调神健脾配穴针刺治疗便秘型肠易激综合征:随机对照研究

Constipation predominant irritable bowel syndrome treated with acupuncture for regulating the mind and strengthening the spleen:a randomized controlled trial

目的:观察调神健脾配穴针刺治疗便秘型肠易激综合征(IBS-C)的临床疗效及对患者生活质量的影响。方法:将60例IBS-C患者随机分为两组,其中,针刺组30例,予针刺治疗,取天枢、足三里、上巨虚、太冲、三阴交、印堂、百会,每日1次,每周5次,4周为一疗程;西药组30例,予口服乳果糖口服溶液,每次15mL,每日3次,4周为一疗程。采用症候分级量化表、生活质量量表(IBS-QOL)观察两组患者在治疗前、治疗后及治疗后2个月随访的临床症状和生活质量的改善情况。结果:1临床症状评分:两组组内不同观测时间点的症状积分差异有统计学意义(P<0.01);在治疗1周后、4周后及治疗后2个月,针刺组临床症状评分低于西药组(P<0.05,P<0.01)。2治疗后两组IBS-QOL评分均较治疗前提高(P<0.01),针刺组治疗后2个月生活质量的改善优于西药组(P<0.05)。3针刺组总有效率为90.0%(27/30),西药组为83.3%(25/30),差异具有统计学意义(P<0.01)。结论:调神健脾针刺法可显著改善IBS-C患者的临床症状,提高患者的生活质量,总体疗效优于口服乳果糖口服溶液,并有一定的远期疗效。

Objective To observe the clinical efficacy on constipation predominant irritable bowel syndrome（IBS-C）treated with acupuncture for regulating the mind and strengthening the spleen and the impacts on the quality of life in the patients.Methods Sixty patients of IBS-C were randomized into two groups.In the acupuncture group（30cases）,acupuncture was applied to Tianshu（ST 25）,Zusanli（ST 36）,Shangjuxu（ST 37）,Taichong（LR 3）,Sanyinjiao（SP 6）,Yintang（GV 29）and Baihui（GV 20）,once a day,5treatments a week and 4weeks treatment as one session.In the western medication group（30cases）,lactulose oral solution was prescribed,15 mL each time,three times a day,4weeks treatment as one session.The symptom grade scale and the quality of life scale（IBS-QOL）were adopted to observe the changes in clinical symptoms and quality of life before treatment,after treatment and 2-month follow-up after treatment in the patients of the two groups separately.Results1 Clinical symptom score：the difference in the symptom score at each time point was significant statistically in intra-group comparison（P0.01）.In 1 week,4 weeks of treatment and 2 months after treatment,the clinical symptom scores in the acupuncture group were lower than those in the western medication group（P0.05,P0.01）.2IBS-QOL score after treatment was improved as compared with that before treatment in the two groups（P0.01）.The improvement of IBS-QOL at 2months after treatment in the acupuncture group was apparently superior to the western medication group（P0.05）.3The total effective rate was 90.0%（27/30）in the acupuncture group and was 83.3%（25/30）in the western medication group.The overall efficacy in the acupuncture group was better than that in the western medication group（P0.01）.Conclusion Acupuncture for regulating the mind and strengthening the spleen significantly relieves the clinical symptoms of IBS-C and improves QOL of patients.The total efficacy is superior to lactulose oral solution and presents a certain of long-term efficacy.