针刺对肠易激综合征患者穴位痛阈的影响  

Effect of Acupuncture on the Acupoint Pain Threshold in Patients with Irritable Bowel Syndrome

作　　者：杨丽娟 王晓信 李彬[2] 王淑斌 张赛 晋志高 邵蕊 王莹 YANG Li-juan;WANG Xiao-xin;LI Bin;WANG Shu-bin;ZHANG Sai;JIN Zhi-gao;SHAO Rui;WANG Ying(China Meitan General Hospital,Beijing 100028,China;Beijing Hospital of Traditional Chinese Medicine,Capital Medical University,Beijing 100010,China;Shunyi District Renhe Town Health Center,Beijing 101300,China;North China University of Science and Technology,Tangshan 100028,China)

机构地区：[1]煤炭总医院,北京100028 [2]首都医科大学附属北京中医医院,北京100010 [3]顺义区仁和镇卫生院,北京101300 [4]华北理工大学,唐山100028

出　　处：《上海针灸杂志》2018年第9期1030-1036,共7页Shanghai Journal of Acupuncture and Moxibustion

基　　金：国家自然科学基金项目(81273676);北京市中医药科技发展资金项目(JJ2013-61)

摘　　要：目的观察针刺治疗肠易激综合征的临床疗效及对患者穴位疼痛阈值的影响。方法将180例IBS患者随机分为针刺1组、针刺2组和对照组,每组60例。针刺1组选取与正常人腧穴疼痛阈值变化大的腧穴为主穴,结合临床辨证再选用适当的配穴;针刺2组以临床资料为基础辨证选穴,分为肝郁脾虚型、脾胃虚弱型、脾肾阳虚型;对照组采用口服西药。观察3组治疗前后穴位疼痛阈值和中医证候积分的变化,并比较临床疗效。结果针刺1组、针刺2组、对照组总有效率依次是80.0%、76.7%、56.7%,针刺1组、针刺2组与对照组总有效率比较,差异有显著统计学意义(P<0.01)。针刺1组、针刺2组中医证候各项积分较治疗前均有改善,腹部不适、泄泻、肠鸣矢气与治疗前比较差异有显著统计学意义(P<0.01),便秘、纳呆、倦怠乏力、抑郁烦躁与治疗前比较差异有统计学意义(P<0.05);对照组证候积分主要症状腹部不适、泄泻、便秘,次要症状肠鸣矢气与治疗前比较,差异有统计学意义(P<0.05)。3组治疗后大肠经、小肠经、脾经、胃经大多数相关穴位的疼痛阈值较同组治疗前升高(P<0.05,P<0.01)。结论针刺治疗对IBS具有很好的疗效。患者穴位疼痛阈值的变化与疾病的病情变化密切相关,可以为治疗选穴提供帮助,为疗效评价提供一种直观化、量化的新途径,为提高临床疗效及阐明针刺作用机理提供可靠的依据。Objective To observe the clinical efficacy of acupuncture in treating irritable bowel syndrome(IBS)and the effect of acupuncture on the acupoint pain threshold.Method A total of 180 IBS patients were randomized into acupuncture group 1,acupuncture group 2 and a control group,with 60 cases in each group.For acupuncture group 1,the acuopints,which had significantly different acupoint pain threshold compared with acupoints in normal people,were selected as the major points,with adjunct points selected according to syndrome differentiation.For acupuncture group 2,the points were selected based on syndrome differentiation according to their clinical data,i.e.the syndrome of liver depression and spleen deficiency,syndrome of spleen-stomach deficiency,and spleen-kidney yang deficiency.The control group was intervened by oral Western medication.The acupoint pain threshold and Chinese medicine symptom and sign scores were evaluated before and after the treatment in the three groups,and the clinical efficacies were compared.Result The total effective rates were 80.0%,76.6%and 56.7%in acupuncture group 1,acupuncture group 2 and the control group,respectively,and the total effective rates in acupuncture group 1 and 2 were significantly different from the rate in the control group(P<0.01).The Chinese medicine symptom and sign scores showed improvements in acupuncture group 1 and 2,and the improvements in abdominal discomfort,diarrhea and bowel sound and flatulence showed extremely statistical significance(P<0.01),while the improvements in constipation,lassitude,and depression and irritability showed statistical significance(P<0.05).In the control group,the scores of main symptoms including abdominal discomfort,diarrhea and constipation and secondary symptoms including bowel sound and flatulence showed significant differences after the treatment(P<0.05).The most of the involved acupoint pain thresholds of the Large Intestine Meridian,Small Intestine Meridian,Spleen Meridian and Stomach Meridian in the three groups significantl

关 键 词：肠易激综合征 针刺疗法 电针 痛觉阈值 

分 类 号：R246.1[医药卫生—针灸推拿学]