尺肤针联合抑木汤治疗肝脾不和型腹泻型肠易激综合征疗效及机制研究  

Curative Efficacy and Mechanism of Chi Skin Acupuncture Combined with Yimu Decoction(抑木汤) in Treatment of Irritable Bowel Syndrome with Predominant Diarrhea(IBS-D)Caused by Disharmony Between Liver and Spleen

作　　者：李颖 高社光[1] 王维[1] 孙胜振[1] 张吉敏 张晓敬[1] 代璞 LI Ying;GAO Sheguang;WANG Wei;SUN Shengzhen;ZHANG Jimin;ZHANG Xiaojing;DAI Pu(Handan Hospital of Traditional Chinese Medicine,Handan 056000,China;Jize Hospital of Traditional Chinese Medicine,Handan 053750,China)

机构地区：[1]邯郸市中医院,河北邯郸056000 [2]邯郸市鸡泽县中医院,河北邯郸053750

出　　处：《山东中医杂志》2022年第12期1296-1302,共7页Shandong Journal of Traditional Chinese Medicine

基　　金：河北省中医药管理局科研计划项目(编号:2019378)。

摘　　要：目的:观察尺肤针联合抑木汤治疗肝脾不和型腹泻型肠易激综合征的临床疗效,并探讨相关机制。方法:选取肝脾不和型腹泻型肠易激综合征患者300例,按照随机数字表法分为西药对照组、抑木汤组、针药联合组各100例。西药对照组采用匹维溴铵片治疗,抑木汤组采用抑木汤治疗,针药联合组采用尺肤针联合抑木汤治疗。三组均以7 d为1个疗程,连续治疗2个疗程。比较三组治疗前后中医证候积分、心理情绪评分以及直肠敏感性、肠道屏障功能、胃肠激素、神经递质、炎症反应相关指标水平,并统计三组临床疗效和复发情况。结果:治疗后1 d、治疗后30 d,三组中医证候积分、心理情绪评分以及直肠敏感性、肠道屏障功能、胃肠激素、神经递质、炎症反应相关指标水平较治疗前均明显改善,差异有统计学意义(P<0.05)。治疗后1 d、治疗后30 d,针药联合组的中医证候积分、心理情绪评分均低于其他两组(P<0.05);直肠敏感性指标排便阈值、腹痛阈值、直肠感知阈值、肛管静息压均高于其他两组(P<0.05);肠道屏障功能相关指标内毒素、D-乳酸、二胺氧化酶含量均低于其他两组(P<0.05);神经肽Y(NPY)、降钙素基因相关肽(CGRP)、5-羟色胺(5-HT)水平均低于其他两组(P<0.05);炎症反应相关指标蛋白酶激活受体-2(PAR-2)、蛋白酶激活受体-4(PAR-4)、白细胞介素-6(IL-6)、白细胞介素-8(IL-8)水平均低于其他两组(P<0.05)。针药联合组治疗总有效率高于其他两组(P<0.05),痊愈患者6个月复发率低于其他两组(P<0.05)。结论:尺肤针联合抑木汤治疗肝脾不和型腹泻型肠易激综合征,可明显改善患者临床症状,提高疗效,降低复发率,其机制可能与提高直肠敏感性和肠道屏障功能、减轻局部炎症有关。Objective:To observe the clinical curative efficacy of Chi skin acupuncture combined with Yimu Decoction(抑木汤)in treatment of irritable bowel syndrome with predominant diarrhea(IBS-D)caused by disharmony between liver and spleen,and to explore the relevant mechanism.Methods:A total of 300 patients with IBS-D caused by disharmony between liver and spleen were divided into western medicine control group,Yimu Decoction group,and acupuncture combined with medicine group by random number table method,with 100 cases in each group.The western medicine control group was treated with pivonium bromide tablets,the Yimu Decoction group was treated with Yimu Decoction,and the acupuncture combined with medicine group was treated with Chi skin acupuncture combined with Yimu Decoction.The three groups all took 7 days as a course of treatment and were treated for 2 consecutive courses.The traditional Chinese medicine(TCM)syndrome score,psychological emotion scores,and levels of indicators related to rectal sensitivity,intestinal barrier function,gastrointestinal hormones,neurotransmitters,and inflammatory reactions were compared before and after treatment among the three groups,and the clinical curative efficacy and recurrence of the three groups were statistically analyzed.Results:On the 1st day and the 30th day after treatment,the TCM syndrome score,psychological emotion scores,and levels of indicators related to rectal sensitivity,intestinal barrier function,gastrointestinal hormones,neurotransmitters,and inflammatory response in the three groups were significantly improved compared with those before treatment(P<0.05).On the 1st day and the 30th day after treatment,the TCM syndrome score and psychological emotion scores of the acupuncture combined with medicine group were lower than those of the other two groups(P<0.05).The levels of rectal sensitivity indicators(defecation threshold,abdominal pain threshold,rectal perception threshold and anal canal rest pressure)in the acupuncture combined with medicine group were highe

关 键 词：尺肤针 抑木汤 腹泻型肠易激综合征 肝脾不和 肠道屏障功能 中医证候 腹痛 泄泻 

分 类 号：R246.1[医药卫生—针灸推拿学] R259[医药卫生—中医临床基础]