电针大肠合穴下合穴配穴治疗功能性肠病双向调节效应的临床研究  

Clinical Study on Bidirectional Regulation Effects of Electroacupuncture at Quchi(LI 11) Combined with Shangjuxu(ST 37) in Treating Functional Bowel Disorders

作　　者：钟峰[1] 曹越[1] 罗容[1] 盛蓉蓉[1] 石文英[1] 刘英含 章薇[1] Zhong Feng;Cao Yue;Luo Rong;Sheng Rongrong;Shi Wenying;Liu Yinghan;Zhang Wei(Department of Acupuneture-Moxibustion and Tuina and Rehabilitation, the First Affiliated Hospital of Hunan University of Chinese Medicine, Changsha 410007, China)

机构地区：[1]湖南中医药大学第一附属医院针灸推拿科,长沙410007

出　　处：《世界中医药》2018年第3期722-726,共5页World Chinese Medicine

基　　金：国家重点基础研究发展计划(973计划)项目(2011CB505202);国家自然科学基金青年基金(81503661);湖南省教育厅优秀青年项目(17B202)

摘　　要：目的:通过运用电针刺激大肠合穴下合穴配穴(曲池、上巨虚),观察针刺对于2种不同状态(便秘、腹泻)的功能性肠病的临床疗效,为探求针刺治疗的双向调节作用机制,扩大针灸主治范围,探索针灸配穴组合疗效提供有效的临床依据。方法:选取2013年8月至2015年12月湖南中医药大学第一附属医院收治的符合相应纳入标准的功能性肠病患者132例(便秘型72例、腹泻型60例),将2型患者各自分为2个电针组,2个药物组,分别为便秘电针组(36例)、便秘药物组(36例)、腹泻电针组(30例)、腹泻药物组(30例)。2电针组均采用针刺双侧曲池、上巨虚后,采用20 Hz电流、连续波刺激30 min。治疗期为4周,共完成16次治疗,第1~2周治疗5次/周,第3~4周治疗3次/周。腹泻药物组口服盐酸洛哌丁胺胶囊,2 mg/次,3次/d,连服4周。便秘药物组口服枸橼酸莫沙必利片,5 mg/次,3次/d,连服4周。各组于治疗前、治疗第2周末、治疗完成后(第4周末)、治疗结束后1个月随访时,分别记录患者周排便次数和大便性状,评估其治疗期间及随访期的心理状态(SAS、SDS),并对数据进行统计与分析。结果:经治疗后,2电针组的周排便次数、大便性状、SAS、SDS均得到有效改善。组内比较中,治疗前后比较差异有显著统计学意义(P<0.01)。随访4周与治疗4周比较,差异无统计学意义(P>0.05),但与治疗前比较,差异有显著统计学意义(P<0.01)。组间比较中,2电针组的临床疗效与同型的药物组比较,其差异均无统计学意义(P>0.05)。结论:电针大肠合穴下合穴配穴能够治疗不同状态(便秘、腹泻)下的功能性肠病,并能产生稳定的、具有一定持续性的双向调节效应。Objective： Through observing the clinical effects of electroacupuncture at Quchi（ LI 11） and Shangjuxu（ ST 37） on functional bowel disorders（ constipation and diarrhea）,to explore two-way adjustment mechanism of acupuncture in treating functional bowel disorders,and to expand application scope,as well as provide effective clinical references for acupuncture combined with acupoints treatment. Methods： A total of 132 cases meeting the inclusion criteria of functional bowel disease（ constipation type 72 cases,diarrhea type 60 cases） who were admitted in our hospital from August 2013 to December 2015 were included and divided into 4 groups,respectively for constipation EA group（ 36 cases）,constipation drug group（ 36 cases）,diarrhea EA group（ 30 cases）,diarrhea drug group（ 30 cases）. Two electroacupuncture groups adopted acupuncture at Quchi（ LI 11） and Shangjuxu（ ST 37） with 20 Hz current and continuous wave stimulation for 30 minutes. 5 times treatment in 1 st and 2 nd week,and 3 times treatment in 3 rd and 4 th week. Four weeks was considered as one treatment course including 16 times treatment. The diarrhea drug group had Loperamide Hydrochlo-ride Capsules,2 mg/time,3 次/d,for 4 weeks continuously. The constipation drug group had pills of Mosapride,5 mg/time,3 次/d,for 4 weeks continuously. Defecation frequency per week,stool characteristics score,mental state assessment（ SAS,SDS） before treatment,end of 2 weeks＇ treatment,after treatment,1 month follow-up after treatment were recorded,statisticed and analyzed. Results： After treatment,the number of defecation frequency per week,stool characteristics score,mental state assessment（ SAS,SDS） of the two EA groups were significantly improved,and the difference was statistically significant（ P 〉0. 01）. Compared with follow-up of 4 weeks and 4 weeks treatment,there was no statistical significance（ P〉 0. 05）,but compared with before treatment,it still had statistically significant difference（ P〈 0.

关 键 词：曲池穴 上巨虚穴 功能性便秘 功能性腹泻 双向调节 

分 类 号：R246[医药卫生—针灸推拿学]