Comparison of Electroacupuncture and Moxibustion on BrainGut Function in Patients with Diarrhea-Predominant Irritable Bowel Syndrome:A Randomized Controlled Trial  

作　　者：赵继梦 卢金花 尹小君 陈兴奎 陈跃华 汤伟军 金小明 吴璐一 包春辉 吴焕淦 施茵 

机构地区：[1]Yueyang Clinical School of Medicine,Shanghai University of Traditional Chinese Medicine [2]Medical Imaging Department,Jinhua Municipal Central Hospital [3]Department of Acupuncture and Moxibustion,Jinhua Municipal Central Hospital [4]Department of Digestive System,Jinhua Municipal Central Hospital [5]Radiology Department,Huashan Hospital,Fudan University [6]Department of Anatomy and Cell Biology,Indiana University School of Medicine [7]Shanghai Research Institute of Acupuncture and Meridian,Shanghai University of Traditional Chinese Medicine

出　　处：《Chinese Journal of Integrative Medicine》2015年第11期855-865,共11页中国结合医学杂志（英文版）

基　　金：Supported by the National Natural Science Foundation of China(No.30973784);Major State Basic Research Development Program of China(973 Program,No.2009CB522900);Shanghai Leading Talent Project of Traditional Chinese Medicine(No.ZYSNXD-RC-LJRC)

摘　　要：Objective： To compare the effects of electroacupuncture （EA） and moxibustion therapies on patients with diarrhea-predominant irritable bowel syndrome （D-IBS）. Methods： A total of 60 D-IBS patients were randomly allocated to the EA group （30 cases） and moxibustion group （30 cases）. Before and after treatment, the gastrointestinal symptoms and psychological symptoms were scored by Visual Analogue Scale, Bristol Stool Form Scale, Hamilton Anxiety Rating Scale （HAMA）, and Hamilton Depression Rating Scale （HAMD）; the expressions of 5-hydroxytryptamine （5-HT）, 5-HT3 receptor （5-HT3R）, and 5-HT4 receptor （5-HT4R） in the sigmoid mucosal tissue were measured by immunohistochemical staining. Additionally, the effects on the functional brain areas of the anterior cingulate cortex （ACC）, insular cortex （IC） and prefrontal cortex （PFC） were observed by functional magnetic resonance imaging. Results： Compared with before treatment, both EA and moxibustion groups reported significant improvements in abdominal pain and abdominal bloating after treatment （P〈0.01 or P〈0.05）. The moxibustion group reported greater improvements in defecation emergency, defecation frequency, and stool feature than the EA group （P〈0.01）. Both HAMA and HAMD scores were significantly decreased in the moxibustion group than in the EA group （P〈0.01）. Both groups demonstrated significantly reduced expressions of 5-HT, 5-HT3R and 5-HT4R in the colonic mucosa after treatment （P〈0.01）, with a greater reduction of 5-HT in the moxibustion group （P〈0.05）. Finally, decreased activated voxel values were observed in the left IC, right IC and PFC brain regions of patients in the moxibustion group under stimulation with 150 mL colorectal distension after treatment （P〈0.05 or P〈0.01）, while in the EA group only PFC area demonstrated a reduction （P〈0.05）. Conclusion： Moxibustion can significantly improve the symptoms of D-IBS, suggesting that moxibustion may be a more Objective： To compare the effects of electroacupuncture （EA） and moxibustion therapies on patients with diarrhea-predominant irritable bowel syndrome （D-IBS）. Methods： A total of 60 D-IBS patients were randomly allocated to the EA group （30 cases） and moxibustion group （30 cases）. Before and after treatment, the gastrointestinal symptoms and psychological symptoms were scored by Visual Analogue Scale, Bristol Stool Form Scale, Hamilton Anxiety Rating Scale （HAMA）, and Hamilton Depression Rating Scale （HAMD）; the expressions of 5-hydroxytryptamine （5-HT）, 5-HT3 receptor （5-HT3R）, and 5-HT4 receptor （5-HT4R） in the sigmoid mucosal tissue were measured by immunohistochemical staining. Additionally, the effects on the functional brain areas of the anterior cingulate cortex （ACC）, insular cortex （IC） and prefrontal cortex （PFC） were observed by functional magnetic resonance imaging. Results： Compared with before treatment, both EA and moxibustion groups reported significant improvements in abdominal pain and abdominal bloating after treatment （P〈0.01 or P〈0.05）. The moxibustion group reported greater improvements in defecation emergency, defecation frequency, and stool feature than the EA group （P〈0.01）. Both HAMA and HAMD scores were significantly decreased in the moxibustion group than in the EA group （P〈0.01）. Both groups demonstrated significantly reduced expressions of 5-HT, 5-HT3R and 5-HT4R in the colonic mucosa after treatment （P〈0.01）, with a greater reduction of 5-HT in the moxibustion group （P〈0.05）. Finally, decreased activated voxel values were observed in the left IC, right IC and PFC brain regions of patients in the moxibustion group under stimulation with 150 mL colorectal distension after treatment （P〈0.05 or P〈0.01）, while in the EA group only PFC area demonstrated a reduction （P〈0.05）. Conclusion： Moxibustion can significantly improve the symptoms of D-IBS, suggesting that moxibustion may be a more

关 键 词：irritable bowel syndrome DIARRHEA MOXIBUSTION ELECTROACUPUNCTURE randomized controlled trial 

分 类 号：R246.1[医药卫生—针灸推拿学]