针刺会阴治疗严重慢性功能性便秘临床疗效观察  

Clinical observation of acupuncture at Huiyin(CV 1) for chronic severe functional constipation

作　　者：姜丽芳[1] 吴洁[2] 符强 姜丽红 陈晨[4] 朱丹[5] 仲远明[6] JIANG Li-fang;WU Jie;FU Qiang;JIANG Li-hong;CHEN Chen;ZHU Dan;ZHONG Yuan-ming(Department of Acupuncture and MoxibustionSecond Affiliated Hospital of Nanjing Medical University,Nanjing 210011,Jiangsu Province,China;Department of DigestiveSecond Affiliated Hospital of Nanjing Medical University,Nanjing 210011,Jiangsu Province,China;Department of General SurgerySecond Affiliated Hospital of Nanjing Medical University,Nanjing 210011,Jiangsu Province,China;Department of Ultrasound Medicine,Second Affiliated Hospital of Nanjing Medical University,Nanjing 210011,Jiangsu Province,China;Department of Acupuncture and Moxibustion,Affiliated Eye Hospital of Nanjing Medical University,Nanjing 210029,Jiangsu Province;Department of Acupuncture and Moxibustion,First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,Jiangsu Province)

机构地区：[1]南京医科大学第二附属医院针灸科,江苏南京210011 [2]南京医科大学第二附属医院消化科,江苏南京210011 [3]南京医科大学第二附属医院普外科,江苏南京210011 [4]南京医科大学第二附属医院超声医学科,江苏南京210011 [5]南京医科大学附属眼科医院针灸科,江苏南京210029 [6]南京医科大学附属第一医院针灸科,江苏南京210029

出　　处：《中国针灸》2023年第2期128-132,共5页Chinese Acupuncture & Moxibustion

基　　金：江苏省第四批中医临床优秀人才研修项目:苏中医科教[2022]1号。

摘　　要：目的:比较针刺会阴与口服西药治疗严重慢性功能性便秘(CSFC)的临床疗效。方法:将64例CSFC患者随机分为针刺组(32例,脱落5例)与西药组(32例,脱落4例)。两组均予常规基础治疗。针刺组予直刺会阴20~30 mm,前4周每日1次,每周5次;后4周隔日1次,每周3次,共治疗8周。西药组于每日早饭前口服琥珀酸普芦卡必利片2 mg,治疗8周。观察两组患者治疗前及治疗第1~8周周平均自主排便(SBM)次数,治疗前后及治疗后1个月随访时便秘症状评分,治疗前后生活质量[便秘生活质量自评量表(PAC-QOL)评分及治疗前后PAC-QOL评分差值≥1分者占比],并于治疗后及随访时评定两组临床疗效。结果:与治疗前比较,两组患者治疗第1~8周周平均SBM次数增加(P<0.05);针刺组治疗第1周周平均SBM次数少于西药组(P<0.05),治疗第4~8周周平均SBM次数多于西药组(P<0.05)。两组治疗后、随访时便秘症状评分及治疗后PAC-QOL评分较治疗前降低(P<0.05),且针刺组低于西药组(P<0.05);针刺组治疗前后PAC-QOL评分差值≥1分者占比高于西药组(P<0.05)。针刺组治疗后及随访总有效率分别为81.5%(22/27)和78.3%(18/23),均优于西药组的42.9%(12/28)和43.5%(10/23,P<0.05)。结论:针刺会阴可有效增加CSFC患者自主排便次数,减轻便秘症状,提高生活质量,治疗后及随访时疗效均优于口服西药。Objective To compare the effect of acupuncture at Huiyin(CV 1) and oral administration of western medication in treatment of chronic severe functional constipation(CSFC). Methods A total of 64 patients with CSFC were randomly divided into an acupuncture group(32 cases, 5 cases dropped off) and a western medication group(32 cases,4 cases dropped off). Both groups were given routine basic treatment. The acupuncture group was treated by directly puncture of 20-30 mm at Huiyin(CV 1), once a day for the first 4 weeks, 5 times a week, once every other day for the next 4 weeks, 3 times a week, totally for 8 weeks. The western medication group was treated with 2 mg prucalopride succinate tablets orally before breakfast every day for 8 weeks. The average number of weekly spontaneous bowel movement(SBM) of the two groups were observed before treatment and 1-8 weeks into treatment. The constipation symptom score before and after treatment, and in follow-up of 1 month after treatment, as well as quality of life [patient assessment of constipation quality of life questionnaire(PAC-QOL) score and the proportion of patients of PAC-QOL score difference before and after treatment≥1] before and after treatment were compared in the two groups. The clinical effects of the two groups were evaluated after treatment and in follow-up. Results Compared before treatment, the average number of weekly SBM in the two groups was increased 1-8 weeks into treatment(P<0.05). The average number of weekly SBM in the acupuncture group was less than that in the western medication group 1 week into treatment(P<0.05), and the average number of weekly SBM in the observation group was more than that in the western medication group 4-8 weeks into treatment(P<0.05). The scores of constipation symptom after treatment and in follow-up and scores of PAC-QOL after-treatment in the two groups were lower than those before treatment(P<0.05), and those in the acupuncture group were lower than the western medication group(P<0.05). The proportion of patients of P

关 键 词：严重慢性功能性便秘 针刺 穴 会阴 生活质量 随机对照试验 

分 类 号：R246.1[医药卫生—针灸推拿学]