穴位埋线配合福松治疗糖尿病便秘:随机对照研究

Diabetic constipation treated with acupoint embedding therapy and forlax:a randomized controlled trial

目的:比较穴位埋线配合口服福松与单纯穴位埋线和单纯口服福松治疗糖尿病便秘的疗效差异。方法:将150例患者随机分为综合组、穴位埋线组、福松组,每组50例。穴位埋线组给予双侧天枢、大横、上巨虚、大肠俞埋线,每周1次;福松组口服福松(聚乙二醇4000散)治疗,每日1次,每次10g;综合组采用穴位埋线配合口服福松,方法同穴位埋线组和福松组,3组均4周为一疗程,共治疗2个疗程。分别于4周后、8周后及停止治疗后2个月比较3组的便秘症状评分,于2个疗程结束后比较3组的临床疗效和不良反应发生情况,于治疗停止后2个月比较3组的复发率。结果:综合组总有效率为98.0%(49/50),优于穴位埋线组的86.0%(43/50)及福松组的78.0%(11/50,均P<0.01)。3组治疗4周、8周后便秘症状评分均较治疗前显著降低(均P<0.05),且综合组优于其他两组(均P<0.05);治疗4周后,穴位埋线组与福松组便秘症状评分比较差异无统计学意义(P>0.05),治疗8周后及停止治疗后2个月埋线组均优于福松组(均P<0.05)。综合组出现药物不良反应者2例,福松组6例,穴位埋线组无不良反应发生。在复发率方面,综合组复发率为8.1%(4/49),低于穴位埋线组的32.6%(14/43)和福松组的59.0%(23/39,均P<0.01)。结论:穴位埋线配合福松治疗糖尿病便秘,在临床疗效、便秘症状评分方面均优于单纯穴位埋线和单纯口服福松治疗。单纯穴位埋线治疗在近期疗效方面与单纯福松治疗无显著差异,但远期疗效及安全性方面优于单纯福松治疗。

Objective To compare the difference among the combined method of oral administration of forlax and acupoint embedding therapy,the simple acupoint embedding therapy and the simple oral administration of forlax in the clinical efficacy on diabetic constipation.Methods One hundred and fifty patients were randomized into a comprehensive group,an acupoint embedding group and a forlax group,50 cases in each one.In the acupoint embedding group,the embedding therapy was applied to bilateral Tianshu（ST 25）,Daheng（SP 15）,Shangjuxu（ST 37）and Dachangshu（BL 25）,once a week.In the forlax group,forlax（polyethylene glycol）was prescribed for oral administration,once a day,10 g each time.In the comprehensive group,the acupoint embedding therapy and forlax were combined and the methods were the same as the first two groups.The treatment for 4 weeks was as one session,and 2 sessions were required in the three groups.Separately,in 4 weeks,8 weeks of treatment and 2 months after treatment,the constipation symptom scores were compared among the three groups.At the end of 2 sessions of treatment,the clinical efficacy and adverse reactions were compared among the three groups.In 2 months after treatment,the recurrence rate was compared among the three groups.Results The total effective rate was 98.0%（49/50）in the comprehensive group,better than 86.0%（43/50）in the acupoint embedding group and 78.0%（11/50）in the forlax group（both P〈0.01）.In the 4 weeks and 8 weeks of treatment,the constipation symptom scores were reduced significantly as compared with those before treatment in the three groups（all P〈0.05）.The results in the comprehensive group were lower than those in the other two groups（all P〈0.05）.In the 4 weeks of treatment,the scores were not different significantly between the acupoint embedding group and the forlax group（P〉0.05）.In 8 weeks of treatment and 2 months after treatment,the scores in the acupoint embedding group were better than those in the forlax group（all P〈0.05）.There were 2 cases of drug adverse reaction in the comprehensive group,6 cases in the forlax group and 0 case in the acupoint embedding group.The recurrence rate was 8.1%（4/49）in the comprehensive group,lower than 32.6%（14/43）in the acupoint embedding group and 59.0%（23/39）in the forlax group（both P〈0.01）.Conclusion The combined therapy of acupoint embedding and forlax achieves the better clinical efficacy on diabetic constipation and constipation symptom scores as compared with the simple acupoint embedding therapy and the oral administration of forlax.The short-term efficacy of the simple acupoint embedding therapy is not different significantly from the simple forlax medication,but the long-term efficacy and safety are better than those of simple forlax medication.