火龙罐辅助针刺治疗中风后便秘疗效及对胃肠神经递质和肠道菌群的影响  

Curative Effect of Fire Dragon Cupping Assisting Acupuncture on Post-stroke Constipation and Its Effect on Gastrointestinal Neurotransmitters and Intestinal Flora

作　　者：李勤 胡秋萍 张龙 张琳[1] 刘雁[1] 赵瑞怀 李静[1] 吴康林 Qin;HU Qiuping;ZHANG Long;ZHANG Lin;LIU Yan;ZHAO Ruihuai;LI Jing;WU Kanglin(The First Affiliated Hospital of Henan University of Chinese Medicine,Zhengzhou Henan 450006,China)

机构地区：[1]河南中医药大学第一附属医院,河南郑州450006

出　　处：《新中医》2024年第9期165-170,共6页New Chinese Medicine

基　　金：河南中医药大学科研苗圃课题(MP2015-2)。

摘　　要：目的:观察火龙罐辅助针刺治疗中风后便秘疗效及对血清胃肠神经递质和肠道菌群的影响。方法:将86例中风后便秘患者按随机数字表法分为对照组和观察组各43例,对照组给予枸橼酸莫沙必利分散片治疗,观察组给予火龙罐辅助针刺治疗。比较2组治疗前后自主排便次数(SBMs)、排便困难程度(DID)、Bristol粪便性状(BFT)及钡餐在半结肠、直肠、全结肠的通过时间。比较2组治疗前后血清胃肠神经递质[一氧化氮(NO)、5-羟色胺(5-HT)、血管活性肠肽(VIP)、胃饥饿素(Ghrelin)、P物质(SP)、胃动素(MTL)],肠道菌群(变形菌门、脱铁杆菌门、放线菌门)的水平。比较2组临床疗效及安全性。结果:治疗后,观察组总有效率97.7%,高于对照组81.4%(P<0.05)。治疗后,2组SBMs、BFT评分均增加(P<0.05),且观察组高于对照组(P<0.05),DID评分均降低(P<0.05),且观察组低于对照组(P<0.05)。治疗后,2组钡餐在半结肠、直肠、全结肠通过的时间均缩短(P<0.05),且观察组短于对照组(P<0.05)。治疗后,观察组血清NO、5-HT、VIP水平均降低(P<0.05),且低于对照组(P<0.05)。治疗后,2组胃肠SP、MTL水平均升高(P<0.05),观察组胃肠Ghrelin水平升高(P<0.05),且观察组SP、MTL、Ghrelin水平均高于对照组(P<0.05)。治疗后,观察组肠道变形菌门、脱铁杆菌门、放线菌门相对丰度均降低(P<0.05),且低于对照组。观察组不良反应发生率为2.3%,低于对照组的25.6%(P<0.05)。结论:火龙罐辅助针刺可有效缓解中风后便秘患者的临床症状,改善血清胃肠神经递质和肠道菌群水平。Objective:To observe the curative effect of Fire Dragon Cupping assisting acupuncture on post-stroke constipation and its effect on gastrointestinal neurotransmitters and intestinal flora.Methods:A total of 86 cases of patients with post-stroke constipation were divided into the control group and the observation group according to the random number table method,with 43 cases in each group.The control group was treated with Mosapride Citrate,and the observation group was treated with Fire Dragon Cupping assisting acupuncture.The frequency of spontaneous bowel movements(SBMs),difficulty of defecation(DID),Bristol fecal trait(BFT)and the passage time of barium meal in half colon,rectum and whole colon were compared before and after treatment between the two groups.The levels of gastrointestinal neurotransmitters[nitric oxide(NO),5-hydroxytryptamine(5-HT),vasoactive intestinal peptide(VIP),Ghrelin,Substance P(SP),motilin(MTL)]and intestinal flora(proteobacteria,deferribacteres,actinobacteria)in serum were compared before and after treatment between the two groups.The clinical effects and safety were compared between the two groups.Results:After treatment,the total effective rate was 97.7%in the observation group,higher than that of 81.4%in the control group(P<0.05).After treatment,the SBMs frequency and BFT scores in the two groups were increased(P<0.05),and the above indexes in the observation group were higher than those in the control group(P<0.05);DID scores in the two groups were decreased(P<0.05),and the score in the observation group was lower than that in the control group(P<0.05).After treatment,the passage time of barium meal in half colon,rectum and whole colon in the two groups were shortened(P<0.05),and the time in the observation group was shorter than that in the control group(P<0.05).After treatment,the levels of NO,5-HT and VIP in serum in the observation group were decreased(P<0.05),and the above levels were lower than those in the control group(P<0.05).After treatment,the levels of gastrointestinal

关 键 词：中风后便秘 火龙罐 针刺 胃肠神经递质 肠道菌群 

分 类 号：R246.6[医药卫生—针灸推拿学]