针刺治疗便秘型肠易激综合征的疗效观察及对血清二胺氧化酶和D-乳酸水平的影响  

Therapeutic observation of acupuncture in treating constipation-predominant irritable bowel syndrome(IBS-C)and its effects on the serum levels of diamine oxidase and D-lactate

作　　者：夏禹威 侯天仙 金灵敏 陈盼碧 翟建华 XIA Yuwei;HOU Tianxian;JIN Lingmin;CHEN Panbi;ZHAI Jianhua(Guizhou University of Traditional Chinese Medicine,Guizhou 550000,China;Hunan Huaihua City Maternal and Child Health Care Hospital,Huaihua 418000,China)

机构地区：[1]贵州中医药大学,贵州550000 [2]湖南省怀化市妇幼保健院,怀化418000

出　　处：《上海针灸杂志》2025年第3期304-309,共6页Shanghai Journal of Acupuncture and Moxibustion

摘　　要：目的观察通腑调神针法治疗便秘型肠易激综合征(constipation-predominant irritable bowel syndrome,IBS-C)的临床疗效及对患者血清二胺氧化酶(diamine oxidase,DAO)和D-乳酸(D-lactate,D-LA)水平的影响。方法将40例IBS-C患者随机分为治疗组和对照组,每组20例。治疗组采用通腑调神针刺治疗,对照组采用穴位旁开非经非穴针刺治疗。观察两组治疗前、治疗1个疗程后、治疗后及随访期肠易激综合征症状严重程度量表(IBS symptom severity scale,IBS-SSS)各项评分及总评分,治疗前后血清DAO、D-LA水平变化,并比较两组临床疗效。结果治疗组治疗1个疗程后IBS-SSS中腹痛不适情况、腹痛发作天数、总评分较治疗前降低(P<0.05);对照组IBS-SSS总评分较治疗前降低(P<0.05)。两组治疗后IBS-SSS各项评分及总评分较治疗前和治疗1个疗程后降低(P<0.05)。治疗组随访期IBS-SSS各项评分及总评分较治疗后升高(P<0.05),腹痛不适情况、排便理想程度及总评分较治疗前降低(P<0.05);对照组IBS-SSS中腹痛不适情况、腹痛发作天数、腹胀不适程度、排便理想程度及总评分较治疗后升高(P<0.05),各项评分及总评分与治疗前比较差异无统计学意义(P>0.05)。治疗组治疗后和随访期IBS-SSS腹痛不适情况、腹痛发作天数、排便理想程度评分和总评分均低于对照组(P<0.05)。两组治疗后血清DAO和D-LA含量低于治疗前,且治疗组低于对照组,差异有统计学意义(P<0.05)。治疗组总有效率为85.0%,高于对照组的25.0%,差异有统计学意义(P<0.05)。结论通腑调神针法治疗IBS-C疗效确切,其机制可能与下调血清DAO、D-LA水平相关。Objective To observe the clinical efficacy of Tong Fu Tiao Shen needling in treating constipation-predominant irritable bowel syndrome(IBS-C)and its impact on the patient’s serum levels of diamine oxidase(DAO)and D-lactate(D-LA).Method Forty IBS-C patients were randomized into a treatment group and a control group,with 20 cases in each group.The treatment group was intervened by Tong Fu Tiao Shen needling,and the control group received acupuncture at sham points near the real points.The two groups were observed for the component and general scores of irritable bowel syndrome symptom severity scale(IBS-SSS)before treatment,after 1 treatment course,after the treatment,and at follow-up;the serum levels of DAO and D-LA were detected before and after the treatment.The clinical efficacy was compared between the two groups.Result After 1 treatment course,the IBS-SSS component scores of abdominal pain severity and number of days of abdominal pain and IBS-SSS total score dropped compared to the baseline in the treatment group(P<0.05);the control group had a decrease in the IBS-SSS total score(P<0.05).After the treatment,the IBS-SSS component and total scores dropped in both groups compared to those before treatment and after 1 treatment course(P<0.05).In the treatment group,the IBS-SSS total and component scores increased at the follow-up compared to those after the treatment(P<0.05),and the scores of abdominal pain severity and satisfaction with bowel habits and the IBS-SSS total score were lower compared to those before the treatment(P<0.05).In the control group,the IBS-SSS component scores of abdominal pain severity,number of days of abdominal pain,abdominal tightness severity,and satisfaction with bowel habits and the IBS-SSS total score were higher at the follow-up compared to those after the treatment(P<0.05),and the component and total scores had no significant differences compared to those before treatment(P>0.05).The IBS-SSS component scores of abdominal pain severity,number of days of abdominal pain,and satisf

关 键 词：肠易激综合征 便秘 针刺疗法 二胺氧化酶 D-乳酸 

分 类 号：R246.1[医药卫生—针灸推拿学]