Qingwei Pills

    The function is mainly for clearing heat and laxative. Used for constipation with heat, sore mouth and tongue, swollen and painful gums, short red urine.

    Usage and dosage: Orally, 2 pills each time (6g per pill), 2 times a day.

    2. Dressing pills (cinnabar aloe pills)

    The function is mainly for clearing liver and laxative. It is used for liver-heat internal accumulation, ambassador is obstructed, upset, irritable, and restless sleep.

    Usage and dosage: Orally, 1.5~3g each time, 2 times a day.

    3. Wooden Champagne Nut Pills

    The function mainly treats stagnation and defecation. Used for constipation caused by stagnant diet and abdominal distension.

    Usage and dosage: Orally, 6g each time, 2 to 3 times a day.

    4. Qirong Runchang Oral Liquid

    The function is mainly for replenishing qi and nourishing yin, invigorating the spleen and kidney, moistening the intestine and laxative. It is used for constipation due to deficiency of both qi and yin, deficiency of spleen and kidney, and loss of large intestine moisturizing.

    Usage and dosage orally. 20ml (1 bottle) once, 3 times a day, or as directed by a doctor.

    5. Si Mo Tang Oral Liquid

    The function mainly treats qi and nirvana, eliminates accumulation and relieves pain. It is used for middle-aged and elderly patients with stagnation of qi, food stagnation syndrome, symptoms such as abdominal distension, abdominal pain, and constipation; and to promote the recovery of gastrointestinal function after abdominal surgery.

    Usage and dosage orally. Adults use 20ml once, 3 times a day, for one week.

    6. Zhishidaozhi pill

    The function mainly treats stagnation, clearing damp-heat. It is used for food stagnation, abdominal distension and pain caused by internal resistance of dampness and heat, reluctance to eat, constipation, and dysentery.

    Usage and dosage orally. 6-9 grams each time, 2 times a day.

    7. Bentong tablets (capsules)

    The function is mainly for strengthening the spleen and kidney, moistening the intestines and laxative. It is used for the deficiency of spleen and kidney and stagnation of intestinal qi. Symptoms: constipation or lack of defecation, fatigue, shortness of breath, dizziness, waist and knee weakness, etc., as well as constipation caused by primary habitual constipation and perianal disease, see the above symptoms.

    Usage and dosage orally. The specification is 0.46g per tablet, 3 tablets at a time, 2 times a day, or as directed by a doctor.

    8. Senna granules (granules)

    The function mainly treats heat-reducing, stagnation and laxative. Used for constipation. It can also be used for intestinal cleaning preparations before intestinal surgery, endoscopy, B-ultrasound, and abdominal X-ray examination. This medicine has great diarrhea power and is easy to form watery diarrhea. It is not suitable for long-term use.

    Usage and dosage: Take it with boiling water, 10g for constipation patients, 2 times a day.

    Nine, special considerations

    (1) People with limited mobility

    Patients who are bedridden and have limited mobility can raise the head of the bed to help the patient sit on the bedpan to defecate. Patients who are concerned about defecation in bed should explain the reason for the need to defecate in bed and provide a screen to avoid disturbing defecation. . During defecation, patients are advised not to exert too much force to prevent cardiovascular and cerebrovascular complications and rectal prolapse.

    (2) Psychiatric patients

    Because psychiatric patients have to insist on taking medication, almost every psychiatric patient has suffered or is suffering from constipation, which often runs through all stages of the disease course. Constipation often occurs at the beginning of treatment after taking psychiatric drugs, and tolerance often develops after several weeks. Constipation affects the body's qi, leading to poor qi and blood, all kinds of diseases, injuries and disfigurement, which seriously affect the quality of life and social functions of patients. Constipation in psychiatric patients not only brings discomfort to the patient, but also seriously affects the patient's physical and mental health and affects the patient's medication compliance.

    Constipation is often caused by the anticholinergic effects of drugs. The drugs inhibit the secretion of intestinal fluid from the intestines and slow down the peristalsis, resulting in the retention of stool in the intestinal cavity, excessive absorption of water, and the dryness and hardness of the stool and the reduction of stool frequency; The sedation, fatigue, restlessness, and reduced exercise caused by medication cannot be ignored.

    In clinical treatment, in addition to increasing drinking water, eating a diet high in fiber, strengthening physical exercise and exercise, and self-massage, more professional guidance and help are needed. When using traditional Chinese medicine to prevent and treat various toxic side effects and drug-induced diseases of psychiatric drugs, we attach great importance to laxative and maintain slight diarrhea. Psychiatric patients maintain unobstructed stools, which not only improves physical fitness, improves quality of life, prevents complications, but also improves compliance with treatment, thereby improving the treatment of mental disorders and promoting recovery.

    (3) The harm of laxative abuse

    The abuse of laxatives refers to the fact that some patients with constipation do not know the cause of constipation and the pharmacological effects of laxatives without doctor's diagnosis and guidance. Once they have symptoms of constipation, they will take laxatives by themselves. Long-term regular use will be harmful.

    1. Covering the cause and taking laxatives can solve the problem of temporary constipation, but if the cause is not known, it is easy to delay the diagnosis and treatment of some organic diseases, which is very harmful.

    2. Haste will not be achieved for a while, and the constipation has been temporarily resolved, but due to unreasonable medication, the symptoms of constipation will become more severe and more difficult to resolve.

    3. Dependence can develop the habit and dependence on laxatives. If you don't take laxatives, you can't relax your bowel movement, so you can't extricate yourself.

    4. Drug resistance can produce resistance to laxatives, but the effect of taking a certain laxative for a long time becomes worse, and the dose of laxative has to be gradually increased.

    5. Side effects Long-term use of laxatives can cause side effects and even aggravate constipation, which has a more adverse effect on the body. If it affects the absorption of fat-soluble vitamins A, D, K, calcium and phosphorus in the intestine, it can stimulate congestion of the pelvic organs, cause menorrhagia in women and abortion in pregnant women.

    Medical "laxative constipation" refers to constipation caused or aggravated by long-term use of stimulant laxatives, which is a kind of chronic intractable constipation. Senna, rhubarb and other laxatives all contain anthraquinones, which can cause damage to the smooth muscle nerve cells of the intestinal wall after long-term application, resulting in decreased intestinal motility, weakening the sensation of defecation and aggravating constipation.

    At the same time, stimulant laxatives can cause pigmentation in the colon. Causes colonic melanosis, and colonic melanosis can become cancerous. Endoscopy revealed that about 22.62% of patients with functional constipation developed melanosis due to long-term use of laxatives.

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