[1]邱亿明,王泽宇,帅艳常.浮针疗法结合隔药灸脐治疗腹泻型肠易激综合征及对患者胃肠激素水平和菌群结构的影响[J].陕西中医,2023,(2):250-254.[doi:DOI:10.3969/j.issn.1000-7369.2023.02.026]
　QIU Yiming,WANG Zeyu,SHUAI Yanchang.Effects of floating acupuncture therapy combined with herb-partitioned moxibustion on the umbilicus in the treatment of diarrhea-type irritable bowel syndrome on the levels of gastrointestinal hormones and flora structure in patients[J].,2023,(2):250-254.[doi:DOI:10.3969/j.issn.1000-7369.2023.02.026]
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浮针疗法结合隔药灸脐治疗腹泻型肠易激综合征及对患者胃肠激素水平和菌群结构的影响

《陕西中医》[ISSN:1000-7369/CN:61-1281/TN]

卷:
期数:
2023年2期
页码:
250-254
栏目:
针灸经络
出版日期:
2023-02-05

文章信息/Info

Title:
Effects of floating acupuncture therapy combined with herb-partitioned moxibustion on the umbilicus in the treatment of diarrhea-type irritable bowel syndrome on the levels of gastrointestinal hormones and flora structure in patients
作者:
邱亿明; 王泽宇; 帅艳常
(株洲市中医伤科医院针灸理疗科,湖南 株洲 412007)
Author(s):
QIU Yiming; WANG Zeyu; SHUAI Yanchang
(Department of Acupuncture and Moxibustion,Zhuzhou Traditional Chinese Medicine Traumatology Hospital,Zhuzhou 412007,China)
关键词:
腹泻型肠易激综合征;  浮针疗法;  隔药灸脐;  内脏敏感性;  胃肠激素;  菌群结构
Keywords:
Diarrhea-type irritable bowel syndrome;  Floating needle therapy;  Herbal moxibustion on the navel;  Visceral sensitivity;  Gastrointestinal hormones;  Microflora structure
分类号:
R 574
DOI:
DOI:10.3969/j.issn.1000-7369.2023.02.026
文献标志码:
A
摘要:
目的:观察浮针疗法结合隔药灸脐治疗腹泻型肠易激综合征及对患者胃肠激素和菌群结构水平的影响。方法:将92例已经确诊为肝脾不和证腹泻型肠易激综合征患者采用简单随机法分为西药组和中医组,各46例。西药组给予马来酸曲美布汀胶囊治疗,而中医组给予浮针疗法结合隔药灸脐治疗。比较两组中医症候积分、胃肠激素、菌群结构、IBS症状严重程度评分量表(IBS-SSS)评分、直肠感觉功能参数的差异,并统计两组疗效。结果:治疗前两组中医症候积分比较,差异无统计学意义(P>0.05),治疗后两组中医症候主症和次症积分较前下降,中医组治疗后中医症候积分低于西药组(P<0.05)。中医组总有效率为93.48%(43/46),明显高于西药组的78.26%(36/46),差异有统计学意义(P<0.05)。治疗前两组胃肠激素、菌群结构比较,差异无统计学意义(P>0.05),治疗后两组胃动素(MTL)、血管活性肠肽(VIP)、生长抑素(SS)及肠杆菌较前下降,双歧杆菌、乳杆菌及拟杆菌较治疗前升高,中医组治疗后胃肠激素、肠杆菌低于西药组,双歧杆菌、拟杆菌高于西药组(P<0.05)。治疗前两组IBS-SSS评分、直肠感觉功能参数比较,差异无统计学意义(P>0.05),治疗后两组初始感觉阈值、初始排便冲动阈值、最大耐受阈值较前升高,IBS-SSS评分较前下降,中医组治疗后直肠感觉功能参数高于西药组,IBS-SSS评分低于西药组(P<0.05)。结论:浮针疗法结合隔药灸脐治疗腹泻型肠易激综合征疗效较好,可有效降低内脏敏感性,改善临床症状,可能与调节胃肠激素和菌群结构有关。
Abstract:
Objective:To observe the effect of floating acupuncture therapy combined with herb-partitioned moxibustion on the umbilicus in the treatment of diarrhea-type irritable bowel syndrome on the levels of gastrointestinal hormones and flora structure in patients.Methods:Ninety-two patients with diarrhea-type irritable bowel syndrome with liver-spleen discord syndrome were divided into western medicine group(n=46)and traditional Chinese medicine group(n=46)by simple random method.The western medicine group was given trimebutine maleate capsules for treatment,while the traditional Chinese medicine group was given floating needling therapy combined with medicine-partitioned moxibustion on the umbilicus.The differences in TCM symptom scores,gastrointestinal hormones,flora structure,IBS symptom severity scale(IBS-SSS)scores,and rectal sensory function parameters were compared between the two groups,and the curative effects of the two groups were calculated.Results:The TCM symptom scores of the two groups were compared before treatment,and there was no statistical significance(P>0.05).The TCM symptom scores of the two groups were decreased after treatment,and the TCM symptom scores of the TCM group were lower than those of the western medicine group(P<0.05).The total effective rate in the traditional Chinese medicine group was 93.48%(43/46),which was significantly higher than that in the western medicine group 78.26%(36/46),with statistical significance(P<0.05).The gastrointestinal hormones and flora structure of the two groups were compared before treatment,and there was no statistical significance(P>0.05).The two groups of motilin(MTL),vasoactive intestinal peptide(VIP),somatostatin(SS)and intestinal After treatment with Bacillus,it was found to be lower than before,and after treatment of Bifidobacterium,Lactobacillus and Bacteroides,it was found to be higher than before.After treatment of traditional Chinese medicine group,gastrointestinal hormones and Enterobacteriaceae were lower than those in western medicine group,and Bifidobacterium and Bacteroides were higher than those in western medicine group(P>0.05).The IBS-SSS scores and rectal sensory function parameters of the two groups were compared before treatment,and there was no statistical significance(P>0.05).The initial sensory threshold,initial defecation urge threshold,and maximum tolerance threshold of the two groups were found to be higher after treatment than before.After treatment,the IBS-SSS score was found to be lower than before.The rectal sensory function parameters in the traditional Chinese medicine group were higher than those in the western medicine group,and the IBS-SSS score was lower than that in the western medicine group(P<0.05).Conclusion:Floating acupuncture combined with herb-partitioned moxibustion on the umbilicus has good curative effect in the treatment of diarrhea-type irritable bowel syndrome,which can effectively reduce visceral sensitivity and improve clinical symptoms,which may be related to the regulation of gastrointestinal hormones and flora structure.

