基于电针治疗严重功能性便秘有效性的经络变动规律探析  

Law of the meridian abnormality based on the effectiveness of electroacupuncture for severe functional constipation

作　　者：刘静[1] 周炜[2] 吕晖[2] 冯勇伟[2] 于秀琴[2] 符晓敏[2] 何玉伟[2] 赵际平 

机构地区：[1]北京中医药大学,北京100700 [2]北京中医药大学附属护国寺中医医院针灸科

出　　处：《中国针灸》2015年第8期785-790,共6页Chinese Acupuncture & Moxibustion

摘　　要：目的：基于电针治疗严重功能性便秘的有效性研究,观察相关经脉的异常变动规律及与针刺疗效的相关性。方法：70例严重功能性便秘患者,随机分为电针组和假电针组,每组35例。电针组深刺天枢、腹结,并连接电针（予疏密波,2 Hz/15 Hz、电流强度0.1～1.0mA）,加针刺上巨虚穴;假电针组以假电针浅刺天枢、腹结旁开穴,加浅刺上巨虚旁开穴,两组均连续治疗8周,前2周每周针5次,后6周每周针3次,分别于治疗前、治疗2、4、6、8周后各时间点运用王居易经络诊察法诊察70例患者脾、胃、大肠经异常变化;并比较两组患者每2周的自发的完全排尽感的大便次数（CSBM）、经络异常值及与CSBM总变动率的相关性。结果：在增加CSBM次数方面,电针组从治疗第2周后开始起效,随着治疗时间的延长,CSBM次数明显增加（均P〈0.05）;假电针组治疗6、8周后CSBM次数较治疗前明显增加（均P〈0.05）;电针组治疗后各时间点CSBM次数均较假电针组明显增加（均P〈0.05）。电针组大肠经异常值于治疗2周后,胃经、脾经相关经络的异常值于4周后均较基线期明显减少（均P〈0.05）,随着治疗时间的延长,大肠经、胃经的异常点逐渐减少（均P〈0.05）,且大肠经、胃经、脾经异常总变动率与CSBM总变动率呈负相关（P〈0.01,P〈0.05）。结论：电针组在增加严重功能性便秘CSBM次数方面有效,疗效优于假电针组且稳定;针刺脾、胃、大肠经的相关经穴确对经络异常有调整作用,且脾胃、大肠经络异常的变动与严重功能性便秘病情的转归和电针疗效具有相关性。Objective To observe the law of the meridian abnormal changes and the correlation with acupuncture efficacy based on the effectiveness study of electroacupuncture（EA）in treatment of severe functional constipation.Methods Seventy patients of severe functional constipation were randomized into an EA group and a shamEA group,35 cases in each one.In the EA group,Tianshu（ST 25）and Fujie（SP 14）were punctured deeply and stimulated with EA（dense-disperse wave,2Hz/15 Hz,0.1to 1.0mA）,and Shangjuxu（ST 37）was needled.In the sham-EA group,the sites lateral to Tianshu（ST 25）and Fujie（SP 14）were punctured shallowly and stimulated with electricity.The site lateral to Shangjuxu（ST 37）was punctured shallowly.The treatment was given continuously for 8 weeks in the two groups,5times weekly in the first 2 weeks and 3times weekly in the rest6 weeks.WANG Juyi＇s meridian examination method was applied to detect the abnormalities of the spleen,stomach and large intestine meridians before treatment,and in 2,4,6and 8weeks among 70 patients separately.The frequency of complete spontaneous bowel movement（CSBM）every two weeks,meridian abnormal value and the relativity with CSBM change rate were compared in the patients between two groups.Results Regarding the increase of CSBM frequency,the effect started since the 2nd week in the EA group,with the treatment going on,CSBM frequency was increased apparently（all P〈0.05）.In the sham-EA group,after 6and 8weeks of treatment,CSBM frequency was increased apparently as compared with that before treatment（all P〈0.05）.The increase of CSBM frequency in the EA group was remarkably as compared with the sham-EA group at every time point（all P〈0.05）.The abnormal value of the large intestine meridian in 2weeks of treatment and the values of the stomach and spleen meridians and the relevant meridians in 4weeks of treatment were all reduced apparently as compared with those in the baseline in the EA group（all P〈0.05）.With the treatment time going on,

关 键 词：严重功能性便秘 电针 王居易 经络诊察法 经络辨证 

分 类 号：R246.1[医药卫生—针灸推拿学]