《金匮要略》通便法探析

通便法即指运用通大便的方法使燥屎、瘀血、宿食、痰饮及虫积等有形之邪从大便而出的一种方法。本文结合《金匮要略》原文对仲景对该法的运用加以探讨。     

A Case of a Patient with a Rectal Ulcer Who Had an Unusual Defecation Habit

Abstract: This case report describes a patient with a rectal ulcer who had an unusual defecation habit. Complete healing was recognized colonoscopically after the patient was instructed to break this habit. A polyp of the ascending colon was detected by a barium enema in a 37-year-old man complaining of anal bleeding. He was admitted to our division to undergo a polypectomy. At the time of the polypectomy, a round ulcer, measuring 1 cm in diameter, was detected on the right wall of the rectum 3 cm from the anal verge. A diagnosis of mucosal prolapse syndrome of the rectum could not be made because the patient did not exhibit the characteristic habit of excessive “straining” mentioned by patients with this syndrome, and no characteristic finding of fibromuscular obliteration was found on histological examination of biopsied specimens taken endoscopically from the lesion. Repeated history taking, however, revealed that the patient had the unusual habit of inserting his finger into his rectum after defecation. He broke this habit following instruction to do so. As a result, on colonoscopic examination 15 month later, the ulcer was found to have become a scar:     

无毒棉籽液抗腹泻作用研究

通过对正常小鼠、生大黄致泻小鼠及脾虚小鼠的作用研究表明，无毒棉籽液有较好的抑制排便频度、治疗腹泻的作用．无毒棉籽液６ｇ／ｋｇ可极其显著地抑制正常小鼠的排便频度，无毒棉籽液６ｇ／ｋｇ和３ｇ／ｋｇ可极其显著地抑制生大黄致泻小鼠及脾虚小鼠的排便频度．６ｇ／ｋｇ无毒棉籽液且可极其显著地抑制正常小鼠及脾虚小鼠的小肠推进运动．     

Behavior in chimeric mice combining differently behaving strains

A/J and C57BL/6J mice behave differently in tests for alcohol preference, open-field activity, defecation in the open field, cricket attacking, and rope climbing. Chimeric mice, i.e., mice containing both A/J cells and C57BL/6J cells, were constructed and tested for these behaviors. Patterns of behavior among A/JC57BL/6J chimeras are such as to suggest that none of these behavior differences is controlled by a single cell or clone and that the same cell population that gives rise to the strain difference in alcohol preference also gives rise to the differences in open-field activity and defecation, while separate cell populations control cricket killing and rope climbing.This research was supported by Research Grants AA 00388 and HD 03015 to M. N. N. and MH 18996 to K. B. Computing assistance was obtained from the Health Sciences Computing Facility, UCLA, supported by NIH Special Research Resources Grant RR-3.     

腹部热敷配合按摩促进早产儿胎粪排出的效果观察

目的探讨腹部热敷配合按摩对促进新生儿胎粪排出的效果。方法以80例早产儿为研究对象,随机分成对照组和实验组,每组40例,对照组给予新生儿常规护理,实验组在常规护理基础上实施腹部热敷配合按摩。观察并记录两组新生儿首次胎粪排出的时间、首次排出胎粪的重量及出生24 h内胎粪排出次数。结果实验组患儿首次排便时间明显早于对照组(p<0.05),首次排出胎粪的量多于对照组(p<0.05),出生24 h内胎粪排出的次数多于对照组(p<0.01)。结论对早产儿早期进行腹部热敷配合按摩能促进早产儿胎粪排泄及胃肠道功能的成熟,防止胎粪排泄延迟发生相关的并发症。     

Toilet Talk: Eliminating Open Defecation and Improved Sanitation in Nepal

Globally, 2.4 billion people lack adequate sanitation, and open defecation remains common. In this article, I present the qualitative findings from an evaluation of a water, sanitation, and hygiene intervention in remote, mid-West Nepal. The evaluation, conducted in 2014, involved villagers from eight wards in Kotgaun Village Development Committee. Drawing on the concept of the “toilet tripod,” I argue as follows: multi-scalar political will provide an important foundation for construction and sustained use of toilets, proximate social pressures contributed significantly to toilet adoption and efforts to eliminate open defecation, and water insecurity constrained improved sanitation and hygiene.     

综合护理干预对老年股骨颈骨折患者术后首次排便的影响

目的探讨综合护理干预对老年股骨颈骨折患者术后首次排便的影响。方法便利抽样法选择2010年11月至2011年11月在镇江市第二人民医院住院治疗的84例老年股骨颈骨折需手术的患者为研究对象,按随机数字表法将其分为观察组和对照组,每组42例。观察组患者采用综合护理干预措施,对照组采用骨科常规护理措施,观察比较两组患者术后自觉肠鸣音时间、肛门排气时间、首次排便时间以及首次大便通畅度情况。结果观察组患者术后自觉肠鸣音时间、肛门排气时间、首次排便时间均早于对照组,且首次大便通畅度优于对照组,差异均有统计学意义(均P<0.01)。对照组有24例术后96h仍未排便,给予通便药物或灌肠干预,而观察组仅有1例患者需灌肠干预。结论综合干预措施能明显缩短老年股骨颈骨折患者术后肠功能恢复时间。     

联合应用消化道干预措施对新生儿黄疸的影响

目的:探讨联合应用消化道干预措施对降低新生儿黄疸的效果。方法:将192例正常足月新生儿随机分为直接消化道干预组、间接消化道干预组、综合组。间接消化道干预组应用游泳并抚触措施、直接消化道干预组应用早期通便措施、综合组联合应用游泳并抚触及早期通便两种措施,比较3组胎粪初排时间、胎粪转黄时间、每日排便次数、生后1～6d黄疸指数及病理性黄疸发生率。结果:综合组胎粪初排时间及胎粪转黄时间较直接消化道干预组和间接消化道干预组提前(P<0.01),每日排便次数较其他两组增多(P<0.01),生后3～6d黄疸指数及病理性黄疸发生率比两组降低(P<0.01)。结论:联合应用消化道干预措施能有效降低新生儿黄疸,减少病理性黄疸的发生率。     

Influence of Body Position on Defecation in Humans

Objectives: To compare three positions for defecation by measuring abdominal pressure and the anorectal angle simultaneously. Methods: We recruited six healthy volunteers. The videomanometric measures included simultaneous fluoroscopic images, abdominal pressures, subtracted rectal pressures and anal sphincter pressures. Three positions were used: sitting, sitting with the hip flexing at 60 ° with respect to the rest of the body, and squatting with the hip flexing at 22.5 ° with respect to the rest of the body. Results: Basal abdominal pressure before defecation on hip‐flex sitting was lower than that with normal sitting, although the difference did not reach statistical significance. Basal abdominal pressure before defecation on squatting (26 cmH₂O) was lower than that with normal sitting (P < 0.01). Abdominal pressure increase (strain) on hip‐flex sitting was lower than that with normal sitting, although this difference did not reach statistical significance. Similarly, the abdominal pressure increase on squatting was smaller than that with normal sitting, and yet the difference did not reach statistical significance. The rectoanal angle on defecation on hip‐flex sitting did not differ from that with normal sitting. The rectoanal angle on defecation on squatting (126 °) was larger than that with normal sitting (100 °) (P < 0.05), and was also larger than that with hip‐flex sitting (99 °) (P < 0.01). Conclusion: The results of the present study suggest that the greater the hip flexion achieved by squatting, the straighter the rectoanal canal will be, and accordingly, less strain will be required for defecation.