火针配合健脾益气汤加减治疗脾胃虚弱型功能性腹泻的临床疗效研究  

Clinical efficacy of fire acupuncture combined with modified JianpiYiqi Decoction on functional diarrhea of spleen stomach weakness type

作　　者：田利军 唐乐 柳庆明 刘英才 TIAN Lijun;TANG Le;LIU Qingming;LIU Yingcai(Department of Acupuncture and Massage,Jinan City People's Hospital,Jinan,Shandong 271199)

机构地区：[1]山东省济南市人民医院针灸推拿科,山东济南271199

出　　处：《河北中医》2023年第7期1164-1168,共5页Hebei Journal of Traditional Chinese Medicine

基　　金：山东省中医药科技发展计划项目(编号:2019-0573)。

摘　　要：目的观察火针配合健脾益气汤加减治疗脾胃虚弱型功能性腹泻的临床疗效。方法选取2020年9月至2022年3月山东省济南市人民医院针灸推拿科收治的功能性腹泻患者64例,按照随机数字表法分为2组,在均予西医常规治疗的基础上,对照组32例联合健脾益气汤加减治疗,治疗组32例在对照组基础上配合火针治疗。2组均治疗4周后统计疗效,比较2组治疗前后中医症状(主症包括大便溏薄、便次增多、完谷不化及隐痛喜按,次症包括脘腹胀闷不适、倦怠乏力、神疲懒言及饮食减少)评分变化情况,比较2组治疗前后每周平均排便次数及粪便性状评分变化情况,比较2组治疗前后胃肠激素指标胃动素(MTL)、血管活性肠肽(VIP)及胃泌素(GAS)水平变化情况,比较2组治疗期间不良反应发生情况。结果治疗组总有效率93.75%(30/32),不良反应总发生率18.75%(6/32),对照组总有效率75.00%(24/32),不良反应总发生率12.50%(4/32),治疗组总有效率高于对照组(P<0.05),且2组不良反应总发生率比较差异无统计学意义(P<0.05)。与本组治疗前比较,2组治疗后中医症状主症、次症评分及总分均降低(P<0.05),且治疗组治疗后中医症状主症、次症评分及总分均低于对照组(P<0.05)。与本组治疗前比较,2组治疗后平均排便次数均减少(P<0.05),平均粪便性状评分均降低(P<0.05),且治疗组治疗后平均排便次数少于对照组(P<0.05),平均粪便性状评分低于对照组(P<0.05)。与本组治疗前比较,2组治疗后MTL及GAS水平均降低(P<0.05),VIP水平均升高(P<0.05),且治疗组治疗后MTL及GAS水平均低于对照组(P<0.05),VIP水平高于对照组(P<0.05)。结论火针配合健脾益气汤加减治疗脾胃虚弱型功能性腹泻临床疗效确切,可有效改善患者中医症状,减少排便次数,改善粪便性状,且安全可靠,其作用可能与降低MTL及GAS水平,升高VIP水平,调节胃肠激素平衡有关。Objective To study the clinical effect of fire needle combined with modified JianpiYiqi Decoction on functional diarrhea of spleen stomach weakness type.Methods Sixty-four patients with functional diarrhea who were admitted to the Department of Acupuncture and Massage,Jinan City People's Hospital of Shandong Province from September 2020 to March 2022 were randomly assigned into control group(n=32)and observation group(n=32).Based on conventional western medicine treatment,the control group was treated with JianpiYiqi Decoction,and the observation group with fire needle and JianpiYiqi Decoction.The curative effects of the two groups after 4 weeks of treatment were compared,and the traditional Chinese medicine(TCM)syndrome scores,defecation times,stool characteristics,gastrointestinal hormone levels(motilin[MTL],vasoactive intestinal peptide[VIP],gastrin gas)as well as the incidence of adverse reactions were included as comparisons between groups before and after treatment.Results The total effective rate in the observation group was higher than that in the control group(93.75%vs 75.00%,P<0.05).there was no statistical significance in the total incidence of adverse reactions between groups(18.75%[6/32]vs 12.50%[4/32],P<0.05).After treatment,the total TCM syndrome score in the two groups decreased,and which in the observation group was more prevalent(P<0.05).The defecation frequency and fecal character score in the two groups decreased,and which were lower in the observation group than in the control group(P<0.05).The levels of MTL,GAS and VIP in the two groups decreased,and which in the observation group were more common(P<0.05).Conclusion For patients with functional diarrhea of spleen stomach weakness type,fire acupuncture combined with JianpiYiqi Decoction has significant curative effect,which can reduce the score of TCM syndromes,improve the frequency of defecation and stool properties,regulate the level of gastrointestinal hormones,and has high safety.The mechanism regulates the balance of gastrointestinal hor

关 键 词：功能性腹泻 脾胃虚弱 中药疗法 火针 

分 类 号：R442.2[医药卫生—诊断学]