电针治疗严重功能性便秘疗效观察

Clinical Effect of Electroacupuncture in Treatment of Severe Functional Constipation

目的评价电针治疗严重功能性便秘的近期和远期临床疗效。方法将70例严重功能性便秘患者随机分为电针组和假电针组,每组35例。电针组患者接受双侧天枢、腹结、上巨虚深刺,假电针组患者接爱双侧天枢旁、腹结旁、上巨虚旁非穴点浅刺。于基线期、治疗8周末和随访12周末,分别观察两组患者每周完全自主排便(complete spontaneous bowel movements,CSBM)次数、自主排便(spontaneous bowel movements,SBM)次数,以及Bristol粪便性状(Bristol Stool Scale,BSS)评分、排便困难程度评分。结果与基线期比较,治疗期和随访期两组每周CSBM次数均显著增加(P<0.01),但电针组每周CSBM次数增加值显著大于假电针组(P<0.01)。在随访期,电针组每周CSBM次数≥3的病例数增加率显著大于假电针组(P<0.05)。在次要结局指标方面,电针组每周SBM次数和BSS评分增加值以及排便困难程度评分降低值均显著大于假电针组。结论电针治疗严重功能性便秘疗效确切,远期疗效较好。

Objective To evaluate the short-term and long-term clinical effect of electroacupuncture（EA）in the treatment of severe functional constipation.Methods Seventy patients with severe functional constipation were randomly divided into EA group（n=35）and sham EA group（n=35）.The EA group received deep acupuncture at bilateral Tianshu（ST 25）,Fujie（SP 16）,and Shangjuxu（ST 39）,while the sham EA group received shallow acupuncture at non-acupoints near bilateral Tianshu（ST 25）,Fujie（SP 16）,and Shangjuxu（ST 39）.The numbers of complete spontaneous bowel movements（CSBM）and spontaneous bowel movements（SBM）per week,Bristol Stool Scale（BSS）score,and defecation difficulty score were determined at baseline,the end of the 8th week of treatment,and the end of the 12 th week of follow-up.Results Both groups showed significant increases in the number of CSBM per week during treatment and follow-up compared with in the baseline period（P〈0.01）,but the EA group had a significantly higher increase than the sham EA group（P〈0.01）.During follow-up,the EA group had a significantly higher rate of increase in the number of cases with ≥3CSBM each week than the sham EA group（P〈0.05）.Compared with the sham EA group,the EA group had significantly higher increases in the number of SBM per week and BSS score and a significantly higher decrease in defecation difficulty score.Conclusion EA has a good clinical effect,particularly in the long term,for patients with severe functional constipation.