浮针疗法对轻中度腹泻型肠易激综合征患者内脏敏感性、胃肠动力、肠道菌群及肠黏膜屏障功能的影响研究  

Effect of Fu's Subcutaneous Needling on Visceral Sensitivity,Gastrointestinal Motility,Intestinal Flora and Intestinal Mucosal Barrier Function in Mild and Moderate Irritable Bowel Syndrome with Diarrhea

作　　者：李旗 田福玲 郭振宇[2] 周立伟 朱好松 LI Qi;TIAN Fuling;GUO Zhenyu;ZHOU Liwei;ZHU Haosong(North China University of Science and Technology,Tangshan 063000,China;Beijing University of Chinese Medicine,Beijing 100029,China;China Medical University Hospital,Taizhong 404332,China;Quzhou County Chinese Medicine Hospital,Handan 057250,China)

机构地区：[1]华北理工大学,河北省唐山市063000 [2]北京中医药大学,北京市100029 [3]中国医药大学附设医院,台湾省台中市404332 [4]河北省邯郸市曲周县中医院,057250

出　　处：《中国全科医学》2021年第9期1111-1115,1130,共6页Chinese General Practice

基　　金：国家自然科学基金资助项目(81303046);河北省自然科学基金资助项目(H2019209565);河北省中医药科学计划项目(2020221)。

摘　　要：背景腹泻型肠易激综合征(IBS-D)是消化系统常见病、多发病之一,但目前单纯应用西药治疗尚不能取得满意疗效,且治疗后易复发。浮针疗法用于治疗IBS-D效果肯定,但其具体作用机制仍不明确。目的探讨浮针疗法对轻中度IBS-D患者内脏敏感性、胃肠动力、肠道菌群及肠黏膜屏障功能的影响。方法选取2019年8月—2020年3月在华北理工大学附属医院消化科门诊及针灸门诊就诊的轻中度IBS-D患者60例,采用随机数字表法分为对照组和观察组,每组30例。对照组患者在常规干预基础上给予复方谷氨酰胺肠溶胶囊治疗,观察组患者在常规干预基础上采用浮针疗法治疗;两组患者均连续治疗14 d。比较两组患者治疗前后肠易激综合征症状严重程度量表(IBS-SSS)评分、内脏敏感指数(VSI)评分、直肠容量刺激感觉指标、肠道菌群数量、生化指标,记录两组患者治疗期间不良反应/并发症发生情况。结果对照组中1例患者被剔除,观察组中2例患者脱落,最终对照组、观察组分别纳入29例、28例患者。治疗后两组患者IBS-SSS、VSI评分及血清白介素6、白介素8、干扰素γ、血管活性肠肽、胃动素、D-乳酸、肿瘤坏死因子α(TNF-α)水平均低于治疗前,排便阈值、疼痛阈值、感觉阈值及血清P物质水平均高于治疗前,双歧杆菌、乳杆菌、拟杆菌数量均多于治疗前(P<0.05);治疗后对照组患者肠杆菌数量少于治疗前(P<0.05);治疗后观察组患者双歧杆菌数量少于对照组,肠杆菌数量多于对照组,血清干扰素γ水平高于对照组(P<0.05)。两组患者治疗期间均未出现明显不良反应/并发症。结论浮针疗法可有效减轻轻中度IBS-D患者症状严重程度,降低患者内脏敏感性,提高患者直肠顺应性,有利于纠正患者肠道菌群失调,并可能通过调节炎性因子、胃肠激素及肠黏膜屏障相关因子而促进轻中度IBS-D患者肠黏膜屏障功能的�Background Irritable bowel syndrome with diarrhea(IBS-D)is a common and frequently-occurring disease of the digestive system,which shows unsatisfactory response to Western medicine treatment,and is easy to recur.Fu's subcutaneous needling has been proved to be effective in treating IBS-D,but the specific mechanism of action is not clear.Objective To explore the effect of Fu's subcutaneous needling on visceral sensitivity,gastrointestinal motility,intestinal flora and intestinal mucosal barrier function in mild and moderate IBS-D.Methods A total of 60 outpatients with mild and moderate IBS-D were selected in Gastroenterology Clinic and Acupuncture and Moxibustion Clinic of North China University of Science and Technology from August 2019 to March 2020 and equally divided into control group and observation group by use of a random number table,receiving a 14-day oral administration of compound glutamin entersoluble capsule with routine care,and Fu's subcutaneous needling with routine care,respectively.Pre-and post-treatment Irritable Bowel Syndrome Severity Scoring System(IBS-SSS)score,visceral sensitivity index(VSI)score,indices related to rectal sensitivity to distension,quantity of intestinal flora and biochemical indicators were compared between the two groups.The incidence of treatment-related adverse reactions/complications was recorded.Results We finally enrolled 29 controls(other one was excluded)and 28 cases(other two were lost to follow up).After treatment,both groups showed significantly decreased IBS-SSS score,VSI score,serum levels of IL-6,IL-8,IFN-γ,vasoactive intestinal peptide,motilin,D-lactic acid and TNF-α,obviously higher defecation threshold,pain threshold,sensory threshold and serum substance P level,as well as notably increased quantities of bifidobacteria,lactobacilli and bacteroides(P<0.05).The post-treatment quantity of enteric bacilli in control group was significantly less than that before treatment(P<0.05).The observation group had significantly less quantity of bifidobacteria,signific

关 键 词：肠易激综合征 腹泻 针刺疗法 浮针疗法 治疗结果 

分 类 号：R574.62[医药卫生—消化系统]