Expert Consensus on Integrated Traditional Chinese and Western Medicine Diagnosis and Treatment of Functional Constipation(2025)
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摘要: 中国中西医结合学会消化系统疾病专业委员会于2017年颁布了《功能性便秘中西医结合诊疗共识意见(2017年)》，对我国功能性便秘(FC)中西医结合诊疗的规范化开展起到了积极的作用。近年来，有关FC的临床诊疗研究有了一定的进展，为进一步规范FC的临床诊疗，中国中西医结合学会消化系统疾病专业委员会牵头成立了FC中西医结合诊疗共识意见起草小组，通过研读国内外相关文献并结合专家们的临床经验，对该共识进行了更新。本次共识以循证资料为基础，涵盖了当前国内外最新研究动态，依据GRADE分级标准进行证据质量评估及推荐强度分级，以期进一步提高临床疗效, 规范临床诊疗过程, 满足临床与科研需要。Abstract: In 2017, the Digestive System Diseases Professional Committee of Chinese Association of Integrative Medicine issued the Consensus on Integrated Traditional Chinese and Western Medicine Diagnosis and Treatment of Functional Constipation (2017), which significantly promoted the standardization of integrated diagnosis and treatment for functional constipation (FC)in China. In recent years, advancements have been made in clinical research on FC. To further refine its clinical management, the Digestive System Diseases Professional Committee of Chinese Association of Integrative Medicine established a drafting group for updating the consensus. Through comprehensive reviews of domestic and international literature and incorporation of expert clinical experience, the consensus has been revised. This updated consensus, grounded in evidence-based research, synthesizes key findings from global studies and evaluates evidence quality and recommendation strength using the GRADE classification system.The aim is to enhance clinical efficacy, standardize diagnostic and therapeutic protocols, and better serve clinical practice and scientific research needs.
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表 1 STC的分度治疗
治疗方法 轻中度STC 重度STC 西药 容积性泻药、渗透性泻药、促动力药、促分泌药、微生态制剂 容积性泻药、渗透性泻药、促动力药、促分泌药、微生态制剂、刺激性泻剂(短期、按需使用) 其他 一般治疗 一般治疗、肠菌移植、骶神经调控 外科治疗 全结肠切除-回肠直肠吻合术、结肠次全切除吻合术、肠造口术 中药 中药汤剂、中成药 中药汤剂、中成药(必要时可短期、按需选用蒽醌类泻剂) 中医外治 针刺(天枢穴为主)、穴位埋线、穴位贴敷、推拿 
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表 2 DD的分度治疗
治疗方法 轻中度DD 重度DD 西药 润滑性泻药、渗透性泻药、促分泌药 润滑性泻药、渗透性泻药、促分泌药、刺激性泻剂(短期、按需使用) 其他 一般治疗、生物反馈 一般治疗、生物反馈、骶神经调控 外科治疗 耻骨直肠肌部分切除术、挂线疗法、小针刀疗法、肛周注射封闭术、扩肛术 中药 中药汤剂、中成药 中药汤剂、中成药(必要时可短期、按需选用蒽醌类泻剂) 中医外治 针刺(八髎穴为主)、推拿、中药灌肠、中药栓剂
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