改良版脐灸对老年功能性便秘患者肠动力、胃肠神经递质及肠道菌群的影响  

Effect of Modified Umbilical Moxibustion on Intestinal Motility,Gastrointestinal Neurotransmitters,and Intestinal Flora in Elderly Patients with Functional Constipation

作　　者：朱晓芳[1] 禹瑞 聂山文[1] 吴秀霞[1] ZHU Xiaofang;YU Rui;NIE Shanwen;WU Xiuxia(Henan Provincial Hospital of Traditional Chinese Medicine,Henan Zhengzhou 450006,China;Zhengzhou Shuqing Medical College,Henan Zhengzhou 450002,China)

机构地区：[1]河南省中医院,河南郑州450006 [2]郑州澍青医学高等专科学校,河南郑州450002

出　　处：《安徽中医药大学学报》2022年第6期59-64,共6页Journal of Anhui University of Chinese Medicine

基　　金：河南省中医药科学研究专项(2022ZY1067)。

摘　　要：目的观察改良版脐灸对老年功能性便秘患者肠动力、胃肠神经递质及肠道菌群的影响。方法将94例患者随机分为对照组和观察组,每组47例。对照组患者口服枸橼莫沙必利,观察组患者接受改良版脐灸治疗,疗程14 d。治疗前后分别观察两组患者排便情况(每周排便次数、粪便性状、粪便pH值、排便困难程度),采用胃肠动力检测仪检测患者肠动力学指标[直肠最低敏感度(rectal minimum sensitivity,RMS)、最大耐受度(maximum tolerance,MT)、直肠顺应性(rectal compliance,RC)、结肠传输试验(colon transport test,CTT)]以评价肠传输功能,放射免疫分析法检测胃肠神经递质[胃动素(motilin,MTL)、5-羟色胺(5-hydroxytryptamine,5-HT)、血管活性肠肽(vasoactive intestinal peptide,VIP)、P物质(substance P,SP)],荧光强度定量法检测肠道菌群(大肠埃希菌、产气夹膜梭菌、乳杆菌、双歧杆菌)数量,基于排便次数、粪便性状和排便困难程度积分判定临床疗效,并观察安全性。结果观察组临床疗效显著优于对照组(P<0.05)。观察组患者每周排便次数,粪便pH值,血清MTL、SP水平的升高程度以及粪便性状、排便困难程度评分,血清5-HT、VIP水平,肠动力学指标RMS、MT、RC、CTT的降低程度显著大于对照组(P<0.05)。与治疗前比较,观察组患者大肠埃希菌数量显著降低(P<0.05),产气夹膜梭菌、乳杆菌、双歧杆菌数量显著升高(P<0.05),而对照组患者4种肠道菌群数量均无明显变化(P>0.05)。观察组总不良反应发生率(4.3%)显著低于对照组(23.4%)(P<0.05)。结论改良版脐灸可缓解老年功能性便秘患者的便秘,调节肠动力、胃肠神经递质和肠道菌群,安全性高。Objective To investigate the effect of modified umbilical moxibustion on intestinal motility,gastrointestinal neurotransmitters,and intestinal flora in elderly patients with functional constipation.Methods A total of 94 patients were randomly divided into control group and observation group,with 47 patients in each group.The patients in the control group were given oral administration of mosapride citrate,while those in the observation group were given modified umbilical moxibustion;the course of treatment was 14 days for both groups.Defecation(weekly defecation frequency,stool form,fecal pH value,and defecation difficulty)was observed before and after treatment;a gastrointestinal motility instrument was used to measure gastrointestinal motility parameters[rectal minimum sensitivity(RMS),maximum tolerance(MT),rectal compliance(RC),and colon transport test(CTT)]to evaluate intestinal transit function;radioimmunoassay was used to measure gastrointestinal neurotransmitters[motilin(MTL),5-hydroxytryptamine(5-HT),vasoactive intestinal peptide(VIP),and substance P(SP)];fluorescence intensity quantification was used to measure intestinal flora(Escherichia coli,Clostridium perfringens,Lactobacillus,and Bifidobacterium).Clinical outcome was evaluated based on defecation frequency and the scores of stool form and defecation difficulty,and safety was also observed for the two groups.Results The observation group had a significantly better clinical outcome than the control group(P<0.05).Compared with the control group,the observation group had significantly greater increases in weekly defecation frequency,fecal pH value,and the serum levels of MTL and SP and significantly greater reductions in the scores of stool form and defecation difficulty,the serum levels of 5-HT and VIP,and the gastrointestinal motility parameters RMS,MT,RC,and CTT(P<0.05).After treatment,the observation group had a significant reduction in the number of Escherichia coli and significant increases in the number of Clostridium perfringens,Lactobacillus,a

关 键 词：功能性便秘 脐灸 肠动力学 胃肠神经递质 肠道菌群 

分 类 号：R256.35[医药卫生—中医内科学]