针刺与西药治疗腹泻型肠易激综合征疗效对照观察

Comparative observation on therapeutic effects between acupuncture and western medication for diarrhea-predominant irritable bowel syndrome

目的:比较疏肝健脾法针刺与西药治疗腹泻型肠易激综合征的疗效差异。方法:将70例患者随机分为针刺组、西药组,每组35例。针刺组穴取天枢、足三里、上巨虚、三阴交、太冲等穴行常规针刺,并在双侧天枢加电针刺激,每日1次,每周治疗3～4次;西药组口服匹维溴铵(得舒特),每次50mg,每日3次,均4周为一疗程。分别于治疗前、1个疗程后观察两组患者临床症状积分及肠易激综合征生活质量评价量表(IBS-QOL)评分,并评定两组疗效及复发率。结果:治疗后两组症状积分、IBS-QOL评分均显著改善(均P<0.01),且针刺组的改善程度优于西药组(均P<0.01);针刺组有效率为94.3%(33/35),优于西药组的77.1%(27/35,P<0.01);3个月后针刺组复发率为36.4%(12/33),明显低于西药组的72.0%(18/25,P<0.01)。结论:疏肝健脾法针刺治疗腹泻型肠易激综合征疗效优于西药匹维溴铵,可明显改善患者生活质量,且复发率低。

Objective To compare the efficacy difference in diarrhea-predominant irritable bowel syndrome between acupuncture in terms of soothing liver and strengthening spleen and western medication.Methods Seventy cases were randomized into an acupuncture group and a western medication group,35 cases in each one.In the acupuncture group,the conventional acupuncture was applied to Tianshu（ST 25）,Zusanli（ST 36）,Shangjuxu（ST 37）,Sanyinjiao（SP 6）,Taichong（LR 3）,etc.The electric stimulation was added at bilateral Tianshu（ST 25）.The treatment was given once a day,3 to 4 treatments required a week.In the western medication group,Pinaverium（Dicetel） was prescribed for oral administration,50 mg each time,3 times a day.The treatment of 4 weeks was taken as one session.Separately,before treatment and after one session of treatment,the clinical symptom score and Irritable Bowel Syndrome Quality of Life（IBS-QOL） score were observed for the patients in two groups.The efficacy and the recurrence rate were assessed in two groups.Results The symptom score and IBS-QOL score were all improved significantly after treatment in two groups（all P〈0.01）.The improvements in the acupuncture group were superior to those in the western medication group（all P〈0.01）.The effective rate was 94.3%（33/35） in the acupuncture group,which was better than 77.1%（27/35） in the western medication group（P〈0.01）.In 3 months,the recurrence rate was 36.4%（12/33） in the acupuncture group,which was remarkably lower than 72.0%（18/25） in the western medication group（P〈0.01）.Conclusion Acupuncture in terms of soothing liver and strengthening spleen achieves the superior efficacy on diarrhea-predominant irritable bowel syndrome as compared with western medicine Pinaverium.It remarkably improves the quality of life for the patients and reduces the recurrence rate of the disease.