天枢穴结合头部足运感区埋线对脑卒中后便秘患者血清SP、VIP含量影响的研究  

Effect of Catgut Embedding under ST25 and Foot Motor Sensory Area on Serum Contents of SP and VIP in Patients with Post-Stroke Constipation

作　　者：李艳秋[1] 王丽芹[1] 郭闯[1] 姜元辉[1] 孙晓伟[1] 东雪 邸之悦[1] 李洪涛[1,2] LI Yanqiu;WANG Liqin;GUO Chuang;JIANG Yuanhui;SUN Xiaowei;DONG Xue;DI Zhiyue;LI Hongtao(The First Affiliated Hospital of Heilongjiang University of Chinese Medicine,Harbin 150040,China;Heilongjiang University of Chinese Medicine,Harbin 150040,China)

机构地区：[1]黑龙江中医药大学附属第一医院,黑龙江哈尔滨150040 [2]黑龙江中医药大学,黑龙江哈尔滨150040

出　　处：《针灸临床杂志》2018年第7期50-54,共5页Journal of Clinical Acupuncture and Moxibustion

基　　金：黑龙江省中医药管理局项目;编号:ZHY16-038

摘　　要：目的:观察双侧天枢穴、双侧头部足运感区埋线治疗中风后便秘的临床效果及其对血清SP、VIP含量的影响。方法:选择90例符合纳入及排除标准的脑卒中患者为研究对象,按随机数字表法进行随机分组,分别为埋线组、针刺组和番泻叶组3组,每组各30例。均给予常规基础护理,埋线组采用双侧天枢、双侧足运感区穴位埋线治疗,每7天埋线1次,共埋2次;针刺组采用针刺双侧天枢、双侧头部足运感区治疗,每日针刺1次,治疗2周;番泻叶组每日服用1次番泻叶,间断或连续服用2周。3组患者分别于治疗前后进行大便性状评分量表、临床评分量表(CCS)、便秘患者生存质量量表(PAC-QOL)评定和测定血清中SP、VIP含量。结果:治疗后3组患者大便性状、CCS和PAC-QOL评分均较疗前明显降低(P<0.05),但疗后3组间大便性状评分比较无统计学差异(P>0.05),CCS、PAC-QOL评分比较埋线组、针刺组均较番泻叶组明显降低(P<0.05),且埋线组降低更为明显(P<0.05)。针刺组与其他两组临床总有效率比较均无统计学差异(P>0.05),而埋线组临床总有效率明显优于番泻叶组(P<0.05);埋线组愈显率明显优于其他两组(P<0.05)。与疗前相比3组患者疗后血清SP含量明显升高、VIP含量明显降低(P<0.05),且治疗后埋线组与其他两组比较有统计学差异(P<0.05)。结论:天枢穴结合头部足运感区埋线治疗脑卒中后便秘疗效较好,能显著改善中风后便秘患者的症状,其发挥作用可能与调节血清中SP、VIP的含量、促进消化道平滑肌的收缩、加快蠕动、重塑排便反射有关。Objective： To observe the clinical efficacy of catgut embedding under bilateral Tianshu point（ ST25） and bilateral foot motor sensory area in treatment of post-stroke constipation,and its effect on serum levels of SP and VIP. Methods： A total of 90 stroke patients were randomly divided into the catugut embedding group（ n = 30）,the acupuncture group（ n = 30）,and the Folium Sennae group（ n = 30）. The three groups were all treated with routine basic nursing care,on this basis,the catgut embedding group was also treated with catgut embedding therapy under bilateral ST25 and bilateral foot motor sensory area,and the catgut embedding was once every seven days for two times; the acupuncture group was treated with needling bilateral ST25 and bilateral foot motor sensory area,once a day for two weeks; the patients in the Folium Sennae group took Folium Sennae once a day for intermittent or continuous two weeks. Scale of stool feature,Constipation Clinical Scale（ CCS） and Pediatric Advanced Care-Quality of Life Scale（ PAC-QOL）,as well as the serum levels of SP and VIP were observed before and after treatment in the three groups. Results： The scores of the stool features,CCS and PAC-QOL were significantly lowered in the three groups after treatment（ P〈0. 05）; however,there was no significant difference in stool features among the three groups（ P〈0. 05）; the scores of CCS and PAC-QOL were significantly lower both in the catgut embedding group and in the acupuncture group than those in Folium Sennae group（ P〈0. 05）,and the decrease of the catgut embedding group was more obvious（ P〈0. 05）.There was no statistical difference between the acupuncture group and the other two groups in terms of the total effective rate（ P〉0. 05）,however,it was significantly higher in the catgut embedding group than that in the Folium Sennae group（ P〈0. 05）,and the catugut embedding group is superior to the other two groups in terms of good improvement rate（ P〈0. 05）. SP content

关 键 词：中风 便秘 穴位埋线 P物质 血管活性肠肽 天枢穴 

分 类 号：R246.6[医药卫生—针灸推拿学]