电针八髎穴联合柴胡舒肝散治疗肝郁气滞型功能性便秘的疗效及对脑肠肽的影响  

Efficacy of Electric Needling Baliao Point Combined with Chaihu Shugan Powder in Treatment of Functional Constipation of Liver Depression and Qi Stagnation Type and Its Effect on Brain-Gut Peptide

作　　者：刘秦浪 高南南 孙林梅 LIU Qin-lang;GAO Nan-nan;SUN Lin-mei(Xi'an Hospital of Traditional Chinese Medicine,Xi'an,Shaanxi 710016;Shaanxi University of Traditional Chinese Medicine,Xianyang,Shaanxi 712046)

机构地区：[1]西安市中医医院,陕西西安710016 [2]陕西中医药大学,陕西咸阳712046

出　　处：《中国肛肠病杂志》2024年第9期38-41,共4页Chinese Journal of Coloproctology

基　　金：陕西中医药大学校级科研课题(2021FS11)。

摘　　要：目的:研究电针八髎穴联合柴胡舒肝散治疗肝郁气滞型功能性便秘(FC)的疗效及对脑肠肽P物质(SP)、血管活性肠肽(VIP)、神经降压素(NT)和5-羟色胺(5-HT)的影响。方法:选取2022年1~12月,本院收治的80例肝郁气滞型FC患者,采用随机数字表法分成治疗组和对照组,每组40例。治疗组采用电针八髎穴联合柴胡疏肝散口服;对照组口服枸橼酸莫沙必利片治疗。比较2组临床疗效、便秘症状(CSS)评分、Bristol粪便性状评分、生活质量(PAC-QOL)评分及焦虑(HAMA)情况等。结果:治疗2周后,2组便秘症状均有明显改善,治疗组有效率为84.62%,明显高于对照组的26.32%(P<0.05);治疗组CSS评分、Bristol粪便性状评分、PAC-QOL及HAMA评分均优于对照组(P<0.05);每周大便次数、全结肠转运时间和结肠传输试验标记物残留数量均优于对照组(P<0.05);血清中SP、VIP、NT和5-HT水平均优于对照组(P<0.05)。结论:电针八髎穴联合柴胡疏肝散治疗肝郁气滞型FC,临床效果显著,可能是通过“肠-脑”互动来升高血清SP、5-HT水平,降低VIP、NT水平来改善其临床症状。Objective To study the efficacy of electric needling Baliao point combined with Chaihu Shugan Powder in the treatment of functional constipation(FC)of liver depression and qi stagnation type and the effect on substance P of intestinal peptide(SP),vasoactive intestinal peptide(VIP),neurotensin(NT)and 5-hydroxytryptamine(5-HT).Methods From January to December 2022,total 80 patients with FC of liver depression and qi stagnation type were selected and divided into treatment group and control group by random number table method,with 40 cases in each group.The treatment group was given electric needling Baliao point combined with Chaihu Shugan Powder.The control group was treated with mosapride citrate tablets.The clinical efficacy,constipation symptom score(CSS),Bristol fecal trait score,quality of life(PAC-QOL)score and anxiety(HAMA)status of the two groups were compared.Results After two weeks of treatment,the symptoms of constipation in both groups were significantly improved.The effective rate of the treatment group was 84.62%,which was significantly higher than that of the control group(26.32%)(P<0.05).CCS score,Bristol fecal trait score,PAC-QOL and HAMA scores in the treatment group were better than those in the control group(P<0.05).The frequency of bowel movement per week,whole colon transport time and the residual number of colon transport test markers were better than those in the control group(P<0.05).The serum levels of SP,VIP,NT and 5-HT were better than those in the control group(P<0.05).Conclusion Electric needling Baliao point combined with Chaihu Shugan Powder has remarkable clinical effect in treatment of FC of liver depression and qi stagnation type,which may be through the interaction of"brain-gut"to increase the serum levels of SP and 5-HT and reduce the levels of VIP and NT to improve the clinical symptoms.

关 键 词：功能性便秘 肝郁气滞型 柴胡舒肝散 八髎穴 脑肠肽 

分 类 号：R256.35[医药卫生—中医内科学]