针刺与电针治疗功能性便秘的疗效及机制

Efficacy of acupuncture and electro-acupuncture in treatment of functional constipation

目的:观察针刺与电针治疗功能性便秘的临床疗效及其对患者血清生长抑素的调节作用.方法:将40例功能性便秘患者随机分为针刺组和电针组,电针组深刺双侧天枢、腹结并接电针仪,采用疏密波,10/50 Hz、电流强度0.1-1.0 m A,以患者腹部肌肉轻微颤动为度,常规针刺上巨虚穴.针刺组相同取穴与针刺,不接电针.均留针30 min.连续治疗4 wk,观察基线期(-1--2 wk)、第一个疗程(1-2 wk)、第二个疗程(3-4 wk)中各组自主排便次数(spontaneous bowel movements,SBM)、完全自主排便次数(complete spontaneous bowe movements,C S B M)、粪便性状评分、排便困难程度评分、便秘特异生活质量评分(patient assessment of constipation quality o life scale,PAC-QOL量表)变化情况,以及治疗前后患者血清生长抑素水平变化.结果:两组在改善便秘各临床症状(SBM、C S B M、粪便性状评分、排便困难程度评分)、提高患者生活质量上均有很好的疗效(P<0.01),针刺组总有效率75%,电针组总有效率85%,二者疗效差异无统计学意义(P>0.05).电针组在第一个疗程结束时在疗效优于针刺组(P<0.05).两组治疗后患者血清生长抑素水平均较治疗前有所下降(P<0.01),组间比较差异无统计学意义(P>0.05).结论:(1)单纯针刺和针刺结合电针治疗功能性便秘均可收到满意疗效,电针治疗显效更快,并可能缩短治疗疗程;(2)针刺治疗功能性便秘的机制可能是通过调节体内生长抑素的水平实现的.

AIM：To evaluate the clinical efficacy of acupuncture and electro-acupuncture in the treatment of functional constipation,and their regulatory effect on serum somatostatin.METHODS：Forty patients with functional constipation were randomly divided into an acupuncture group and an electro-acupuncture group.The EA group received deep electroacupuncture at bilateral Tianshu（S25） and Fujie（SP14） points and conventional electroacupuncture at Shangjuxu（S37） point.The acupuncture group received acupuncture at the same acupoints.The treatment period was4 wk.Spontaneous bowel movements（SBM）,complete spontaneous bowel movements（CSBM）,stool consistency score,defecation difficulty score,constipation-specific quality of life scores（PAC-QOL scale） at baseline（wk-1 to-2）,the end of the first（1-2 wk after treatment）and second（3-4 wk after treatment） course were evaluated.Serum somatostatin levels before and after treatment were measured.RESULTS：Both groups had significant improvement of constipation symptoms（independent defecation,stool score,constipation severity score） and the quality of life（P 〈 0.01）.The total effective rates of the acupuncture group and electro-acupuncture group were 75%and85%,respectively,which showed no significant difference between the groups（P 〉 0.05）.The electro-acupuncture group had better efficacy than acupuncture group at the end of the first course（P 〈 0.05）.Serum somatostatin levels decreased in both groups after treatment（P〈 0.01）.CONCLUSION：Both acupuncture and electroacupuncture have satisfactory results for treating functional constipation,and electroacupuncture treatment may shorten the course of treatment.The mechanism of acupuncture treatment for constipation functional may be through regulating somatostatin levels.