开四关法治疗老年功能性便秘临床疗效观察  

Clinical Effect of “Acupuncture and Moxibustion at Four Specific Acupoints” in Treatment of Elderly Functional Constipation

作　　者：张思斌 张正 周颖 杨原芳 聂小峰 尤梦奇 ZHANG Si-bin;ZHANG Zheng;ZHOU Ying;YANG Yuan-fang;NIE Xiao-feng;YOU Meng-qi(Clinical Medical School of Acupuncture and Rehabilitation,Guangzhou University of Chinese Medicine,Guangdong Guangzhou 510006,China)

机构地区：[1]广州中医药大学针灸康复临床医学院,广东广州510006

出　　处：《安徽中医药大学学报》2018年第2期55-58,共4页Journal of Anhui University of Chinese Medicine

摘　　要：目的观察开四关法治疗老年功能性便秘的临床疗效。方法将70例老年功能性便秘患者按随机数字表法分为治疗组和对照组,各35例。治疗组采用开四关法,对照组予常规针刺法。分别于治疗前后观察两组患者每周自主排便(spontaneous bowel movements,SBM)次数、便秘患者生活质量评价量表(patient assessment of constipation quality of life questionnaire,PAC-QOL)评分及简明生活质量量表(36-item short-form health survey,SF-36)评分,并检测一氧化氮(nitric oxide,NO)、一氧化氮合酶(nitric oxide synthase,NOS)、血管活性肠肽(vasoactive intestinal peptide,VIP)水平。结果治疗组临床疗效优于对照组(P<0.05);在治疗2周、4周后,治疗组SBM次数均显著大于对照组(P<0.05)。两组患者治疗后PACQOL和SF-36总评分均有显著变化(P<0.05),且治疗组较对照组改善明显(P<0.05)。治疗组治疗后NO、NOS、VIP降低程度显著大于对照组(P<0.05)。结论开四关法治疗老年功能性便秘疗效确切,其部分机制可能与降低血清NO有关。Objective To investigate the clinical effect of acupuncture and moxibustion at four specific acupoints in the treatment of elderly functional constipation.Methods A total of 70 elderly patients with functional constipation were randomly divided into treatment group and control group,with 35 patients in each group.The patients in the treatment group were given acupuncture and moxibustion at four specific acupoints,and those in the control group were given conventional acupuncture.The two groups were observed in terms of weekly number of times of spontaneous bowel movements(SBM),Patient Assessment of Constipation Quality of Life Questionnaire(PAC-QOL)score,and 36-Item Short-Form Health Survey(SF-36)score before and after treatment,and the levels of nitric oxide(NO),nitric oxide synthase(NOS),and vasoactive intestinal peptide(VIP)were also measured.Results The treatment group had a significantly better clinical outcome than the control group(P<0.05),and after 2 and 4 weeks of treatment,the treatment group had a significantly higher number of times of SBM than the control group(P<0.05).Both groups had significant improvements in total scores of PAC-QOL and SF-36 after treatment(P<0.05),and the treatment group had significantly greater improvements than the control group(P<0.05).After treatment,the treatment group had significantly greater reductions in NO,NOS,and VIP compared with the control group(P<0.05).Conclusion Acupuncture and moxibustion at four specific acupoints has a good clinical effect in the treatment of elderly functional constipation,possibly by reducing serum NO.

关 键 词：功能性便秘 开四关 降气通腑 一氧化氮 一氧化氮合酶 血管活性肠肽 

分 类 号：R256.35[医药卫生—中医内科学]