子午流注法温灸联合穴位贴敷治疗功能性便秘的疗效观察  

Observations on the efficacy of Zi Wu Liu Zhu gentle moxibustion plus acupoint application for functional constipation

作　　者：袁志强[1] 王冬琴 杨英楠 陈瑜[1] YUAN Zhiqiang;WANG Dongqin;YANG Yingnan;CHEN Yu(Shanghai Baoshan District Luodian Hospital,Shanghai 201908,China)

机构地区：[1]上海市宝山区罗店医院,上海201908

出　　处：《上海针灸杂志》2024年第6期610-615,共6页Shanghai Journal of Acupuncture and Moxibustion

基　　金：上海市宝山区卫生和计划生育委员会科研课题计划项目[BSZK-2018-A10(01)]。

摘　　要：目的观察子午流注穴位温灸联合自拟软坚散神阙穴贴敷治疗功能性便秘的临床疗效及对患者血清胃动素(motilin,MTL)和5-羟色胺4受体(5-hydroxytryptamine serotonin receptor 4,5-HT4R)水平的影响。方法选取80例功能性便秘患者,用随机数字表法等分为对照组和研究组,每组40例。对照组用子午流注穴位温灸进行治疗,研究组用子午流注穴位温灸包联合自拟软坚散神阙穴贴敷治疗。比较两组临床疗效,观察两组治疗前后症状评分、直肠压力以及血清MTL、5-HT4R、神经型一氧化氮合酶(neuronal nitric oxide synthase,nNOS)、一氧化氮(nitric oxide,NO)、血管活性肠多肽(vasoactive intestinal polypeptide,VIP)、超氧化物歧化酶(superoxide dismutase,SOD)、丙二醛(malondialdehyde,MDA)和谷胱甘肽(glutathione r-glutamyl cysteingl glycine,GSH)水平的变化。结果研究组总有效率明显高于对照组(P<0.05)。治疗后,两组血清MTL和5-HT4R水平均高于治疗前(P<0.05),且研究组均高于对照组(P<0.05)。治疗后,两组临床症状评分以及血清nNOS、NO和VIP水平均低于治疗前,且研究组均低于对照组(P<0.05)。治疗后,两组直肠肛门抑制反射阈值和首次排便感觉阈值均低于治疗前(P<0.05),最大缩榨压和直肠静息压均高于治疗前(P<0.05);且研究组上述指标均优于对照组(P<0.05)。治疗后,两组血清MDA水平均低于治疗前(P<0.05),血清SOD和GSH水平均高于治疗前(P<0.05);且研究组上述指标均优于对照组(P<0.05)。结论在常规治疗基础上,子午流注穴位温灸联合自拟软坚散神阙穴贴敷治疗功能性便秘的临床疗效优于单一温灸包治疗,可提高血清MTL和5-HT4R水平,缓解临床症状和直肠压力,改善血清肠神经递质、SOD、MDA和GSH水平。Objective To observe the clinical efficacy of Zi Wu Liu Zhu(midnight-noon ebb-flow)acupoint gentle moxibustion plus application of self-prescribed Ruan Jian San at Shenque(CV8)for functional constipation and its effect on serum motilin(MTL)and 5-hydroxytryptamine 4 receptor(5-HT4R)levels in the patients.Method Eighty patients with functional constipation were allocated,using a random number table,to a control group and a study group,with 40 cases in each group.The control group was treated with Zi Wu Liu Zhu acupoint gentle moxibustion and the study group received application of self-prescribed Ruan Jian San at Shenque in addition.The clinical therapeutic effects were compared between the two groups.The symptom score,rectal pressure,as well as serum MTL,5-HT4R,neuronal nitric oxide synthase(nNOS),nitric oxide(NO),vasoactive intestinal polypeptide(VIP),superoxide dismutase(SOD),malondialdehyde(MDA)and glutathione(GSH)levels were observed in the two groups before and after treatment.Result The total efficacy rate was significantly higher in the study group than in the control group(P<0.05).After treatment,serum MTL and 5-HT4R levels increased in the two groups compared with those before treatment(P<0.05)and were higher in the study group than those in the control group(P<0.05).After treatment,the clinical symptom score,and serum nNOS,NO and VIP levels decreased in the two groups compared with those before treatment(P<0.05)and were lower in the study group than those in the control group(P<0.05).After treatment,the rectoanal inhibitory reflex threshold and the first defecation sensory threshold decreased(P<0.05)and the maximum compression pressure and rectal resting pressure increased(P<0.05)in the two groups compared with those before treatment;the above indicators were better in the study group than those in the control group(P<0.05).After treatment,serum MDA levels decreased(P<0.05)and SOD and GSH levels increased(P<0.05)in the two groups compared with those before treatment;the above indicators were better in th

关 键 词：子午流注 灸法 穴位贴敷法 穴 神阙 便秘 直肠压力 胃动素 5-羟色胺4受体 

分 类 号：R246.1[医药卫生—针灸推拿学]