健脾温肾汤联合热补针法对腹泻型肠易激综合征脾肾阳虚证患者肠道微循环、脑肠肽及肠黏膜免疫屏障作用的影响  

Effect of Jianpi Wenshen Decoction (健脾温肾汤) Combined with Hot-Reinforcing Acupuncture on Intestinal Microcirculation, Brain-Gut Peptide and Intestinal Mucosal Immune Barrier in Patients with Diarrhea Irritable Bowel Syndrome of Spleen and Kidney Yang D

作　　者：阎晓悦 王京奇 张静 YAN Xiao-yue;WANG Jing-qi;ZHANG Jing(Beijng Mentougou Hospital of Traditional Chinese Medicine,Beijng 102300,China;Beijing Integrated Traditional Chinese and Western Medicine Hospital,Beijng 100039,China)

机构地区：[1]北京市门头沟中医医院,北京102300 [2]北京市中西医结合医院,北京100039

出　　处：《中医药导报》2021年第4期87-91,共5页Guiding Journal of Traditional Chinese Medicine and Pharmacy

基　　金：北京市科学重点研发计划(2018JY91257-3009)。

摘　　要：目的:探讨健脾温肾汤联合热补针法对腹泻型肠易激综合征脾肾阳虚证患者肠道微循环、脑肠肽及肠黏膜免疫屏障作用的影响。方法:选择76例腹泻型肠易激综合征脾肾阳虚证患者进行前瞻性研究,根据随机数字表法将纳入研究的病例分为治疗组和对照组各38例。两组患者均口服匹维溴铵片和双歧杆菌四联活菌片进行治疗,治疗组患者在此基础上联合健脾温肾汤和热补针法进行治疗。4周为1个疗程,两组患者均连续治疗2个疗程,统计疗效。对比两组患者治疗前后中医证候积分、血清5-HT含量、血浆NPY含量、血浆VIP含量、血清d-lactate含量、血清DAO含量。结果:治疗组总有效率为100.00%(38/38),对照组总有效率为89.47%(34/38),治疗组优于对照组(P<0.05)。治疗后两组患者各项中医证候积分及总积分均低于治疗前(P<0.05),且治疗组患者治疗后各项中医证候积分及总积分低于对照组(P<0.05)。治疗后两组患者血清5-HT含量明显低于治疗前(P<0.05),且治疗组患者治疗后血清5-HT含量明显低于对照组(P<0.05);治疗后两组患者血浆NPY含量明显高于治疗前(P<0.05),且治疗组患者治疗后血浆NPY含量明显高于对照组(P<0.05);治疗后两组患者血浆VIP含量、血清d-lactate含量、血清DAO含量均明显低于治疗前(P<0.05),且治疗组患者治疗后血浆VIP含量、血清d-lactate含量、血清DAO含量均明显低于对照组(P<0.05)。结论:健脾温肾汤联合热补针法治疗腹泻型肠易激综合征脾肾阳虚证患者疗效较好,可有效促进患者肠道微循环,改善肠动力紊乱,调节脑肠肽分泌平衡,并促进肠黏膜免疫屏障功能恢复。Objective: Objective: To explore the effect of Jianpi Wenshen Decoction combined with heat-reinforcing acupuncture on intestinal microcirculation, brain-gut peptide and intestinal mucosal immune barrier in patients with diarrhea irritable bowel syndrome of spleen and kidney Yang deficiency syndrome. Methods: A total of 76 patients with diarrhea irritable bowel syndrome of spleen and kidney Yang deficiency syndrome were selected for prospective study, and the cases included in the study were divided into treatment and control groups according to the random number table method, 38 cases in each group. Patients were treated with Piveronium Bromide Tablets and Bifidobacterium Quadruple Viable Bacteria Tablets in the two groups. On the basis of this,patients were Jianpi Wenshen Decoction and heat-reinforcing acupuncture in the treatment group. A course of treatment lasted four weeks. Patients were treated continuously for two courses in the two groups, and the curative effect was counted. The TCM syndrome score, serum 5-HT content, plasma NPY content, plasma VIP content, serum d-lactate content and serum DAO content were compared between the two groups before and after treatment. Results: The total effective rate was 100.00%(38/38) in treatment group and 89.47%(34/38) in control group. And the treatment group showed better efficacy than control group(P <0.05). After treatment, the TCM syndrome scores and total TCM syndrome scores were reduced in the two groups(P <0.05), and the treatment group showed lower TCM syndrome scores and total TCM syndrome scores than control group(P <0.05). After treatment, the serum 5-HT content reduced in the two groups(P<0.05), and the treatment group showed lower serum 5-HT content than control group(P<0.05). After treatment, the plasma NPY content was increased in the two groups(P<0.05), and the treatment group showed higher plasma NPY content than control group(P<0.05).The plasma VIP content, serum d-lactate and serum DAO were reduced in the two groups(P<0.05), and the treatment group

关 键 词：腹泻型肠易激综合征 脾肾阳虚证 健脾温肾汤 热补针法 肠道微循环 脑肠肽 肠黏膜免疫屏障作用 

分 类 号：R256.34[医药卫生—中医内科学]