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目的:探讨针刺治疗慢性功能性便秘(CFC)的疗效.方法:对90例患者采用两组穴位隔日交替针刺,第1组:天枢、气海、上巨虚等;第2组:中髎、下髎、大肠俞等;中髎、下髎、天枢、上巨虚配合电针治疗.每日1次,10次为一疗程.通过便秘患者日记观察患者排便频率、排便费力程度、每次排便时间、排便不尽感、便质、便意感和评估生活质量问卷评分(PAC-QOL),以了解治疗前后的变化.结果:治疗后,患者排便频率、排便费力程度、每次排便时间、排便不尽感、便质、便意感和生活质量各项积分均较治疗前明显改善(均P＜0.01),总有效率为67.7%(61/90);不同动力学机制慢性功能性便秘针刺疗效不同,结肠慢传输型优于盆底失弛缓型(P＜0.05),肠易激综合征便秘型优于盆底失弛缓型和盆底松弛型(均P＜0.05).有效随访52例,治疗后1个月痊愈3例,显效6例,有效23例,无效20例;治疗后3个月痊愈3例,显效5例,有效16例,无效28例.结论:针刺治疗具有明确病因病位和分类诊断的慢性功能性便秘疗效确切,但不同动力学机制CFC疗效有差异.对盆底失弛缓型和盆底松弛型便秘,需进一步优化治疗方案,提高疗效.“,”Objective To discuss the efficacy of acupuncture for chronic functional constipation (CFC). Methods Two groups of points were applied alternatively to 90 cases by acupuncture: ① Tiānshū (天枢 ST 25), Qìhǎi (气海 CV 6), Shàngjùxū (上巨虚 ST 37), etc. ②Zhōngliáo (中髎 BL 33), Xiàliáo (下髎 BE 34), Dàchángshū (大肠俞 BL 25), etc. Electroacupuncture was applied in combination at Zhōngliáo (中髎 BL 33), Xiàliáo (下髎 BL 34), Tiānshū (天枢 dT 25) and Shàngjùxū (上巨虚 ST 37), once a day, 10 treatments made one session. By constipation diary of patients, frequency of going to stool, straining severity, time of once bowl evacuation, a sense of incomplete bowel emptying, stool quality, a sense of defecation and the Patient Assessment of Constipation Quality of Life questionnaire(PAC-QOL), as well as the changes before and after treatment were observed. Results After treatment, the apparent improvements were achieved in frequency of going to stool, straining severity, time of once bowl evacuation, a sense of incomplete bowel emptying, a sense of defecation and score of PAC-QOL as compared with those before treatment(all P＜0.01). The total effective rate was 67.7% (61/70). The acupuncture efficacies were various on CFC of different dynamic mechanisms. The efficacy on slow transit constipation (STC) was superior to that caused by spastic pelvic floor syndrome(SPFS-C) (P＜0.05), the efficacy on constipation caused by irritable bowel syndrome(IBS-C) was superior to that on either SPFS-C or constipation caused by relaxant pelvic floor syndrome (RPFS-C) (both P＜0.05). Of 52 cases in effective follow-up, 1 month after treatment, 3 cases were cured, 6 cases markedly effective, 23 cases effective, and 20 cases failed; 3 months after treatment, 3 cases were cured, 5 cases markedly effective, 16 cases effective and 28 cases failed. Conclusion Acupuncture has definite efficacy on CFC with definite etiology, foci and diagnostic classification. But, the efficacies are different due to various dynamic mechanisms. A further optimized treatment program is required to improve the efficacy on SPFS-C and RPFS-C.