推拿手法干预卒中后便秘:一项随机对照试验OA

Objective:To observe the clinical efficacy of Tuina(Chinese therapeutic massage)in treating poststroke constipation and the impact on intestinal microbiota. Methods:Forty-eight patients with poststroke constipation were randomized into a treatment group and a control group,and another 10 poststroke patients without constipation were recruited as a healthy control group.The healthy control group received no constipation-related intervention;the control group received behavioral intervention;the treatment group received Tuina therapy in addition to the control group's intervention,once daily for 30 min per session,for 10 consecutive days.Post-treatment changes in the Cleveland clinic constipation score(CCCS),Bristol stool form scale(BSFS)score,self-rating depression scale(SDS)score,self-rating anxiety scale(SAS)score,and patient assessment of constipation quality of life scale(PAC-QOL)score were compared between the two constipation groups.The intestinal microbiota composition and diversity were compared among fecal samples from each group. Results:After treatment,the CCCS,SAS,SDS,and PAC-QOL scores decreased in the treatment group,showing statistical significance(P<0.05);the BSFS score increased after treatment,with statistical significance(P<0.05).The control group only showed a notable decrease in the CCCS after treatment(P<0.05).After intervention,the relative abundance of Bifidobacterium significantly increased in the treatment group(P<0.05),and β-diversity changed significantly(P<0.05),which were statistically parallel to those in the healthy control group(P>0.05). Conclusion:Integrating Tuina manipulations with behavioral intervention is effective in treating poststroke constipation and can exert regulatory effects on intestinal microbiota;the mechanism may involve elevating the relative abundance of beneficial bacteria,improving microbiota structure,and adjusting mood.