隔药灸脐法治疗实证便秘疗效观察

Clinical observation of herb-partition moxibustion at navel for constipation with excess syndrome

目的:观察隔药与隔淀粉灸脐法治疗实证便秘的临床疗效差异。方法:将60例实证便秘患者随机分为隔药灸脐组和隔淀粉灸脐组,每组30例。隔药灸脐组采用隔药灸神阙穴,隔淀粉灸脐组采用隔淀粉灸神阙穴,均每周治疗1次,共治疗4次。分别于治疗前后及随访期观察两组患者便秘严重程度评分及生活质量评分(PAC-QOL),并比较两组的临床疗效。结果:治疗结束后,隔药灸脐组便秘严重程度及生活质量评分均较治疗前降低(P<0.01,P<0.05),且优于隔淀粉灸脐组(P<0.01,P<0.05);隔药灸脐组对实证便秘各个证型,即热秘(84.6%)、气秘(77.8%)、冷秘(87.5%)均有较好的疗效,且对热秘、气秘的改善优于隔淀粉灸脐组(均P<0.05);隔药灸脐组有效率(25/30,83.3%)优于隔淀粉灸脐组(13/30,43.3%)。随访期,隔药灸脐组便秘严重程度及生活质量评分与治疗后比较,差异均无统计学意义(均P>0.05),但均优于隔淀粉灸脐组(P<0.01,P<0.05);隔药灸脐组有效率86.6%(26/30)优于隔淀粉灸脐组的50.0%(15/30,P<0.01)。结论:隔药灸脐治疗实证便秘的疗效优于隔淀粉灸脐,且远期疗效更好。

Objective To observe the effect differences between herb-partition moxibustion and starch-partition moxibustion at navel for constipation with excess syndrome.Methods Sixty patients were randomly assigned into an herb-partition moxibustion at navel group（herbal group）and a starch-partition moxibustion at navel group（starch group）,30 cases in each one.The acupoint was Shenque（CV 8）in the two groups.The treatment was given once a week and 4times totally.Scores for constipation degree and quality of life（PAC-QOL）were observed before and after treatment and at follow-up;clinical effects were compared between the two groups as well.Results After treatment,the scores of constipation degree and QOL were lower than those before treatment in the herbal group（P〈0.01,P〈0.05）,which were better than those of the starch group（P〈0.01,P〈0.05）.Good effects were achieved for heat constipation（84.6%）,qi constipation（77.8%）and cold constipation（87.5%）in the herbal group,and the improvements of heat constipation and qi constipation were better than corresponding results in the starch group（both P〈0.05）.The effective rate of the herbal group was 83.3%（25/30）,and it was better than 43.3%（13/30）of the starch group.The two scores at follow-up had no statistical significances compared with those after treatment in the herbal group（both P〈0.05）,but superior to ones of the starch group（P〈0.01,P〈0.05）;the effective rate of the herbal group was 86.6%（26/30）,which was better than 50.0%（15/30）of the starch group（P〈0.01）.Conclusion Herb-partition moxibustion at navel achieves better shortterm and long-term effects than starch-partition for constipation with excess syndrome.