摘要
目的观察针药并用治疗腹泻型肠易激综合征(diarrhea-irritable bowel syndrome,IBS-D)肝郁脾虚证的临床疗效以及对患者血清5-羟色胺(5-hydroxytryptamine,5-HT)、降钙素基因相关肽(calcitonin gene related peptide,CGRP)以及内皮素(endothelin,ET)的影响。方法选择60例IBS-D(肝郁脾虚证)患者作为研究对象,将患者随机分为观察组和对照组,每组30例。观察组患者采用针刺配合白术芍药散加减进行治疗,对照组仅采用针刺治疗。观察记录两组患者治疗总有效率、治疗前后中医临床症状积分差异以及IBS-D治疗前后专用生活质量量表(diarrhea-irritable bowel syndrome quality of life scale,IBS-QOL)评分差异以及两组患者治疗前后血清中5-HT、CGRP以及ET水平差异。结果观察组总有效率为83.3%,显著高于对照组的63.3%(P<0.05);治疗前两组患者中医临床症状总积分、各临床症状症状积分及IBS-QOL评分比较差异均无统计学意义(P>0.05);两组患者治疗后中医临床症状总积分、各临床症状症候积分及IBS-QOL评分与同组治疗前比较均显著降低(P<0.05);治疗后观察组中医临床症状总积分、IBS-QOL评分及治疗后3个月随访中医临床症状总积分、IBS-QOL评分与对照组比较均显著降低(P<0.05);治疗后观察组各种临床症状症状积分与对照组比较,均显著降低(P<0.05);治疗前两组患者血清中5-HT、CGRP以及ET水平比较差异无统计学意义(P>0.05);两组患者治疗后5-HT、CGRP以及ET水平与同组治疗前比较均显著降低(P<0.05);治疗后观察组5-HT、CGRP以及ET水平与对照组比较,显著降低(P<0.05)。结论针药并用治疗IBS-D(肝郁脾虚证)能够有效缓解患者临床症状,提高其生活质量,其作用机制可能是通过降低患者血清中的5-HT、CGRP以及ET水平来达到治疗的作用。
Objective To observe the efficacy of acupuncture plus medication in treating diarrhea-irritable bowel syndrome（IBS-D） due to liver depression and spleen deficiency, and its effect on serum 5-hydroxytryptamine（5-HT）, calcitonin gene-related peptide（CGRP） and endothelin（ET）. Method Sixty IBS-D（liver depression and spleen deficiency） were recruited and randomized into an observation group and a control group, 30 cases each. Patients in the observation group were intervened by acupuncture plus modified Bai Zhu Shao Yao powder, while the control group was intervened by acupuncture alone. The total effective rate, change of syndrome score of traditional Chinese medicine（TCM） and diarrhea-irritable bowel syndrome quality of life scale（IBS-QOL）, as well as the levels of serum 5-HT, CGRP and ET, were observed. Result The total effective rate was 83.3% in the observation group, significantly higher than 63.3% in the control group（P〈0.05）. There were no significant differences in comparing the global and component TCM symptoms scores and IBS-QOL between the two groups before the treatment（P〉0.05）. The global and component TCM symptoms scores and IBS-QOL dropped significantly in both groups after the intervention（P〈0.05）. The global TCM symptoms score and IBS-QOL in the observation group were significantly lower than those in the control group after the intervention and 3 months after the intervention（P〈0.05）; the component TCM symptoms scores in the observation group were significantly lower than those in the control group after the intervention（P〈0.05）. There were no significant differences in comparing the serum 5-HT, CGRP and ET levels between the two groups（P〉0.05） before the treatment. The levels of 5-HT, CGRP and ET decreased significantly after the treatment in both groups（P〈0.05）; after the intervention, the levels of 5-HT, CGRP and ET in the observation group were significantly lower than those in the control group（P〈0.05）. Conclusion Acupu
出处
《上海针灸杂志》
2017年第8期929-934,共6页
Shanghai Journal of Acupuncture and Moxibustion
基金
河南省中医药专项课题(2015ZY02013)
