揿针对改善帕金森病患者便秘症状的作用  

Evaluation on efficacy of press-needle in treating constipation Parkinson's disease

作　　者：李立红[1] 张海峰[2] 陈晟[3] 汪凡[1] 齐亮 王乐[5] 

机构地区：[1]浙江省人民医院针灸科,杭州医学硕士310014 [2]浙江省中医院康复科,杭州310006 [3]浙江省人民医院肝肠外科,杭州310014 [4]北京市东城区第二妇幼保健院,北京100061 [5]北京中医药大学东方医院中医脑病科,北京100078

出　　处：《医学研究生学报》2017年第7期762-766,共5页Journal of Medical Postgraduates

基　　金：浙江省中医药优秀青年人才基金(2016ZQ006)

摘　　要：目的药物治疗帕金森病(PD)便秘会导致依赖性,甚至造成胃肠道其他损害。文中通过观察揿针俞募配穴法和口服枸橼酸枸橼酸莫沙必利片2种治疗方法,比较患者在接受治疗后的肛肠动力学和PD便秘症状的改善程度。方法回顾性分析2013年5月至2016年9月期间浙江省人民医院针灸科和北京东方医院脑病科门诊收治的PD便秘患者60例,随机分为对照组(n=30)和试验组(n=30)。对照组采用口服枸橼酸莫沙必利片,治疗组采用揿针治疗。通过自身对照和组间对照比较两组临床疗效、便秘患者生活质量(PAC-QOL)量表评分和肛门直肠动力学检查结果。结果治疗组总有效率81.7%,显著高于对照组(70%),组间比较差异有统计学意义(P<0.05);治疗组和对照组均可改善PAC-QOL量表评分情况,与治疗前比较差异均有统计学意义(P<0.01),治疗后组间比较差异无统计学意义(P>0.05);两组与治疗前比较,肛肠动力学指标差异有统计学意义(P<0.05),组间比较差异无统计学意义(P>0.05)。结论揿针和枸橼酸莫沙必利片治疗PD便秘症状均可改善患者的生活质量和肛肠动力学,疗效近似。但揿针俞募配穴法在改善PD便秘症状中总有效率高于枸橼酸莫沙必利片,且操作方便、患者痛苦小,值得临床推广应用。Objective The clinical manifestations of Parkinson＇s disease（ PD） are divided into non-motor symptoms and motor symptoms. Constipation is one of the common symptoms of non-motor symptoms of the disease. Constipation symptoms in PD generally occur earlier for 5 ~ 20 years,while drug treatment for PD constipation can lead to gastrointestinal damage. This study investigated the improvement in the treatment of anorectal dynamics and constipation symptoms in Parkinson ＇s disease by oral mosapride and press-needle therapy of Shu-Mu point. Methods 60 patients diagnosed as constipation of Parkinson＇s disease were randomly divided into control group and treatment group,30 cases in each group; patients in the control group were treated with oral mosapride tablets,while patients in the treatment group received press-needle therapy,three times per week. The observation course in both groups last for three months and follow-up visits were conducted before and after the course. Efficacy evaluation,PAC-QOL scale and anorectal dynamic examination were applied in the follow-up visit. Results The efficiency of treatment group was 81.7%,significantly higher than control group（ 70%）,representing significant difference between the two groups（ P〈0.05）. Both the methods could improve the PAC-QOL scale,and significant difference was found in comparison to that before the treatment（ P〈0.01）,while no statistical significance was found between treatment group and control group after treatment（ P〉0.05）. As to the anorectal dynamics,significant difference was found before and after the treatment in both groups（ P〈0.05,P〈0.01）,while no statistical significance were found between the two groups after treatment（ P〉0.05）. Conclusion Both oral mosapride and press-needle can improve the quality of life and anorectal dynamics for PD patients,representing no significant difference. However,compared with mosapride,the overall efficacy of press-needle is better in improving the symptoms of constipation in

关 键 词：帕金森病 便秘 揿针 俞募配穴 

分 类 号：R749[医药卫生—神经病学与精神病学]