[Zishen Tongfu acupuncture for elderly functional constipation of yin deficiency: a randomized controlled trial]

To observe the clinical effect of Zishen Tongfu (nourishing kidney and promoting qi movement of fu-organ) acupuncture in the treatment of functional constipation (FC) of yin deficiency in the elderly.

A total of 84 elderly patients with FC of yin deficiency were randomly assigned to an acupuncture group (42 cases, 3 cases dropped out) and a sham acupuncture group (42 cases, 2 cases dropped out). The patients in the acupuncture group received acupuncture at Zhaohai (KI6), Dazhong (KI4), Taixi (KI3), Tianshu (ST25), and Shangjuxu (ST37) on both sides. In the sham acupuncture group, non-meridian and non-acupoint points were selected, and blunt acupuncture needles were used to reach the skin surface through the fixed pad without piercing the skin. Both groups were treated for 30 min each time, once every other day, three times a week for 8 weeks. The complete spontaneous bowel movements (CSBMs) and emergency medication were observed before and after treatment and during follow-up (after 12 weeks of treatment completion). The scores of Bristol stool form scale (BSFS), patient assessment of constipation-symptom (PAC-SYM), patient assessment of constipation-quality of life (PAC-QOL), self-rating anxiety scale (SAS) and self-rating depression scale (SDS) were compared between the two groups before and after treatment, and the safety evaluation and assessment of blinding success were performed.

After treatment, the CSBMs of the two groups were higher than those before treatment (P<0.001), and those in the acupuncture group were more than the sham acupuncture group (P<0.001). During follow-up, CSBMs in the acupuncture group were increased compared with those before treatment (P<0.05), and more than those in the sham acupuncture group (P<0.05). After treatment, the BSFS score of the acupuncture group was higher than that before treatment (P<0.001), and the score in the acupuncture group was higher than that in the sham acupuncture group (P<0.001). The scores of PAC-SYM, PAC-QOL, SAS and SDS in the two groups were lower than those before treatment (P<0.001), and the scores of PAC-SYM and PAC-QOL in the acupuncture group were lower than those in the sham acupuncture group (P<0.001). After treatment and during follow-up, the proportion of patients without medication in the acupuncture group was higher than that in the sham acupuncture group (P<0.05). There was no significant difference in the incidence of acupuncture adverse events between the two groups (P>0.05). The implementation of the blind method in both groups was ideal.

Zishen Tongfu acupuncture can increase CSBMs in elderly FC patients of yin deficiency, relieve constipation-related clinical symptoms, improve the quality of life, reduce the use of emergency medication, and is safe and reliable.