火龙灸联合久泻方治疗脾肾阳虚型腹泻型肠易激综合征疗效及对肠黏膜屏障、炎症因子、脑肠轴的影响  

Efficacy of fire dragon moxibustion combined with Jiuxie decoction on irritable bowel syndrome with diarrhea of spleen-kidney Yang deficiency and its effect on intestinal mucosal barrier,inflammatory factors and brain-gut axis

作　　者：郑薇薇 赵耀 刘兴山[1] ZHENG Weiwei;ZHAO Yao;LIU Xingshan(Weifang Hospital of Traditional Chinese Medicine,Weifang 261000,Shandong,China)

机构地区：[1]潍坊市中医院,山东潍坊261000

出　　处：《现代中西医结合杂志》2022年第16期2191-2196,2204,共7页Modern Journal of Integrated Traditional Chinese and Western Medicine

基　　金：山东省中医药科技发展计划项目(2019-0708)。

摘　　要：目的观察久泻方联合火龙灸治疗脾肾阳虚型腹泻型肠易激综合征(IBS-D)的疗效及对肠黏膜屏障、炎症因子、脑肠轴的影响。方法选取2019年10月-2021年3月就诊于潍坊市中医院的脾肾阳虚型IBS-D患者120例,随机分为4组:内治组30例采用久泻方口服治疗,外治组30例采用火龙灸治疗,联合组30例采用久泻方口服联合火龙灸治疗,对照组30例采用马来酸曲美布汀片治疗,疗程均为2周。观察4组治疗前后中医症状积分(4项主症、3项次症)、肠易激综合征症状严重程度量表(IBS-SSS)积分及血清D-乳酸、二胺氧化酶(DAO)、白细胞介素-1β(IL-1β)、P物质(SP)、血管活性肠肽(VIP)、5-羟色胺(5-HT)水平变化,比较4组中医证候疗效、IBS-SSS量表疗效及不良反应发生情况。结果治疗后4组4项主症积分、IBS-SSS积分及内治组、外治组、联合组3项次症积分均较治疗前明显降低(P均<0.05),联合组各项主症积分、IBS-SSS积分均明显低于其他3组(P均<0.05),内治组、外治组各项主症积分、IBS-SSS积分均明显低于对照组(P均<0.05),内治组、外治组治疗后的腹痛、腹泻、腹胀积分及IBS-SSS积分比较差异均无统计学意义(P均>0.05);联合组3项次症积分、内治组倦怠乏力积分、外治组腰膝酸软积分均明显低于对照组(P均<0.05)。治疗后4组血清D-乳酸、DAO、IL-1β、SP、VIP、5-HT水平均较治疗前明显降低(P均<0.05),且联合组各指标水平均明显低于其他3组(P均<0.05),内治组、外治组各指标水平均明显低于对照组(P均<0.05);内治组血清D-乳酸、DAO、SP、VIP水平均明显低于外治组(P均<0.05),血清IL-1β水平明显高于外治组(P<0.05),血清5-HT水平与外治组比较差异无统计学意义(P>0.05)。内治组、外治组、联合组中医证候总有效率及内治组、联合组IBS-SSS量表总有效率均明显高于对照组(P均<0.05)。4组均未见不良反应发生。结论久泻方、火龙灸单用和联�Objective It is to observe the curative effect of Jiuxie decoctioni combined with fire dragon moxibustion in the treatment of irritable bowel syndrome with diarrhea(IBS-D)of spleen-kidney Yang deficiency and its effects on intestinal mucosal barrier,inflammatory factors and brain-gut axis.Methods A total of 120 patients with IBS-D of spleen-kidney Yang deficiency treated in Weifang Hospital of Traditional Chinese Medicine from October 2019 to March 2021 were selected and randomly divided into 4 groups:30 cases in the internal treatment group were treated with Jiuxie decoction orally,and the external treatment group was treated with fire dragon moxibustion,30 cases in the combination group were treated with Jiuxie decoction orally combined with fire dragon moxibustion,and 30 cases in the control group were treated with trimebutine maleate tablets,all the course of treatment was 2 weeks.The changes in the scores of traditional Chinese medicine(TCM)symptoms(4 main symptoms and 3 sub-symptoms),scores of irritable bowel syndrome symptom severity scale(IBS-SSS)and the levels of serum D-lactate,diamine oxidase(DAO),interleukin-1β(IL-1β),substance P(SP),vasoactive intestinal peptide(VIP),and 5-hydroxytryptamine(5-HT)before and after treatment were observed in the four groups,and the efficacy of TCM syndromes and IBS-SSS scale and adverse reactions occurred among the four groups were compared.Results After treatment,the scores of 4 main symptoms and IBS-SSS scores of the 4 groups and the scores of 3 sub-symptoms of the internal treatment group,external treatment group and combination group were significantly lower than those before treatment(all P<0.05),the scores of every main symptom and IBS-SSS scores of the combination group were significantly lower than those of the other three groups(all P<0.05),and the scores of main symptoms and IBS-SSS scores of the internal treatment group and external treatment group were significantly lower than those of the control group(all P<0.05),there was no significant difference in th

关 键 词：肠易激综合征 腹泻型 脾肾阳虚型 火龙灸 肠道屏障 

分 类 号：R574[医药卫生—消化系统]