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in children's FC，and provide a basis for improving primary-level doctors' capacity of diagnosis and management of children's
FC. Methods In July 2020，130 doctors who had access with children's patients in their daily diagnosis and treatment were
selected from primary-level medical and health institutions in Xicheng District，Beijing. A self-designed questionnaire from
our research group was administered to the included physicians. The content included awareness of the common symptoms of FC
diagnosis for children ≥ 6 months of age，and the recommended treatment methods，recommended treatment drugs，medication
timing and treatment duration for children with FC. Results Questionnaires from 108（83.1%） basic medical doctors were
validly returned，including 34（31.5%） from general practitioners，30（27.8%） from pediatricians，30（27.8%） from
traditional Chinese medicine doctors，and the average monthly outpatient volume with pediatric patients（10.1±4.4） cases was
obtained. For the diagnosis of FC in children：when children aged ≥ 6 months presented with less frequent bowel movements，
hard stools，bleeding during defecation，fecal incontinence，difficulty in defecating，and crying symptoms before passing
thick stools，40.7%（44/108），39.8%（43/108），23.1%（25/108），9.3%（14/108），39.8%（43/108），23.1%
（25/108） of the basic medical doctors would consider the diagnosis of FC；51.9%（56/108） of the physicians considered FC
to be diagnosed when two symptoms，including low frequency of defecation and difficulty in defecating，existed simultaneously；
according to 25.0%（27/108） of the physicians，FC can be diagnosed when four symptoms including less frequent defecation，
hard stools，bleeding during defecation，and difficulty in defecating were present at the same time. For the treatment of FC in
children：pharmacotherapy was recommended as the main treatment of choice for FC in children by primary physicians in 37.0%
（40/108）；nonpharmacologic therapy was recommended as the preferred treatment by 63.0%（68/108） of the primary
physicians，with 88.2%（60/68） recommending abdominal massage，85.3%（58/68） recommending a high fiber diet，
82.4%（56/68） recommending toilet training，and 72.1%（49/68） recommending increased fluid intake. Lactulose therapy
was recommended by 75.9%（82/108） of the primary physicians；27.8%（30/108） of the primary physicians recommended
combination therapy with microenemas of sodium citrate，sodium dodecylsulfonylacetate，and sorbitol as the rectal treatment，
and 64.8%（70/108） of the primary physicians recommended rectal administration when children had particularly difficult bowel
movements. According to the basic medical practitioners，the mean time from initiation of treatment to having a positive response
was（4.1±2.6）days in children；the mean treatment duration of FC in children by primary physicians was（21.2±4.3）days；
88.9% of doctors believed that the average termination time of constipation treatment was（46.0±9.3） days. When the frequency
and/or consistency of bowel movements returned to normal or the patient no longer had discomfort，88.9% of physicians responded
that they would consider discontinuing the treatment. Conclusion Although general primary doctors know some methods of
diagnosis and treatment of children's constipation，their overall level of awareness still needs to be improved. It is recommended
to further enhance the existing primary physicians' awareness and comprehensive management of FC in children，and to develop
a comprehensive management model of FC in children in primary health facilities to improve the management level of children's
functional constipation，thereby reducing the prevalence and increasing the cure rate.
【Key words】 Constipation；Child health services；Community health services；Clinical competence；Toilet
training；Administration，rectal

功能性便秘（functional constipation，FC）是世界 / 专家共识。本研究旨在调查基层医生的儿童 FC 诊疗
范围内儿童和青少年的常见健康问题，通常起源于婴儿 水平，一方面为针对性提高基层医生儿童 FC 诊疗与管
期和幼儿期，以大便稀少、疼痛、硬为主要临床特点， 理能力、促进社区儿童 FC 规范性管理提供建议，另一
可伴有大便失禁和腹痛 ［1］ 。有研究显示，在美国，儿 方面也为相关指南 / 专家共识的制定提供证据。
科门诊有 3%~5% 的患儿是因 FC 就诊 ［2］ ，其中 1 岁以 1 对象与方法
下儿童因 FC 及其相关症状紧急就诊的比例最高 ［3］ 。 1.1 研究对象 于 2020 年 7 月，采用方便抽样法在北
在基层医疗卫生机构，FC 也是儿童父母门诊就诊时咨 京市西城区基层医疗卫生机构中选取日常诊疗中能够接
询的常见问题 ［4］ 。北美儿科胃肠病、肝病及营养学 触到儿童患者的医生为研究对象（n=130）。纳入标准：（1）
会（NASPGHAN）和欧洲儿童胃肠、肝病和营养学会 具有儿科、全科、中医科、儿童保健执业资格证的在岗
（ESPGHAN）等已发布成年人 FC 和儿童 FC 相关的诊 临床医师；（2）在日常诊疗过程中能够接触到儿童患者；
断和管理指南 ［5］ 。相比较而言，目前针对亚洲地区儿 （3）了解本研究内容，并愿意参与研究。本研究经首
童 FC 方面的研究数据较少。FC 在发展中国家的患病形 都医科大学附属复兴医院伦理委员会审核批准（审批号：
势也不容乐观，但我国目前尚缺乏儿童 FC 相关的指南 2020FXHEC-KY038/2020FXHEC-KSKY003）。