基于骶神经调节的电针中下髎联合补中益气汤治疗中气下陷型肛门坠胀疗效观察  

Clinical Study on Electroacupuncture Combined with Buzhong Yiqi Decoction(补中益气汤)in Treatment of Anal Discomfort

作　　者：王镇澜 廖健 李进安 杨年美 贾道勇 杨碧英 王永多 王奎 汪爱平 WANG Zhenlan;LIAO Jian;LI Jin’an;YANG Nianmei;JIA Daoyong;YANG Biying;WANG Yongduo;WANG Kui;WANG Aiping(Chongqing University Three Gorges Hospital,Chongqing 404000,China)

机构地区：[1]重庆大学附属三峡医院,重庆404000

出　　处：《中华中医药学刊》2024年第11期214-217,共4页Chinese Archives of Traditional Chinese Medicine

基　　金：重庆市科卫联合中医药项目(2022MSXM163)。

摘　　要：目的基于骶神经调节(SNM)理论指导下,观察电针中下髎联合补中益气汤治疗中气下陷型肛门坠胀的临床疗效及安全性。方法将符合纳入标准的120例中气下陷型肛门坠胀患者随机分为4组,对照组、中药组、针刺组和针药联合组,每组30例。对照组予氟哌噻吨美利曲辛片(10.5 mg,2次/d口服)治疗,中药组予煎服中药补中益气汤(100 mL,3次/d口服),针刺组在SNM理论指导下电针中下髎(3次/周),针药联合组在口服补中益气汤的基础上联合电针中下髎(针刺治疗方法同针刺组,煎服补中益气汤法同中药组)。采用疼痛视觉模拟评分比较判断止痛疗效,采用Galzer盆底表皮肌电评分与直肠感觉功能评分对患者治疗前后的疗效进行客观评价,采用SF-36评分对患者治疗前后各维度改善程度进行评估。最后比较4组的满意度及不良反应发生率。结果治疗后,各组指标均得到了不同程度的改善,其中针药联合组在疼痛、Galzer盆底表皮肌电、直肠感觉功能、SF-36各维度改善程度均优于其他3组,差异有统计学意义(P<0.05)。4组患者治疗全程均未出现任何不良反应。结论基于SNM理论指导下,电针中下髎联合补中益气汤治疗中气下陷型肛门坠胀可提高止痛疗效,客观改善患者的直肠感觉功能与盆底表皮肌电评分,从而进一步改善患者的生活质量和心理健康程度。Objective Based on sacral neuromodulation(SNM)theory,to observe the clinical efficacy of electroacupuncture[Zhongliao(BL33),Xialiao(BL34)]combined with Buzhong Yiqi Decoction(补中益气汤)in the treatment of sinking of middle Qi type of anal discomfort.Method All patients who met the inclusion criteria were randomly divided into 4 groups:control group,Buzhong Yiqi Decoction group,electroacupuncture group and combination group,with 30 cases in each group.The control group was treated with flupiperazol melitracine capsules(10.5 mg,orally,twice a day).Buzhong Yiqi Decoction group was given Buzhong Yiqi Decoction(100 mL,orally,three times a day).Under the guidance of SNM theory,the electroacupuncture group used electroacupuncture at Zhongliao(BL33)and Xialiao(BL34)(three times a week).The combination group received electroacupuncture(the same method as the electroacupuncture group)plus oral Buzhong Yiqi Decoction(the same method as the Buzhong Yiqi Decoction group).The visual analogue scale score was used to compare the analgesic effect.Galzer pelvic floor epidermal electromyography score and rectal sensory function score were used to evaluate the curative effect objectively.The MOS item short from health survey(SF-36)scores were used to evaluate the improvement of each dimension before and after treatment.Finally,the satisfaction and the incidence of adverse reactions of the four groups were compared.Result After treatment,the therapeutic indexes of each group were improved to varying degrees.In terms of pain,Galzer pelvic floor epidermal electromyography,rectal sensory function and SF-36,the combination group was better than those of the other three groups,with statistical significance(P<0.05).There was no adverse reaction during the whole treatment in 4 groups.Conclusion Based on the guidance of SNM theory,electroacupuncture at Zhongliao(BL33)and Xialiao(BL34)combined with Buzhong Yiqi Decoction in the treatment of anorectal discomfort caused by sinking of middle Qi can improve the analgesic effect,objectively

关 键 词：SNM理论 中气下陷 肛门坠胀 针药联合 电针中下髎 补中益气汤 

分 类 号：R259.748[医药卫生—中西医结合] R245.97[医药卫生—中医内科学]