火龙灸联合久泻方治疗脾肾阳虚型肠易激综合征临床观察  

Clinical Observation on Fire-dragon Moxibustion and Jiuxie Decoction in the Treatment of Spleen-kidney Yang Deficiency Type of Irritable Bowel Syndrome

作　　者：袁肖肖 刘兴山[2] 潘林康 YUAN Xiaoxiao;LIU Xingshan;PAN Linkang(Shandong University of Traditional Chinese Medicine,Jinan 250014,China;Weifang Hospital of TCM,Weifang 261000,China)

机构地区：[1]山东中医药大学,山东济南250014 [2]潍坊市中医院,山东潍坊261000

出　　处：《西部中医药》2025年第4期139-143,共5页Western Journal of Traditional Chinese Medicine

基　　金：山东省中医药科技发展计划项目(2019-0708)。

摘　　要：目的:探讨火龙灸联合久泻方治疗脾肾阳虚型肠易激综合征(irritable bowel syndrome,IBS)的临床疗效及其对血清miR-495、miR-181c-5p表达的影响。方法:选取98例患者采取前瞻性随机对照研究,以随机数字表分为观察组和对照组,每组49例。对照组给予马来酸曲美布汀片治疗,观察组在对照组基础上给予火龙灸联合久泻方治疗,均治疗1个月。观察两组临床疗效,治疗前后证候积分、IBS生活质量(irritable bowel syndrome-quality of life,IBS-QOL)评分、内脏敏感指数(visceral sensitivity index,VSI)评分、胃肠激素水平[血清5-羟色胺(5-hydroxytryptamine,5-HT)、血管活性肠肽(vasoactive intestinal peptide,VIP)、P物质(substance P,SP)水平]、血清炎症因子水平[白细胞介素6(interleukin-6,IL-6)、白细胞介素1α(interleukin-1α,IL-1α)、超敏C反应蛋白(hypersensitive c-reactive protein,hs-CRP)]、肠道菌群数量、血清miR-495、miR-181c-5p表达水平的变化情况。结果:观察组总有效率[87.76%(43/49)]高于对照组[77.55%(38/49)](P<0.05);两组治疗后证候积分、IBS-QOL评分、VSI评分、血清5-HT、VIP、IL-1α、hs-CRP、IL-6水平及肠杆菌数量较治疗前降低(P<0.05),且观察组低于对照组(P<0.05);血清SP、血清miR-495、miR-181c-5p表达水平及乳杆菌数量、双歧杆菌数量均较治疗前升高(P<0.05),且观察组高于对照组(P<0.05)。结论:火龙灸联合久泻方治疗脾肾阳虚型IBS患者疗效显著,可改善患者生活质量,同时通过下调血清miR-495、miR-181c-5p表达,抑制血清炎症因子反应,以达到调节胃肠激素水平、调整肠道菌群目的。Objective:To explore clinical effects of fire-dragon moxibustion and Jiuxie(chronic diarrhea)prescription in the treatment of spleen-kidney Yang deficiency type of irritable bowel syndrome(IBS)and its influence on the expressions of serum miR-495 and miR-181c-5p.Methods:A prospective randomized controlled study was conducted on 98 patients,who were randomized into the observation group and the control group by random number table with 49 cases in each group.The control group was treated with triamterine maleate tablets,and the observation group accepted fire-dragon moxibustion and Jiuxie prescription on the foundation of the therapy the control group accepted,and both groups were treated for one month.To observe clinical effects,syndrome integrals before and after the treatment,the scores of IBS-QOL,VSI scores,the levels of gastrointestinal hormone including 5-HT,VIP and SP,the levels of serum inflammatory factors including IL-6,IL-1αand hs-CRP,the number of gut flora,the expressions of serum miR-495 and miR-181c-5p between the two groups.Results:Total effective rate of the observation group was[87.76%(43/49)],higher than[77.55%(38/49)](P<0.05);syndrome integrals after the treatment,the scores of IBS-QOL,VSI scores,the levels of 5-HT and VIP,IL-1α,hs-CRP and IL-6,as well as the number of gut flora were lowered in the two groups compared with before the treatment(P<0.05),and the observation group was lower than the control group(P<0.05);the expressions of serum SP,miR-495 and miR-181c-5p,the number of Bacillus lactis and Bacillus bifidus were elevated than before the treatment(P<0.05),and the observation group was higher than the control group(P<0.05).Conclusion:Firedragon moxibustion and Jiuxie prescription could gain noticeable clinical effects in the treatment of spleen-kidney Yang deficiency type of IBS,which could improve the patients'quality of life,meanwhile down-regulate the expressions of serum miR-495 and miR-181c-5p,inhibit the reaction of serum inflammatory factors,so as to achieve the goals of regul

关 键 词：肠易激综合征 脾肾阳虚 火龙灸 久泻方 血清miR-495 血清miR-181c-5p 

分 类 号：R256.34[医药卫生—中医内科学]