Articles

Constipation

Related Health Condition

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Constipation

Introduction

Although it's not a disease, constipation is a common clinical symptom, and it seriously affects the quality of life. Generally, people in good health defecate once a day or 3-4 times a week. Constipation refers to the difficulty in defecation or an abnormally long interval between defecations. Traditional Chinese medicine breaks the condition down into these subcategories: splenic constipation, yang constipation, and yin constipation, etc.

Etiology/Pathogenesis

According to TCM, exhaustion of body fluids due to excessive heat, stagnation of qi, deficiency in both qi and blood, and accumulation of yin-cold, can all lead to dysfunction of the large intestine, resulting in retention of feces. In addition, deficiencies in blood and body fluids and deficiency in qi can also result in constipation: the former by causing the intestinal tract being inadequately lubricated, and the latter by causing obstruction in the flow of visceral qi.

Primary Treatments with Chinese Medicinal Herbs

Ma Zi Ren Wan

Luo treated 50 cases of habitual constipation in the elderly with modified Ma Zi Ren Wan. The modified formula consisted of Ma Zi Ren (Semen Cannabis), Yu Li Ren (Semen Pruni), Gua Lou Ren (Semen Trichosanthis), Bo Zi Ren (Semen Biotae), Tian Hua Fen (Radix Trichosanthis), Mai Dong (Radix Ophiopogonis), Dong Gua Ren (Semen Benincasae), Lu Gen (Rhizoma Phragmitis), Ge Gen (Radix Puerariae), Da Huang (Radix et Rhizoma Rhei), and Gan Cao (Radix Glycyrrhizae). One course of treatment continued for 3 days. The results indicated that the treatment was effective in all 50 cases. Some patients experienced complete relief after taking as few as three doses of the formula. (1)

Wu treated 55 cases of habitual constipation in middle-aged and older people with Ma Zi Ren Wan and modified Zeng Ye Tang. The combined formula consisted of Ma Zi Ren (Semen Cannabis), Ku Xing Ren (Semen Armeniacae Amarum), Zhi Shi (Fructus Aurantii Immaturus), Hou Po (Cortex Magnoliae Officinalis), Xuan Shen (Radix Scrophulariae), Sheng Di Huang (Radix Rehmanniae), Bai Shao (Radix Paeoniae Alba), Mai Dong (Radix Ophiopogonis), and Da Huang (Radix et Rhizoma Rhei). One dose of the formula was given as a decoction and was administered in two portions. The course of the treatment continued for 7 days. The results indicated that after two courses of treatment, 36 cases were resolved, another 15 cases had improved, and the remaining 4 cases did not respond to the treatment, with a total effectiveness rate of treatment 92.6%. (2)

Other Treatments with Chinese Medicinal Herbs

Bu Zhong Yi Qi Tang

Fan treated 47 cases of intractable constipation with Bu Zhong Yi Qi Tang. The formula consisted of Huang Qi (Radix Astragali seu Hedysari), Gan Cao (Radix Glycyrrhizae), Dang Shen (Radix Codonopsis Pilosulae), Dang Gui (Radix Angelicae Sinensis), Zhi Shi (Fructus Aurantii Immaturus), Chen Pi (Pericarpium Citri Reticulatae), Sheng Ma (Rhizoma Cimicifugae), Chai Hu (Radix Bupleuri), and Bai Zhu (Rhizoma Atractylodis Macrocephalae). One dose of the formula in a decoction (with a spoonful of honey added) was administered daily, and one course of treatment lasted for 10 days. The results showed that after 1-6 courses of treatment, 39 cases were resolved, and the remaining 8 cases had improved. (3)

Si Mo Yin

Li treated 40 cases of chronic functional constipation with Si Mo Yin. The formula consisted of Mu Xiang (Radix Aucklandiae), Zhi Qiao (Fructus Aurantii), Bing Lang (Semen Arecae), and Wu Yao (Radix Linderae). The results indicated that after two weeks of treatment, 32 cases had significantly improved, another 4 cases improved, and the remaining 4 cases did not respond to the treatment. (4)

