温针灸八髎穴与天枢穴联合养血滋阴汤对老年人功能性便秘临床症状和血清胃肠激素水平的影响  

Effects of warm acupuncture at Baliao and Tianshu point combined with Yangxue Ziyin decoction on clinical symptoms and serum gastrointestinal hormones in the elderly with functional constipation

作　　者：杜明[1] 张若琳 戴秋红 郝冉[1] DU Ming;ZHANG Ruolin;DAI Qiuhong;HAO Ran(Department of Spleen and Stomach,Qinhuangdao Hospital of Traditional Chinese Medicine,Qinhuangdao 066000,China)

机构地区：[1]秦皇岛市中医医院脾胃科,河北秦皇岛066000 [2]哈尔滨医科大学第一附属医院神经内科,黑龙江哈尔滨150000

出　　处：《陕西中医》2024年第6期841-845,共5页Shaanxi Journal of Traditional Chinese Medicine

基　　金：河北省中医药管理局科研计划项目(2020372)。

摘　　要：目的:探究温针灸八髎穴与天枢穴联合养血滋阴汤对老年功能性便秘(FC)临床症状和血清胃肠激素水平的影响。方法:选取108例老年FC患者,随机分为研究组和对照组各54例。对照组服用枸橼酸莫沙必利片,研究组在对照组的基础上采用温针灸八髎穴与天枢穴联合养血滋阴汤进行治疗。评估两组治疗后的疗效,治疗前后评估两组患者的排便情况(排便不尽感评分、排便费力评分、排便不成功次数)、便秘严重程度和中医证候评分,测定两组患者治疗前后的胃肠激素水平[血清胃动素(MTL)、血管活性肠肽(VIP)、胃泌素(GAS)],肛肠动力学指标[肛管静息压(ARP)、直肠静息压(RRP)],并观察不良反应。结果:治疗后,研究组的治疗总有效率高于对照组(P<0.05);两组治疗后排便不尽感评分、排便费力评分与治疗前相比均有下降,且研究组高于对照组(P<0.05);两组治疗后MTL、VIP、GAS、ARP和RRP水平均比治疗前升高,且研究组高于对照组(P<0.05);治疗期间两组不良反应发生率比较差异无统计学意义(P>0.05)。结论:温针灸八髎穴与天枢穴联合养血滋阴汤治疗老年FC能有效提升临床疗效,改善患者的便秘情况,促进胃肠激素分泌,改善肛肠动力学指标,且安全性良好。Objective:To explore the effects of warm acupuncture at Baliao and Tianshu point combined with Yangxue Ziyin decoction on clinical symptoms and serum gastrointestinal hormones in the elderly with functional constipation(FC).Methods:A total of 108 elderly patients with FC were enrolled and randomly divided into study group(54 cases)and control group(54 cases).The control group was treated with mosapride citrate tablets,while study group was treated with warm acupuncture at Baliao and Tianshu point combined with Yangxue Ziyin decoction on basis of control group.The curative effect after treatment,defecation status(scores of uncompleted defecation and difficult defecation,times of unsuccessful defecation)before and after treatment,severity of constipation and scores of TCM syndromes in the two groups were evaluated.The levels of gastrointestinal hormones[serum motilin(MTL),vasoactive intestinal peptide(VIP),gastrin(GAS)]and anorectal dynamics indexes[anal canal rest pressure(ARP),rectal rest pressure(RRP)]in the two groups were detected before and after treatment.The adverse reactions were observed.Results:After treatment,total response rate of treatment in study group was higher than that in control group(96.30%vs 83.33%,P<0.05).After treatment,scores of uncompleted defecation and difficult defecation were decreased in both groups,which were higher in study group than in control group(P<0.05).After treatment,levels of MTL,VIP,GAS,ARP and RRP were increased in both groups,which were higher in study group than in control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups during treatment(P>0.05).Conclusion:The curative effect of warm acupuncture at Baliao and Tianshu point combined with Yangxue Ziyin decoction is good in elderly patients with FC,which can effectively improve constipation,promote the secretion of gastrointestinal hormones and improve anorectal dynamics indexes,with good safety.

关 键 词：功能性便秘 老年 温针灸 八髎穴 天枢穴 养血滋阴汤 胃肠激素水平 

分 类 号：R256.35[医药卫生—中医内科学]