结肠水疗联合针刺治疗慢传输型便秘与胃肠激素关系的研究

Study on the Relevance of Colonic Irrigation and Acupuncture Therapy in the Treatment of Slow Transit Constipation and Gut Hormones

背景:近年便秘患者数量呈逐年上升趋势,其中以慢传输型便秘(STC)居多。研究提示STC的发病机制中有胃肠激素参与。目的:观察结肠水疗联合针刺治疗对STC患者的临床疗效,以及胃肠激素水平变化在其中的作用。方法:36例STC患者接受结肠水疗联合针刺治疗,30例健康体检者作为正常对照组。以放射免疫法测定STC组治疗前后空腹血浆生长抑素(SS)、胃动素(MTL)、P物质(SP)和血管活性肠肽(VIP)水平,比色法测定空腹血清一氧化氮合酶(NOS)水平。结果:STC组治疗后临床症状改善总有效率为88.9%。患者治疗前血浆SS、VIP和血清NOS水平显著高于正常对照组,血浆MTL、SP水平显著低于正常对照组(P<0.05);经结肠水疗联合针刺治疗后,上述胃肠激素水平均较治疗前显著改善(P<0.05)。结论:结肠水疗联合针刺治疗能改善STC患者的临床症状,调节胃肠激素水平。血SS、MTL、SP、VIP、NOS水平改变可能参与了该疗法对STC患者临床症状的改善作用。

Acupuncture Therapy in the Treatment of Slow Transit WANG Weining, HUA NG Ping. Department of Gastroenterology, Background： The prevalence of constipation is increasing in recent years, especially the slow transit constipation （STC）. Studies indicated that gut hormones is one of the pathogenetic mechanisms of STC. Aims： To appraise the clinical efficacy of colonic irrigation and acupuncture therapy on STC, and to explore whether gut hormones are involved in this process. Methods： Thirty-six patients with STC were treated with colonic irrigation and acupuncture therapy, and 30 healthy individuals served as controls. Radioimmunoassay was used to determine the fasting plasma levels of somatostatin （SS）, motilin （MTL）, substance P （SP） and vasoactive intestinal peptide （VIP） in STC patients prior to and after the treatment, and the fasting serum level of nitric oxide synthase （NOS） was assayed by chromometry. Results： The efficacy rate for symptom improvement of STC group was 88.9%. The plasma levels of SS, VIP and serum level of NOS in STC patients prior to the treatment were significantly higher than those in the controls, while the plasma levels of MTL and SP were significantly lower when compared with those in the controls （P〈0.05）. After treated with colonic irrigation and acupuncture therapy, levels of the above-mentioned gut hormones improved significantly （P〈0.05）. Conclusions： Treatment with colonic irrigation and acupuncture therapy improves the clinical symptoms and modulates the levels of gut hormones in STC patients. The changes of SS, MTL, SP, VIP and NOS might be involved in the effectiveness of the combined therapy in STC patients.