针刺联合穴位贴敷对非小细胞肺癌相关性便秘患者生活质量的影响  

Effect of acupuncture combined with acupoint application on the quality of life in patients with non-small-cell lung cancer-associated constipation

作　　者：陈乐为 钟建国 杜位良 沈小雨 CHEN Lewei;ZHONG Jianguo;DU Weiliang;SHEN Xiaoyu(The Second Affiliated Hospital of Chengdu Medical College(The Nuclear Industry 416 Hospital),Chengdu 610000,China)

机构地区：[1]成都医学院第二附属医院(核工业四一六医院),成都610000

出　　处：《上海针灸杂志》2025年第2期170-176,共7页Shanghai Journal of Acupuncture and Moxibustion

基　　金：四川省医学科研青年创新课题(Q21085);四川省中医药管理局科研课题(2020LC0122)。

摘　　要：目的观察上下通调法针刺联合神阙穴贴敷对非小细胞肺癌相关性便秘患者大便性状、肠道菌群和生活质量的影响。方法纳入非小细胞肺癌相关性便秘患者108例,采用随机数字表法分为对照组、腹针组和观察组,每组36例。3组均进行健康指导,对照组采用神阙穴穴位贴敷治疗,腹针组在对照组基础上联合针刺治疗,观察组在对照组基础上联合上下通调法针刺治疗。观察3组治疗前以及治疗1周、2周和3周后Wexner便秘量表(Wexner continence grading scale,WCGS)评分和Bristol粪便性状评分的变化,观察3组治疗前后便秘患者生活质量量表(patient-assessment of constipation quality of life,PAC-QOL)评分以及血清5-羟色胺(5-hydroxytryptamine,5-HT)、血清血管活性肠肽(vasoactive intestinal peptide,VIP)和肠道菌群(玫瑰杆菌属、双歧杆菌属及丹毒杆菌属)水平的变化。结果WCGS和Bristol粪便性状评分,治疗方法与时间存在交互作用(P<0.05);观察组治疗2周和3周后WCGS评分均低于其余两组(P<0.05),观察组治疗1周、2周和3周后Bristol粪便性状评分均低于其余两组(P<0.05)。观察组治疗后PAC-QOL躯体不适、担心焦虑和满意程度3个维度评分均低于其余两组(P<0.05)。观察组治疗后血清5-HT水平和双歧杆菌属相对丰度均高于其余两组(P<0.05),血清VIP水平和丹毒杆菌属相对丰度均低于其余两组(P<0.05),玫瑰杆菌属相对丰度高于对照组(P<0.05)。结论在健康指导下,上下通调法针刺联合神阙穴贴敷治疗可改善非小细胞肺癌相关性便秘患者的便秘症状和大便性状,改善脑肠肽指标,调节肠道菌群紊乱。Objective To observe the effect of Shang Xia Tong Tiao acupuncture plus application at Shenque(CV8)on stool form,intestinal flora,and quality of life in patients with non-small-cell lung cancer(NSCLC)-associated constipation.Method A total of 108 patients with NSCLC-associated constipation were recruited and allocated to a control group,an abdominal acupuncture group,and an observation group using the random number table method,with 36 participants in each group.Health guidance was offered to all three groups.In addition,the control group received application at Shenque.In addition to the intervention given to the control group,the acupuncture group received acupuncture treatment,and the observation group received Shang Xia Tong Tiao acupuncture treatment.The Wexner continence grading scale(WCGS)score and Bristol stool form score were observed before the treatment and after 1,2,and 3 weeks of treatment.The three groups were also observed for post-treatment changes in the patient-assessment of constipation quality of life(PAC-QOL)score,serum levels of 5-hydroxytryptamine(5-HT)and vasoactive intestinal peptide(VIP),and intestinal flora levels(Roseobacter,Bifidobacterium,and Erysipelothrix).Result The treatment method and timing had interaction effects on the WCGS and Bristol scores(P<0.05);the WCGS score was lower in the observation group compared to the other two groups after 2 and 3 weeks of treatment,respectively(P<0.05),and the Bristol score was lower in the observation group than in the other two groups after 1,2,and 3 weeks of treatment(P<0.05).After the treatment,three dimension scores in the PAC-QOL,i.e.physical discomfort,worry and anxiety,and satisfaction degree,were lower in the observation group than in the other two groups(P<0.05).After the intervention,the observation group had a higher serum 5-HT level and Bifidobacterium relative abundance compared to the other two groups(P<0.05),the serum VIP level and the relative abundance of Erysipelothrix were lower in the observation group than in the other tw

关 键 词：针刺疗法 穴位贴敷法 穴 神阙 便秘 癌 非小细胞肺 生活质量 肠道菌群 

分 类 号：R246.5[医药卫生—针灸推拿学]