参考文献/References:

[1] Kristina B,Briana L,Zachary JB.Chronic diarrhea in adults:Evaluation and differential diagnosis[J].American Family Physician,2020,101(8):472-480.
[2] 张 续,赵莉平,安 荣.肠易激综合征生物标志物研究进展[J].陕西医学杂志,2022,51(8):1038-1041.
[3] 陈 敏,谢 欣,石云舟,等.中医药治疗腹泻型肠易激综合征的比较效果研究现状及思考[J].中国全科医学,2022,25(15):1795-1800.
[4] 陈 璐,徐万里,裴丽霞,等.“调神健脾”针法对腹泻型肠易激综合征患者肠道菌群及粪便短链脂肪酸含量的影响[J].中国针灸,2021,41(2):137-141.
[5] 熊 引.艾灸、穴位敷贴联合综合护理对腹泻型肠易激综合征病人生活质量及心理状况的影响[J].护理研究,2022,36(11):2031-2033.
[6] 中华中医药学会脾胃病分会.肠易激综合征中医诊疗专家共识意见(2017)[J].中医杂志,2017,58(18):1614-1620.
[7] 国家食品药品监督管理总局.中药新药临床研究指导原则(试行)[M].北京:中国医药科技出版社,2002:139-143.
[8] 李乾构,周学文,单兆伟.中医消化病诊疗指南[M].北京:中国中医药出版社,2006:90-94.
[9] Valeria S,Juliane H,Fritz RM,et al.Adding a liquid test meal to a standardized lactulose hydrogen breath test significantly influences abdominal symptom generation and hydrogen values[J].European Journal of Gastroenterology and Hepatology,2021,33(12):1485-1494.
[10] Taraneh M,Shekoufeh N,Mohammad A.An update on efficacy and safety considerations for the latest drugs used to treat irritable bowel syndrome[J].Expert Opinion on Drug Metabolism & Toxicology,2020,16(7):583-604.
[11] 毛心勇,倪文超,国 嵩,等.基于“湿邪致病”认识腹泻型肠易激综合征[J].吉林中医药,2022,42(1):12-16.
[12] 卢 洁,林 萍,张 荣,等.浮针联合少腹逐瘀汤对寒凝血瘀型原发性痛经患者的临床疗效[J].中成药,2022,44(2):679-683.
[13] 刘信君,梁家彬,陆彦青,等.浮针治疗输尿管结石性肾绞痛探析[J].针灸临床杂志,2021,37(2):92-96.
[14] 李 旗,田福玲,郭振宇,等.浮针疗法对轻中度腹泻型肠易激综合征患者内脏敏感性、胃肠动力、肠道菌群及肠黏膜屏障功能的影响研究[J].中国全科医学,2021,24(9):1111-1115,1130.
[15] 邓剑勇,朱慧君.针刺联合隔盐隔姜灸神阙穴治疗脾肾阳虚型腹泻型肠易激综合征临床研究[J].河北中医,2019,41(9):1415-1418.
[16] 梁 金,陈 茜,张 璇.痛泻四神汤腹泻型肠易激综合征的胃肠激素水平变化及临床意义观察[J].世界中医药,2020,15(1):71-75,80.
[17] 贾小萌,陈伟健,钟 悦,等.针刺调神方联合参苓白术散治疗脾虚湿盛腹泻型肠易激综合征的临床观察[J].广州中医药大学学报,2022,39(7):1573-1577.
[18] 杜 航,何文生,胡红兰,等.白术活性成分药理作用研究进展[J].江苏中医药,2022,54(5):76-80.
[19] 范晓阳,侯彦婕,贾世艳,等.山药化学成分及皂苷类成分药理作用的研究进展[J].中医药信息,2021,38(9):79-84.
[20] 马艳春,范楚晨,冯天甜,等.茯苓的化学成分和药理作用研究进展[J].中医药学报,2021,49(12):108-111.
[21] 李榕娇,郭维龙,孙慧冰,等.肠易激综合征患者肠道菌群分布和炎症因子及血清NPY、SP、5-HT水平的变化[J].中国微生态学杂志,2020,32(9):74-78.
[22] 王 云,赵 崧.基于内脏高敏感从脾阳不足论述腹泻型肠易激综合征临床症状[J].陕西中医,2022,43(5):612-615,623.
[23] 林雪冬,王玲玲,黄小燕,等.隔药灸神阙穴治疗腹泻型肠易激综合征的疗效观察及其对血清5-HT、IL-10的影响[J].中国中医药科技,2022,29(3):356-359.
[24] 王 萍,汪镇朝,刘英孟,等.丁香挥发油的化学成分与药理作用研究进展[J].中成药,2022,44(3):871-878.

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备注/Memo

备注/Memo:
基金项目:湖南省中医药科研计划项目(2015146); 湖南省株洲市创新型城市建设专项社会化出资项目(54)
更新日期/Last Update: 2023-02-08