针刺联合痛泻逍遥方治疗腹泻型肠易激综合征临床研究  

Clinical study of acupuncture combined with Tongxie Xiaoyao recipe on diarrhea-predominant irritable bowel syndrome

作　　者：孙胜振[1] 王维[2] 高社光[1] 张吉敏 李颖 SUN Shengzhen;WANG Wei;GAO Sheguang;ZHANG Jimin;LI Ying(Second Department of Spleen and Stomach Diseases,Handan Hospital of Traditional Chinese Medicine,Handan,Hebei 056001;Center of preventive treatment,Handan Hospital of Traditional Chinese Medicine,Handan,Hebei 056001)

机构地区：[1]河北省邯郸市中医院脾胃病二科,河北邯郸056001 [2]河北省邯郸市中医院治未病中心,河北邯郸056001

出　　处：《河北中医》2022年第5期754-758,共5页Hebei Journal of Traditional Chinese Medicine

基　　金：河北省中医药管理局2019年度中医药类科研计划课题(编号:2019378)。

摘　　要：目的观察针刺联合痛泻逍遥方治疗腹泻型肠易激综合征(IBS-D)肝郁脾虚证的临床疗效,并对其中可能的机制进行探讨。方法将80例IBS-D肝郁脾虚证患者按照随机数字表法分为2组。对照组40例采用匹维溴铵片口服治疗,治疗组40例采用针刺联合痛泻逍遥方治疗,2组均治疗2个月。比较2组治疗前后IBS症状严重程度量表(IBS-SSS)、14项汉密尔顿焦虑量表(HAMA-14)和17项汉密尔顿抑郁量表(HAMD-17)评分,以及血清白细胞介素6(IL-6)、IL-8、肿瘤坏死因子α(TNF-α)、P物质(SP)、神经肽Y(NPY)水平变化,比较2组临床疗效。结果治疗后,2组IBS-SSS各项评分和总分,HAMA-14、HAMD-17评分和血清IL-6、IL-8、TNF-α、SP水平均较本组治疗前降低(P<0.05),NPY水平均较本组治疗前升高(P<0.05),且治疗组各指标改善均优于对照组(P<0.05)。治疗组总有效率89.47%(34/38),对照组总有效率69.23%(27/39),治疗组总有效率优于对照组(P<0.05)。结论针刺联合痛泻逍遥方治疗IBS-D肝郁脾虚证的疗效显著,能明显改善临床症状和焦虑抑郁状态,减轻炎性反应,其机制可能与调控神经肽有关。Objective To observe the clinical efficacy of acupuncture combined with self-made Tongxie Xiaoyao recipe on diarrhea-predominant irritable bowel syndrome(IBS-D),and to explore the possible mechanism.Methods Totally 80 IBS-D patients with liver depression and spleen deficiency syndrome were randomly divided into two group,40 cases in each,the control group were treated with pinaverium bromide orally,and the treatment group were treated with acupuncture combined with Tongxie Xiaoyao recipe.Treated for 2 months,the aiming was to compare IBS severity rating scale(IBS-SSS),Hamilton anxiety rating scale-14(HAMA-14),Hamilton anxiety rating scale-17(HAMA-17),and serum interleukin-6(IL-6),IL-8,tumor necrosis factor alpha(TNF-α),substance P(SP),neuropeptide Y(NPY)between the two groups before and after treatment.The clinical efficacy of the two groups was compared.Results After treatment,the IBS-SSS scores and total scores,HAMA-14,HAMD-17 scores and serum IL-6,IL-8,TNF-α,SP levels in the two groups were lower(P<0.05);NPY levels were higher than those before treatment in this group(P<0.05),and the improvement was better in the treatment group than the control group(P<0.05).The total effective rate of the treatment group was better than that of the control group(89.47%[34/38]vs 69.23%[27/39],(P<0.05),respectively).Conclusion For IBS-D patients(liver stagnation and spleen deficiency syndrome)acupuncture combined with Tongxie Xiaoyao recipe has significant curative effect,which can significantly improve clinical symptoms,anxiety and depression,and reduce inflammatory response by regulating neuropeptide.

关 键 词：肠易激综合征 针刺疗法 中药疗法 神经肽Y 

分 类 号：R574.405.31[医药卫生—消化系统] R245.31[医药卫生—内科学]