穴位埋线治疗便秘型肠易激综合征的疗效观察及对血清SP含量的影响  

Observation of the therapeutic effect of catgut-embedding therapy in the treatment of constipation-predominant irritable bowel syndrome and its influence on serum SP content

作　　者：陈盼碧 侯天仙 陈艺 金灵敏 况莎莎 杨孝芳 CHEN Panbi;HOU Tianxian;CHEN Yi;JIN Lingmin;KUANG Shasha;YANG Xiaofang(Guizhou University of Traditional Chinese Medicine,Guiyang 550025,China;Huaihua City Maternal and Child Health Care Hospital of Hunan Province,Huaihua 418000,China;Affiliated Hospital of Zunyi Medical University,Zunyi 563000,China;Chongqing Fuling People’s Hospital,Chongqing 408000,China)

机构地区：[1]贵州中医药大学,贵阳550025 [2]湖南省怀化市妇幼保健院,怀化418000 [3]遵义医科大学附属医院,遵义563000 [4]重庆市涪陵区人民医院,重庆408000

出　　处：《上海针灸杂志》2024年第1期40-46,共7页Shanghai Journal of Acupuncture and Moxibustion

基　　金：贵州省研究生教育创新计划项目[黔教合YJSCXJH(2018)075];贵州中医药大学重大专项项目[黔科合平台人才(2017)5735号-34]。

摘　　要：目的观察穴位埋线治疗便秘型肠易激综合征(constipation-predominant irritable bowel syndrome,IBS-C)的临床疗效及对血清P物质(substance P,SP)含量的影响。方法43例IBS-C患者随机分为观察组(22例)和对照组(21例)。观察组采用埋线方法治疗,对照组采用枸橼酸莫沙必利分散片治疗。观察两组治疗前后及随访期肠易激综合征症状严重程度量表(IBS symptom severity scale,IBS-SSS)评分、肠易激综合征生活质量量表(irritable bowel syndrome quality of life,IBS-QOL)评分和焦虑自评量表(self-rating anxiety scale,SAS)评分的变化及治疗前后血清SP含量变化。结果观察组治疗后及随访期IBS-SSS各项评分与总评分较治疗前降低(P<0.05),随访期IBS-SSS各项评分与总评分较治疗后升高(P<0.05);对照组治疗后IBS-SSS各项评分与总评分较治疗前降低(P<0.05),随访期IBS-SSS各项评分与总分较治疗后升高(P<0.05);观察组治疗后和随访期腹痛不适评分低于对照组(P<0.05)。两组治疗后及随访期IBS-QOL总评分高于治疗前,两组随访期IBS-QOL评分低于治疗后,差异有统计学意义(P<0.05);观察组治疗后及随访期IBS-QOL评分高于对照组(P<0.05)。观察组治疗后及随访期SAS评分均降低(P<0.05),随访期SAS评分高于治疗后(P<0.05);对照组治疗后SAS评分低于治疗前(P<0.05),随访期SAS评分高于治疗后(P<0.05);观察组治疗后及随访期SAS评分均低于对照组(P<0.05)。两组治疗后血清SP含量均降低(P<0.05);观察组血清SP含量低于对照组(P<0.05)。观察组临床疗效高于对照组,差异具有统计学意义(P<0.05)。结论穴位埋线和枸橼酸莫沙必利分散片均能缓解IBS-C患者临床症状,提高其生活质量,但穴位埋线相较于枸橼酸莫沙必利分散片临床疗效更稳定和持久;在改善腹痛和生活质量方面穴位埋线的远期效应更优。穴位埋线治疗IBS-C的作用机制可能与下调血清SP含量密切相关。Objective To observe the clinical efficacy of acupoint catgut embedding in the treatment of constiption-predominant irritable bowel syndrome(IBS-C)and its effect on serum substance P(SP)content.Method Forty-three IBS-C patients were randomly divided into an observation group(22 cases)and a control group(21 cases).The observation group was treated with catgut-embedding therapy,and the control group was treated with Mosapride citrate dispersible tablets.IBS symptom severity scale(IBS-SSS)scores,irritable bowel syndrome quality of life(IBS-QOL)scores and self-rating anxiety scale(SAS)scores were observed before and after treatment and at follow-up,and serum SP levels were observed before and after treatment.Result Each IBS-SSS scores and total IBS-SSS scores after treatment and at follow-up were lower than those before treatment in the observation group(P<0.05),and each IBS-SSS scores and total IBS-SSS scores at follow-up were higher than those after treatment(P<0.05).Each item scores and total scores of IBS-SSS in the control group after treatment were lower than those before treatment(P<0.05),and each item scores and total scores of IBS-SSS at follow-up were higher than those after treatment(P<0.05).The abdominal pain and discomfort scores of the observation group were lower than those of the control group after treatment and at follow-up(P<0.05).The total IBS-QOL scores of the two groups after treatment and at follow-up were higher than those before treatment,and the IBS-QOL scores of the two groups at follow-up were lower than those after treatment,and the differences were statistically significant(P<0.05).After treatment and at follow-up,the IBS-QOL scores of the observation group were higher than those of the control group(P<0.05).The SAS scores of the observation group after treatment and at follow-up were decreased(P<0.05),and the SAS scores at follow-up were higher than that after treatment(P<0.05).In the control group,the SAS scores after treatment were lower than that before treatment(P<0.05),and the SAS

关 键 词：埋线 肠易激综合征 便秘 P物质 肠易激综合征症状严重程度量表 肠易激综合征生活质量量表 焦虑自评量表 

分 类 号：R246.1[医药卫生—针灸推拿学]