非植入性骶神经刺激对功能性便秘患者NOS、CCK表达及症状的近期影响  

Short-term efficacy of non-implantable sacral nerve stimulation on expressions of NOS,CCK and symptom of patients with chronic functional constipation

作　　者：张波 郑建勇 李世森 沈云天 夏航校 ZHANG Bo;ZHENG Jian-yong;LI Shi-sen;SHEN Yun-tian;XIA Hang-xiao(Department of Digestive Surgery,Xijing Hospital,the Air Force Medical University,Xi’an 710032,Shaanxi,China;Department of Anorectal Surgery,Xi’an Mayinglong Coloproctological Hospital,Xi’an 710005,Shaanxi,China)

机构地区：[1]空军军医大学西京医院消化外科,西安710032 [2]西安马应龙肛肠医院肛肠科,西安710005

出　　处：《中国临床医学》2022年第5期837-842,共6页Chinese Journal of Clinical Medicine

基　　金：国家自然科学基金(81470816)。

摘　　要：目的探讨非植入性骶神经刺激(sacral nerve stimulation,SNS)治疗功能性便秘(functional constipation,FC)的效果,为FC临床治疗方案的制定提供依据。方法选择2016年9月至2020年11月在西安马应龙肛肠医院肛四科住院接受电刺激治疗的132例FC患者为研究对象,随机分为2组。SNS组65例,其中出口梗阻型便秘(outlet obstructive constipation,OCC)38例、混合型便秘(mixed constipation,MIX)27例,采用SNS治疗;电针组67例,其中OCC 37例、MIX 30例,采用电针八髎穴治疗。比较2组组间、组内不同类型及组间同类型患者治疗前后Wexner评分、血清一氧化氮合成酶(nitricoxide synthase,NOS)和胆囊收缩素(cholecystokinin,CCK)水平。结果2组患者治疗后Wexner评分和CCK降低,NOS升高,差异均有统计学意义(P<0.05)。2组OCC和MIX患者治疗前NOS和CCK水平差异均无统计学意义,治疗后差异有统计学意义(P<0.05),均未恢复至正常水平。结论2种治疗方法均能改善便秘症状,并可调节血清NOS和CCK水平,其中非植入性SNS的效果优于电针八髎穴治疗,但2种方法均不能使NOS、CCK恢复正常。Objective To explore the effect of non-implantable sacral nerve stimulation(SNS)on the symptoms of patients with functional constipation(FC),in order to provide more basis for the establishment of clinical treatment plan for FC.Methods 132 FC patients hospitalized in the Department of Anorectal Surery,Xi’an Mayinglong Coloproctological Hospital from September 2016 to November 2020 were selected and divided into two groups.There were 65 patients treated with SNS in the SNS group,included 38 patients with outlet obstructive constipation(OCC)and 27 patients with mixed constipation(MIX);There were 67 patients treated with electroacupuncture at eight-liao point in the control group,included 37 patients with OCC and 30 patients with MIX.Wexner score,nitricoxide synthase(NOS)and cholecystokinin(CCK)levels were compared intra-and inter-groups.Results After treatment,Wexner score and CCK level decreased,and NOS level increased in both groups(P<0.05).There was no significant difference in the levels of NOS and CCK between the two groups before treatment,while the differences between the two groups after treatment were statistically significant(P<0.05).The levels of NOS and CCK in the two groups were abnormal(P<0.05).Conclusions Both treatments can improve the symptoms of constipation and regulate the levels of serum NOS and CCK,and the effect of non-implantable SNS is better,but two methods could not return NOS and CCKlevelsto normal.

关 键 词：功能性便秘 骶神经刺激 一氧化氮合成酶 胆囊收缩素 

分 类 号：R256.35[医药卫生—中医内科学]