增液承气汤联合督脉灸法对卒中后排便障碍患者肠黏膜屏障保护及自主神经、胃电活动和血清酪氨酸激酶受体、microRNA-128的影响  

Effects of Zengye Chengqi Decoction combined with Dumai moxibustion on intestinal mucosal barrier protection,autonomic nerve,gastric electrical activity,serum c-Kit and microRNA-128 in patients with post-stroke defecation obstacles

作　　者：刘淑萍[1] 王田[1] 刘更[1] 华雪君 余洪敏 李晓菲 LIU Shuping;WANG Tian;LIU Geng;HUA Xuejun;YU Hongmin;LI Xiaofei(The Second Department of Encephalopathy,Qinhuangdao Hospital of Traditional Chinese Medicine,Qinhuangdao,Hebei,066000,China)

机构地区：[1]秦皇岛市中医医院脑病二科,河北秦皇岛066000

出　　处：《中国中西医结合消化杂志》2024年第10期916-921,共6页Chinese Journal of Integrated Traditional and Western Medicine on Digestion

基　　金：河北省卫生健康委医学科学研究课题(No:20200135);秦皇岛市科学技术研究与发展计划(No:202005A043)。

摘　　要：目的:观察增液承气汤联合督脉灸法对卒中后排便障碍患者肠黏膜屏障保护及自主神经、胃电活动和血清酪氨酸激酶受体(c-Kit)、microRNA-128(miR-128)的影响。方法:选取2022年2月—2024年2月秦皇岛市中医医院就诊的卒中后排便障碍患者120例,按照随机数字表法分为西医组和中西医结合组,每组各60例。西医组给予常规西医治疗,中西医结合组在西医组治疗基础上给予增液承气汤联合督脉灸法治疗,疗程结束后比较2组临床疗效,治疗前、后进行中医证候、便秘严重度评分量表(CSS)、自主神经症状自评量表(SCOPA-AUT)、便秘患者生活质量量表(PAC-QOL)评价,检测患者胃电活动主频率、波形平均幅值,测定血清脂多糖、干细胞因子(SCF)、D-乳酸、c-Kit、miR-128水平。结果:中西医结合组患者总有效率高于西医组(96.67%vs 83.33%,P<0.05);中西医结合组大便干结、面红身热、口干口臭、腹胀腹痛、小便短赤评分低于西医组(P<0.05);中西医结合组PAC-QOL、CSS、SCOPA-AUT评分低于西医组(P<0.05);中西医结合组主频率、波形平均幅值高于西医组(P<0.05);中西医结合组脂多糖、D-乳酸表达量低于西医组(P<0.05);中西医结合组SCF、c-Kit、miR-128表达量高于西医组(P<0.05)。结论:增液承气汤联合督脉灸法治疗卒中后排便障碍患者,可保护肠黏膜屏障,提升SCF、c-Kit、miR-128水平,改善胃电活动、自主神经,提升临床疗效及生活质量。Objective To observe the effects of Zengye Chengqi Decoction combined with Dumai moxibustion on intestinal mucosal barrier protection,autonomic nerve,gastric electrical activity,serum tyrosine kinase receptor(c-Kit)and microRNA-128(miR-128)in patients with post-stroke defecation obstacles.Methods A total of 120 patients with post-stroke defecation obstacles were selected from Qinhuangdao Hospital of Traditional Chinese Medicine from February 2022 to February 2024.According to the random number table method,they were divided into the Western medicine group and the Traditional Chinese Medicine(TCM)and Western medicine treatment group,each consisting of 60 patients.The Western medicine group received conventional Western medical treatment,while the TCM and Western medicine treatment group received additional treatment with Zengye Chengqi Decoction combined with Dumai moxibustion.The clinical efficacy of the two groups was compared after treatment.TCM syndrome,Constipation Severity Scale(CSS),autonomic Symptom Scale(SCOPA-AUT)and constipation Patients Quality of Life Scale(PAC-QOL)were evaluated before and after treatment.The main frequency of gastric electrical activity and the average amplitude of waveform were detected.Serum levels of lipopolysaccharide,stem cell factor(SCF),D-lactic acid,c-Kit and miR-128 were determined.Results The total effective rate was 96.67%in the treatment group of TCM and Western medicine,and 83.33%in the Western medicine group.The total effective rate in the treatment group of TCM and Western medicine was higher than that in the Western medicine group(P<0.05).The red score of dry stool,red face and hot body,dry mouth and halitosis,abdominal distension and pain,short urine in the treatment group of TCM and Western medicine were lower than those in the Western medicine group(P<0.05).The scores of PAC-QOL,CSS and SCOPA-AUT in the treatment group of TCM and Western medicine were lower than those in the Western medicine group(P<0.05).The main frequency and average amplitude of waveforms in th

关 键 词：增液承气汤 督脉灸法 卒中后排便障碍 肠黏膜屏障 自主神经 胃电活动 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R256.35[医药卫生—临床医学]