Yun Chang Tong Bian Tang

Sun treated 45 cases of chronic habitual constipation with Yun Chang Tong Bian Tang. The formula consisted of Dang Shen (Radix Codonopsis), Huang Qi (Radix Astragali seu Hedysari), Chai Hu (Radix Bupleuri), Sheng Ma (Rhizoma Cimicifugae), Xuan Shen (Radix Scrophulariae), Mai Dong (Radix Ophiopogonis), Ma Zi Ren (Semen Cannabis), Xing Ren (Semen Armeniacae Amarum), Shu Di Huang (Radix Rehmanniae Praeparata), and Dang Gui (Radix Angelicae Sinensis). One dose of the formula in a decoction was administered a day, orally. In addition, the patients drank 200ml of light saline on empty stomach each morning while under treatment. The course of treatment lasted 1 week. The results showed that 35 cases were resolved, another 6 cases had improved, and the remaining 4 cases did not respond to the treatment, with a total effectiveness rate of 91.1%. (5)

Zhong's Constipation Formula

Zhong treated 42 cases of constipation in the elderly by promoting blood circulation to remove blood stasis. The formula consisted of Hong Hua (Flos Carthami), Chuan Xiong (Rhizoma Ligustici Chuanxiong), Zhi Qiao (Fructus Aurantii), Dang Gui (Radix Angelicae Sinensis), Chi Shao (Radix Paeoniae Rubra), and Dan Shen (Radix Salviae Miltiorrhizae). One dose of the formula in a decoction was administered orally daily, and one course of treatment lasted for 20 days. The results showed that 26 cases were resolved, another 12 cases had improved, and the remaining 4 cases did not respond to the treatment, with a total effectiveness rate being 90.48%. (6)

Other Treatments

Massage therapy
Zhang et al. treated 42 cases of infantile constipation with herbs and massage. Two parts of Da Huang (Radix et Rhizoma Rhei) and one part of Zhi Shi (Fructus Aurantii Immaturus) were ground into fine powder. A paste made of the mixed powder with vinegar was applied to the patient’s navel daily, and the abdominal area was massaged twice a day. At the same time, the patients undertook a healthier diet and started potty-training. One course of treatment lasted for 3 days. The results: after one course of treatment, 18 cases had shown great improvement, another 22 cases had improved, and the remaining 2 cases did not respond to the treatment, with a total effectiveness rate of 95.24%. (7)

Zhang et al. treated 145 cases of habitual constipation among the elderly with massage therapy combined with Tong Bian Gao (an herbal paste). The herbal paste consists of Da Huang (Rhubarb), Mang Xiao, Huo Ma Ren (Linum), Xing Ren (Apricot Seed), salt (Sal), Zhi Shi (Immature Bitter Oranges), and Ma You (Sesame oil). The acupoints used were Zhong Wan (Ren 12), Tian Shu (St 25), Da Heng (Sp 15), Wei Shu (UB 21), and Da Chang Shu (UB 25). In addition, massage was also performed on the navel, abdomen, spine, and Urinary Bladder Channel. The results: 102 cases were resolved, 20 cases improved greatly, another 18 cases improved somewhat, and the remaining 5 cases did not respond to the treatment. (8)

References

  1. Luo Qiu Bo. Treating 50 cases of senile habitual constipation with Ma Zi Ren Wan. Zhejiang Journal of Integrated Medicine. 2000;10(3):170-171.
  2. Wu Zhen Xi. 55 cases of senile constipation treated with Ma Zi Ren Wan and modified Zeng Ye Tang. Journal of New TCM. 2000;32(1):18.
  3. Fan Hua. 47 cases of refractory constipation treated with Bu Zhong Yi Qi Tang. Journal of Chinese Folk Medicine. 1999;7(12):39-40.
  4. Li Xin Cheng. Chronic functional constipation treated with Si Mo Yin. Hubei Journal of Traditional Chinese Medicine. 1999;22(2):54.
  5. Sun Feng. 45 cases of constipation treated self-formulated Yun Chang Tong Bian Tang. Anhui Journal of TCM Clinical Application. 1999;11(1):7.
  6. Zhong Chuan Zhen. 42 cases of senile constipation treated by promoting blood circulation to remove blood stasis. Journal of Applied TCM. 1999;15(7):14-15.
  7. Zhang Li Min, et al. 42 cases of infantile constipation treated with Tong Bian San paste and massage. Journal of External Application of Traditional Chinese Medicine. 1999;8(3):47.
  8. Zhang Xiao Ting, et al. 145 cases of senile habitual constipation treated by massage with Tong Bian Gao. Journal of Shang TCM University. 1999;23(6):453-454.