电针疗法对慢传输型便秘患者便秘症状、心理状态和结肠传输功能的影响

The efficacy of electroacupuncture at the oppilative symptoms,colonic transit and anxiety and depression state in slow transit constipation patients

目的评价电针疗法对慢传输型便秘患者结肠传输功能、症状、心理状态及生活质量的影响。方法纳入符合罗马Ⅲ诊断标准的慢传输型便秘患者60例,随机分为治疗组和对照组。治疗组使用电针刺激足三里穴和天枢穴,对照组口服枸橼酸莫沙比利片,治疗前后分别行结肠传输试验,记录排便困难症状评分表、抑郁焦虑评分表和生活质量评分表。结果 (1)治疗组和对照组治疗后,排便困难症状均明显改善(P<0.05);(2)通过治疗前后结肠传输试验的比较,治疗组72 h钡条残留总量明显减少(P<0.05),其中位于结肠区的钡条明显减少(P<0.01),对照组有同样变化(P<0.05);(3)与治疗前相比,治疗组患者SDS、SAS评分明显降低(P<0.05),对照组SDS和SAS评分无明显改变(P>0.05);(4)经电针治疗后,患者生活质量8个维度均明显改善(P均<0.05),其中活力、社会功能和精神健康3个维度的改善较药物治疗组明显(P均<0.05)。结论电针刺激足三里穴和天枢穴不仅可以改善慢传输型便秘患者排便困难情况,加快结肠的传输,还可以改善患者的心理状态,提高生活质量。

Objective To evaluate the efficacy and safety of electroacupuncture at acupoints （Zusanli and Tianshu） on symptom relief and improvement of quality of life in slow transit constipation patients. Methods 60 patients with slow transit constipation （STC） who fulfilled the Rome m criteria were randomly assigned to the treated group or control group. The treated group was treated with electroacupuncture at acupoints （Zusanli and Tianshu） , patients in the con- trol group orally took Mosapride. The symptoms, self-rating anxiety and depress scale （SADS） , quality of life （SF-36） were recorded before and after treatment. X-ray examination with barium strips, radio-opaque marker was used to detect the colonic transit status. Results （1） The dyschesia symptom scores were significantly improved at the end of treat- ment in the treated group and the control group （ P 〈 0.05 ）. （2） The number of vestigial barium strips of the treatment group was significantly lower than that before treatment （P 〈 0.05） , and the change was especially obvious in the colon sector （P 〈0.01 ）. The control group had the same change （P 〈0.05）. （3） The scores of SDS and SAS of the treat- ment group after the treatment were significantly lower than those before treatment （P 〈 0.05）. However, there were no significant differences in the SDS and SAS scores before and after the drug treatment in the control group （P 〉 0.05 ）. （4） The quality of life, vitality （VT） , social function （SF） and mental health （MH） were much better improved in the treatment group than those in the control group （P 〈 0.05）. Conclusion Electroacupuncture at the acupoints Zusanli and Tianshu is capable of promoting colonic transit in STC patients, improving the oppilative symptoms and ameliorating anxiety and depression state and the quality of life.