引经中药联合脐灸治疗气虚便秘患者的疗效及对肠神经递质水平的影响  

Channel ushering drug combined with umbilical moxibustion in the treatment of constipation patients with Qi deficiency and its effect on the level of enteric neurotransmitters

作　　者：娄艳芳[1] 都文渊[1] 姚建景 刘伟花 王淑玲[1] LOU Yanfang;DU Wenyuan;YAO Jianjing;LIU Weihua;WANG Shuling(Department of Encephalopathy,Shijiazhuang Hospital of traditional Chinese Medicine,Shijiazhuang,Hebei 050000,China)

机构地区：[1]石家庄市中医院脑病科,河北石家庄050000

出　　处：《中国临床研究》2023年第6期924-928,938,共6页Chinese Journal of Clinical Research

基　　金：河北省中医药管理局科研计划项目(ZL20180008)。

摘　　要：目的探讨引经中药联合脐灸治疗气虚便秘患者的疗效及对肠神经递质水平的影响。方法选取2019年1月至2021年8月石家庄市中医院收治的148例气虚便秘患者作为研究对象,按照随机数字表法1∶1比例分为联合组、对照组,各74例。对照组采用脐灸治疗,联合组在对照组基础上加用引经中药治疗。比较两组疗效、治疗前后中医证候积分、便秘症状、大便性状评分、血清肠神经递质水平[一氧化氮(NO)、5-羟色胺(5-HT)、血管活性肠肽(VIP)、P物质(SP)]、升结肠黏膜水通道蛋白3(AQP3)、水通道蛋白8(AQP8)表达及3个月复发情况。结果联合组总有效率(95.95%)较对照组(85.14%)增高(P<0.05);治疗后联合组中医证候积分、便秘症状、大便性状评分较对照组低(P<0.05);血清VIP、NO、5-HT水平较对照组低,SP较对照组高(P<0.05);AQP3、AQP8表达水平较对照组低(P<0.05);联合组复发率(6.76%)较对照组(17.57%)低(P<0.05)。结论引经中药联合脐灸治疗气虚便秘患者效果显著,可有效改善便秘症状,降低复发率,作用机制可能与调节肠神经递质及AQP有关。Objective To investigate the clinical effect of channel ushering drug combined with umbilical moxibustion in the treatment of constipation patients with Qi deficiency and its effect on the levels of enteric neurotransmitters.Methods A total 148 constipation patients with Qi deficiency treated in Shijiazhuang Hospital of traditional Chinese Medicine from January 2019 to August 2021 were selected and divided into combined group and control group according to random number table method(n=74,each).The control group was treated by umbilical moxibustion,while the combination group was treated by channel ushering drug on the basis of the control group.Efficacy,TCM syndrome scores,constipation symptoms,stool trait scores,serum levels of intestinal neurotransmitter[nitric oxide(NO),5-hydroxytryptamine(5-HT),vasoactive intestinal peptide(VIP),substance P(SP)],expression of aquaporin 3(AQP3),aquaporin 8(AQP8)in ascending colon mucosae before and after treatment,and recurrence at 3 months were compared between the two groups.Results The overall response rate in the combination group was higher than that in the control group(95.95%vs 85.14%,P<0.05).The TCM syndrome score,constipation symptom,and stool trait score were lower in the combination group after treatment than those in the control group(P<0.05).After treatment,the levels of serum VIP,NO and 5-HT in the combination group were lower than those in the control group,and SP was higher than that in the control group(P<0.05).AQP3 and AQP8 levels were lower in the combination group after treatment compared with the control group(P<0.05).The recurrence rate in the combination group was lower than that in the control group(6.76%vs 17.57%,P<0.05).Conclusion Channel ushering drug combined with umbilical moxibustion has a certain effect in the treatment of constipation patients with Qi deficiency,which can effectively improve constipation symptoms and reduce recurrence rate,and the mechanism of action may be related to the regulation of intestinal neurotransmitters and AQPs.

关 键 词：便秘 引经中药 气虚 脐灸 肠神经递质 水通道蛋白 

分 类 号：R243[医药卫生—中医临床基础] R245[医药卫生—中医学]