调神健脾针刺法联合电针治疗腹泻型肠易激综合征的疗效观察及对肥大细胞活化的影响  

Observation on the efficacy of Tiao Shen Jian Pi acupuncture combined with electroacupuncture in the treatment of irritable bowel syndrome-diarrheal and its effect on mast cell activation

作　　者：占道伟[1] 刘军[1] 徐颖梅[1] 洪中华[1] 李玲[1] 沈志炜 罗开涛[1] 孙建华[2] ZHAN Daowei;LIU Jun;XU Yingmei;HONG Zhonghua;LI Ling;SHEN Zhiwei;LUO KaiTao;SUN Jianhua(Jiaxing Hospital of Traditional Chinese Medicine Affiliated to Zhejiang Chinese Medical University,Jiaxing 314001,China;Affiliated Hospital of Nanjing University of Chinese Medicine,Nanjing 210029,China)

机构地区：[1]浙江中医药大学附属嘉兴市中医医院,嘉兴314001 [2]南京中医药大学附属医院,南京210029

出　　处：《上海针灸杂志》2024年第6期594-598,共5页Shanghai Journal of Acupuncture and Moxibustion

基　　金：浙江省中医药科技计划(2021ZB289);嘉兴市中医药重点学科支撑学科项目(2019XK-A06-康复)。

摘　　要：目的观察调神健脾针刺法联合电针治疗对腹泻型肠易激综合征(irritable bowel syndromediarrheal,IBS-D)的临床疗效及其对患者肠黏膜肥大细胞活化的影响。方法将60例IBS-D患者按随机数字表法分为药物组和观察组,每组30例。药物组予口服马来酸曲美布汀分散片治疗,观察组予调神健脾针刺法联合电针治疗。观察两组治疗前后肠易激综合征症状严重程度量表(irritable bowel syndrome-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)评分和医院焦虑抑郁量表(hospital anxiety and depression scale,HADS)评分及肠黏膜肥大细胞(mast cells,MCs)活化程度的变化。比较两组临床疗效。结果观察组总有效率优于药物组(P<0.05)。治疗后,两组IBS-SSS和HADS评分均降低(P<0.05),且观察组均优于药物组(P<0.05)。治疗后,两组IBS-QOL评分均升高(P<0.05),且观察组高于药物组(P<0.05)。治疗后,两组MCs数量与脱颗粒比例均降低(P<0.05),且观察组优于药物组(P<0.05)。结论“调神健脾”针刺法联合电针治疗IBS-D的临床疗效优于单一口服药物治疗,可缓解腹痛等临床症状,提高生活质量,改善抑郁状态,降低MCs活化程度。Objective To observe the clinical efficacy of Tiao Shen Jian Pi acupuncture combined with electroacupuncture in the treatment of irritable bowel syndrome-diarrheal(IBS-D)and its effect on the activation of the intestinal mucosal mast cells.Method A total of 60 patients with IBS-D according to the random number table method into a medication group and an observation group,with 30 cases in each group.The medication group was treated with Trimebutine maleate dispersible tablets,and the observation group was treated with Tiao Shen Jian Pi acupuncture combined with electroacupuncture.The irritable bowel syndrome-symptom severity scale(IBS-SSS)score,the irritable bowel syndrome-the quality of Life(IBS-QOL)score,the hospital anxiety and depression scale(HADS)score and the activation of mast cells(MCs)in the intestinal mucosa were observed before and after treatment in the two groups.The clinical efficacy was compared between the two groups.Result The total effective rate of the observation group was better than that of the medication group(P<0.05).After treatment,the IBS-SSS and HADS scores of both groups decreased(P<0.05),and those of the observation group were better than those of the medication group(P<0.05).After treatment,the IBS-QOL score increased in both groups(P<0.05),and that of the observation group was higher than that of the medication group(P<0.05).After treatment,the number of MCs and the proportion of degranulation decreased in both groups(P<0.05),and those of the observation group were better than those of the medication group(P<0.05).Conclusion Tiao Shen Jian Pi acupuncture combined with electroacupuncture is superior to single oral medication in the treatment of IBS-D,which can relieve abdominal pain and other clinical symptoms,improve the quality of life,improve depression,and reduce the activation of MCs.

关 键 词：针刺疗法 电针 肠易激综合征 腹泻 肥大细胞 胃肠功能紊乱 

分 类 号：R246.1[医药卫生—针灸推拿学]