针刺联合生物反馈治疗中风后便秘的疗效观察及对胃肠激素的影响  

Observation on the efficacy of acupuncture combined with biofeedback in treating post-stroke constipation and its effect on gastrointestinal hormones

作　　者：王慈[1] 周丽芳 万文婷 丁邦友[1] 张广渊[1] WANG Ci;ZHOU Lifang;WAN Wenting;DING Bangyou;ZHANG Guangyuan(Yueyang Hospital of Integrated Traditional Chinese and Western Medicine,Shanghai University of Traditional Chinese Medicine,Shanghai 200437,China)

机构地区：[1]上海中医药大学附属岳阳中西医结合医院,上海200437

出　　处：《上海针灸杂志》2024年第11期1229-1233,共5页Shanghai Journal of Acupuncture and Moxibustion

基　　金：上海市针灸临床医学研究中心项目(20MC1920500)。

摘　　要：目的观察“调枢通腑”针刺联合生物反馈治疗中风后便秘的临床疗效及对胃肠激素的影响。方法将120例中风后便秘患者随机分为对照组和联合组,每组60例。对照组采用常规生物反馈治疗法,联合组在对照组基础上采用“调枢通腑”针刺治疗。比较两组治疗前后血清胃动素(motilin,MTL)、血管活性肠肽(vasoactive intestinal polypeptide,VIP)和神经降压素(neurotensin,NT)水平,比较两组治疗前后Bristol粪便性状、便秘患者症状自评量表(patient assessment of constipation symptoms,PAC-SYM)、焦虑自评量表(self-rating anxiety scale,SAS)和抑郁自评量表(self-rating depression scale,SDS)评分,并比较两组临床疗效。结果联合组总有效率(91.7%)明显高于对照组(76.7%)(P<0.05)。治疗后,两组Bristol粪便性状评分均降低(P<0.05),且联合组低于对照组(P<0.05)。治疗后,两组血清MTL、VIP、NT水平均改善(P<0.05);且联合组血清MTL水平明显高于对照组(P<0.05),血清VIP、NT水平低于对照组(P<0.05)。治疗后,两组PAC-SYM评分均降低(P<0.05),且联合组低于对照组(P<0.05)。治疗后,两组SAS与SDS评分均降低(P<0.05),且联合组低于对照组(P<0.05)。结论“调枢通腑”针刺联合生物反馈治疗对中风后便秘患者临床疗效确切,有助于优化大便性状,降低PAC-SYM评分,改善负性心态。Objective To observe the clinical efficacy of“Tiaoshu Tongfu”acupuncture combined with biofeedback in the treatment of post-stroke constipation and its effect on gastrointestinal hormones.Method A total of 120 patients with post-stroke constipation were randomly divided into the control group and the combination group,with 60 cases in each group.The control group was treated with conventional biofeedback therapy,while the combination group was treated with“Tiaoshu Tongfu”acupuncture on the basis of the control group.Comparison of serum motilin(MTL),vasoactive intestinal polypeptide(VIP)and neurotensin(NT)levels were performed before and after treatment in both groups,comparison of patient assessment of constipation symptoms(PAC-SYM),Bristol stool form,self-rating anxiety scale(SAS)and self-rating depression scale(SDS)scores were performed before and after treatment in both groups,and the clinical efficacy of the two groups was compared.Result The total effective rate of the combination group(91.7%)was significantly higher than that of the control group(76.7%)(P<0.05).After treatment,the Bristol stool form score was decreased in the two groups(P<0.05),and that in the combination group was lower than that in the control group(P<0.05).After treatment,the levels of serum MTL,VIP and NT in the two groups were improved(P<0.05).The serum MTL level of the combination group was significantly higher than that of the control group(P<0.05),and the serum VIP and NT levels were lower than those of the control group(P<0.05).After treatment,the PAC-SYM score was decreased in the two groups(P<0.05),and the PAC-SYM score in the combination group was lower than that in the control group(P<0.05).After treatment,the SAS and SDS scores of the two groups were decreased(P<0.05),and the SAS and SDS scores of the combination group were lower than those of the control group(P<0.05).Conclusion“Tiaoshu Tongfu”Acupuncture combined with biofeedback therapy is effective in optimizing stool properties,lowering PAC-SYM score and impro

关 键 词：针刺疗法 中风 便秘 胃肠激素 便秘患者症状自评量表 焦虑 抑郁 

分 类 号：R246.6[医药卫生—针灸推拿学]