基于“肠–脑轴”针刺疗法配合感统训练治疗孤独症谱系障碍患儿的疗效及对胃肠症状的影响  

Efficacy of acupuncture based on"gut-brain axis"combined with sensory integration training on autism spectrum disorder and its effect on gastrointestinal symptoms

作　　者：王楠[1] 王国琴[1] 陈栋[1] WANG Nan;WANG Guoqin;CHEN Dong(Department of Acupuncture-Moxibustion and Rehabilitation,Jiangsu Provincial Hospital of TCM,Nanjing 210029,China)

机构地区：[1]江苏省中医院针灸康复科,南京210029

出　　处：《中国针灸》2025年第1期36-40,60,共6页Chinese Acupuncture & Moxibustion

基　　金：国家自然科学基金资助项目:82004456。

摘　　要：目的:探讨基于“肠-脑轴”针刺疗法配合感统训练治疗孤独症谱系障碍(简称孤独症)患儿的疗效及对胃肠症状的影响。方法:将96例孤独症患儿随机分为观察组和对照组,每组48例,各脱落3例。对照组采用感统训练,观察组在对照组的基础上采用基于“肠-脑轴”的针刺治疗,头针选取额五针(双侧头维、头临泣和神庭)、四神聪,体针穴取中枢及双侧天枢、脾俞、心俞、足三里、合谷、太冲,隔日1次,每周3次。两组均治疗12周。比较两组患儿治疗前后孤独症行为量表(ABC)、儿童孤独症评定量表(CARS)、孤独症治疗评估量表(ATEC)、胃肠中医症状评分及肠道菌群相对丰度,评估两组的临床疗效。结果:治疗后,两组患儿ABC、CARS评分较治疗前降低(P<0.001,P<0.05),且观察组ABC、CARS评分低于对照组(P<0.01)。治疗后,观察组患儿ATEC语言、感知觉、社交、行为评分及总分较治疗前降低(P<0.001,P<0.01),对照组患儿ATEC语言、社交、行为评分及总分较治疗前降低(P<0.01,P<0.001,P<0.05);观察组ATEC各项评分及总分均低于对照组(P<0.05)。治疗后,两组患儿大便稀溏、胃脘疼痛、胃脘痞满、食欲减退评分及总分均较治疗前降低(P<0.001),且观察组低于对照组(P<0.001)。治疗后,两组患儿大肠埃希菌、肠球菌相对丰度较治疗前降低(P<0.001),且观察组低于对照组(P<0.001);双歧杆菌、乳酸杆菌相对丰度较治疗前升高(P<0.001),且观察组高于对照组(P<0.001)。观察组总有效率为88.9%(40/45),高于对照组的66.7%(30/45,P<0.05)。结论:在感统训练基础上行基于“肠-脑轴”针刺疗法可改善孤独症患儿行为状态和胃肠症状,纠正肠道菌群失调。Objective To explore the efficacy of acupuncture based on"gut-brain axis"combined with sensory integration training in children with autism spectrum disorder(autism)and its effect on gastrointestinal symptoms.Methods A total of 96 children with autism were randomized into an observation group and a control group,48 cases in each group,with 3 cases dropped out.Children in the control group received sensory integration training.On the basis of the treatment in the control group,children in the observation group received acupuncture therapy based on"gut-brain axis",and the point selection of scalp acupuncture was forehead five needles,i.e.bilateral Touwei(ST8),Toulinqi(GB15),Shenting(GV24)and Sishencong(EX-HN1),the point selection of body acupuncture was Zhongshu(GV7)and bilateral Tianshu(ST25),Pishu(BL20),Xinshu(BL15),Zusanli(ST36),Hegu(LI4),Taichong(LR3).Acupuncture was delivered once every other day,3 times a week.Both groups were treated for 12 weeks.Before and after treatment,the scores of autism behavior checklist(ABC),childhood autism rating scale(CARS),autism treatment evaluation checklist(ATEC)and gastrointestinal TCM symptoms,as well as the relative abundance of intestinal flora were compared,and the clinical efficacy was evaluated in the two groups.Results After treatment,the ABC and CARS scores were decreased compared with those before treatment in the two groups(P<0.001,P<0.05),and the ABC and CARS scores in the observation group were lower than those in the control group(P<0.01).After treatment,the item scores of language,sensory perception,sociability,behavior,and the total score of ATEC in the observation group were decreased compared with those before treatment(P<0.001,P<0.01),the item scores of language,sociability,behavior,and the total score of ATEC in the control group were decreased compared with those before treatment(P<0.01,P<0.001,P<0.05);the each-item and total scores in the observation group were lower than those in the control group(P<0.05).After treatment,the scores of loose stool,stomac

关 键 词：孤独症谱系障碍 针刺 肠-脑轴 感统训练 胃肠症状 肠道菌群 随机对照试验 

分 类 号：R246.6[医药卫生—针灸推拿学]