疏肝健脾调神针刺法治疗老年便秘型肠易激综合征观察  

Clinical Effecacy of Shugan Jianpi Tiaoshen Treatment for Senile Constipation Type of Irritable Bowel Syndrome

作　　者：王瑾[1] 

机构地区：[1]浙江中医药大学第一临床医学院,杭州310053

出　　处：《浙江中医药大学学报》2016年第6期494-497,共4页Journal of Zhejiang Chinese Medical University

摘　　要：[目的]观察疏肝健脾调神法治疗老年便秘型肠易激综合征(IBS-C)患者的临床疗效及5-HT的变化。[方法]自2014年6月至2015年6月共纳入符合标准的IBS-C患者68例,随机分为对照组34例和针刺组34例。对照组34例口服乳果糖口服液和枸橼酸莫沙必利治疗,针刺组34例在对照组基础上采用针刺治疗,取穴为天枢、足三里、上巨虚、太冲、行间、期门、百会、内关,观察两组患者治疗前后便秘症状、抑郁症状、生活质量及血清5-HT含量。[结果]对照组和针刺组患者治疗后便秘症状和抑郁症状分值均较治疗前降低(P<0.05),提示两种治疗方法均能有效改善IBS-C患者便秘、抑郁症状;针刺组治疗后便秘症状及抑郁症状分值均显著低于对照组(P<0.05),针刺治疗IBS-C患者的效果更为显著。两组患者在治疗后SF-36量表8个维度的分值均高于治疗前(P<0.05),提示两种治疗方法均能提高患者生活质量;治疗后针刺组患者生理功能、生理职能分值与对照组比较差异无统计学意义(P>0.05),而在躯体疼痛、活力、情感职能、精神健康、社会功能、总体健康分值上均要高于对照组差异有统计学意义(P<0.05),提示针刺治疗可以更有效地减轻躯体不适,提高患者生活质量。治疗后对照组与针刺组血清5-HT含量相对治疗前均有下降,且针刺组5-HT含量明显低于对照组(P<0.05),表明针灸治疗调节5-HT含量的作用更显著。[结论]疏肝健脾调神针刺法能够调节老年IBS-C患者5-HT水平,从而发挥其调节胃肠功能的作用,改善患者便秘及抑郁症状,提高患者的生活质量,是治疗老年IBS-C的有效治疗方法。[Objective] To observe the clinical efficacy and 5-HT of Shugan Jianpi Tiaoshen acupuncture treatment for senile patients with constipation type of irritable bowel syndrome（IBS-C）. [Method] A total of 68 patients with IBS-C were allocated into control group and acupuncture group from June 2015 to June 2014. 34 patients in the control group, who accepted Lactulose oral solution and Citrate Mosapride Citrate, of in 15 males and 19 females, the mean age was 66.8, the average duration of disease was 15.6 months; 34 patients in acupuncture group, who accepted acupuncture treatment based on control group, in 17 males and 17 females, the mean age was 65.9, the average duration of disease was 17.1 months. Acupoint selection： Tianshu, Zusanli, Taichong, Xingjian, Qimen, Baihui, Neiguan. Observe constipation symptoms, depressive symptoms, and quality of life and serum 5-HT levels before and after treatment. [Result] The pre-treatment constipation symptoms and depressive symptom scores in two groups were decreased than post-treatment（P〈O.05）, which showed two methods can improve constipation and depressive symptoms of IBS-C patients. After treatment, constipation symptoms and depressive symptoms score in acupuncture group were lower than that in control group（P〈0.05）, which showed the effect of acupuncture was better. The eight dimensions of SF-36 were higher than those before treatment in total patients（P〈0.05）, which showed two methods can improve quality of life of patients; differences of physiological function, physiological function between acupuncture group and control group had no statistical significance（P〉0.05）, but body pain, vitality, emotional function, mental health, social function, and general health values were higher than that of the control group（P〈0.05）, which showed acupuncture treatment can reduce physical discomfort and improve the quality of life of patients. After treatment,serum 5-HT in control group was 33.8 pg/ml, in acupuncture group was 27.6 pg/m, which were

关 键 词：便秘 老年 肠易激综合征 针刺 疏肝健脾调神法 5-HT 乳果糖口服液 枸橼酸莫沙必利 

分 类 号：R574.4[医药卫生—消化系统]