精灸联合匹维溴铵治疗腹泻型肠易激综合征的疗效及对脑肠肽的影响  

Clinical Efficacy of Refined Moxibustion Combined with Pinaverium Bromide in Treatment of IBS-D and Its Influence to Brain-Gut Peptides

作　　者：卢莎[1] 黄伟[1] 汤园园[2] 李佳[1] LU Sha;HUANG Wei;TANG Yuanyuan;LI Jia(Hubei University of Chinese Medicine,Wuhan 430061,China;The Sixth Hospital of Wuhan,Wuhan 430015,China)

机构地区：[1]湖北中医药大学,湖北武汉430061 [2]武汉市第六医院,湖北武汉430015

出　　处：《针灸临床杂志》2023年第1期15-19,共5页Journal of Clinical Acupuncture and Moxibustion

基　　金：武汉市中青年医学骨干人才(第六批),编号:武卫生计生通[2018]116号。

摘　　要：目的:观察精灸与常规针刺疗法分别联合匹维溴铵治疗腹泻型肠易激综合征(IBS-D)的疗效及对各脑肠肽指标的影响。方法:将本院接受诊疗的IBS-D患者92例随机分为对照组(匹维溴铵+常规针刺疗法)和观察组(匹维溴铵+精灸疗法)各46例。运用自制中医症候积分量表评估并比较两组患者症状积分;检测并比较两组脑肠肽5-羟色胺(5-HT)、P物质(PSP)、血管活性肠肽(VIP)与神经肽Y(NPY)指标水平;比较两组直肠敏感性指标,包括排便阈值、腹痛阈值、直肠感知阈值及肛肠静息压;比较两组患者近远期疗效。结果:治疗结束后第6周、第3个月观察组总有效率均显著高于对照组(P<0.05);治疗后,观察组大便性状、大便频次、排便不尽感、有无黏液便、腹部不适评分及各症候积分总分显著低于对照组,差异有统计学意义(P<0.05);观察组血清5-HT、SP及VIP水平显著低于对照组,差异有统计学意义(P<0.05),而血清NPY水平显著高于对照组,差异有统计学意义(P<0.05);观察组排便阈值、腹痛阈值、直肠感知阈值及肛肠静息压显著高于对照组,差异有统计学意义(P<0.05)。结论:匹维溴铵联合精灸疗法可改善IBS-D患者临床症状,降低脑肠肽指标水平及直肠敏感性指标,且具有较好的近远期疗效。Objective:To investigate the clinical efficacy of refined moxibustion combined with Pinaverium bromide in treatment of diarrhea-predominant irritable bowel syndrome(IBS-D)and its influence to brain-gut peptides.Methods:92 patients with IBS-D were randomly divided into the control group and the observation group,with 46 cases in each group.The control group was treated with conventional acupuncture combined with Pivirium bromide;whereas the observation group was treated with refined moxibustion combined with Pinaverium bromide.The symptom scores were evaluated and compared by using the self-made TCM symptom score scale between the two groups.The brain-gut peptides,including 5-HT,PSP,VIP and NPY,were detected and compared between the two groups.The rectal sensitivity indexes,including defecation threshold,abdominal pain threshold,rectal perception threshold and anorectal resting pressure,were compared between the two groups.The short-term and long-term effects were also compared between the two groups.Results:The total effective rate of the observation group was significantly higher than that of the control group at the 6th week and the 3rd month after the treatment(P<0.05).The scores of stool feature,stool frequency,feeling of incomplete defecation,presence or absence of mucus stool,and abdominal discomfort,as well as the total score of symptoms were significantly lower in the observation group than those in the control group after the treatment(P<0.05).The serum levels of 5-HT,SP and VIP were significantly lower in the observation group than those in the control group(P<0.05),whereas the serum level of NPY was significantly higher than that in the control group after the treatment(P<0.05).The defecation threshold,the abdominal pain threshold,the rectal perception threshold and the anorectal resting pressure were significantly higher in the observation group than those in the control group after the treatment(P<0.05).Conclusion:Refined moxibustion combined with Pivirium bromide can improve clinical symptoms,reduce

关 键 词：腹泻型肠易激综合征 精灸 常规针刺 匹维溴铵 脑肠肽 

分 类 号：R246.1[医药卫生—针灸推拿学]