灵龟八法择时取穴治疗腹泻型肠易激综合征临床观察

Clinical Observation of Ling Gui Ba Fa Time-based Points Selection in Treating Diarrhea-predominant Irritable Bowel Syndrome

目的比较灵龟八法择时取穴法与常规针刺法治疗脾胃虚弱腹泻型肠易激综合征的临床疗效差异。方法将60例患者随机分为灵龟八法组、常规针刺组,每组30例。灵龟八法组主穴取公孙,客穴取内关,配穴取大肠俞、天枢、上巨虚、三阴交、脾俞、足三里;常规针刺组主穴取公孙、内关,配穴取大肠俞、天枢、上巨虚、三阴交、脾俞、足三里。每星期针刺治疗3次(如果1天之内灵龟八法有多个时辰来开公孙穴,按医生与患者约定较方便的时间,约定患者就诊,进行针刺治疗),10次为1个疗程,观察治疗前后两组患者中医证候评分表、肠易激综合征特异性生活质量量表(IBS-QOL)变化情况及临床疗效。结果灵龟八法组总有效率为86.7%,常规针刺组总有效率为73.3%,灵龟八法组优于常规针刺组(P<0.01);两组患者治疗后泄泻、腹胀、腹痛等临床症状评分较治疗前均明显降低(P<0.01),但灵龟八法组泄泻、腹胀、腹痛等症状评分较常规针刺组降低更明显(P<0.01)。结论灵龟八法择时取穴治疗肠易激综合征疗效优于常规针刺。

Objective To compare the clinical efficacy between Ling Gui Ba Fa（eight magic turtle techniques） time-based points selection method and ordinary acupuncture in treating diarrhea-predominant irritable bowel syndrome（IBS-D） due to spleen-stomach deficiency. Method Sixty patients were randomized into Ling Gui Ba Fa group and ordinary acupuncture group, 30 cases each. In Ling Gui Ba Fa group, Gongsun（SP4） was selected as the host point, Neiguan（PC6） as the guest point, and Dachangshu（BL25）, Tianshu（ST25）, Shangjuxu（ST37）, Sanyinjiao（SP6）, Pishu（BL20） and Zusanli（ST36） as the adjunctive points; in the ordinary acupuncture group, Gongsun and Neiguan were selected as the major points, and Dachangshu, Tianshu, Shangjuxu, Sanyinjiao, Pishu and Zusanli were selected as the adjunctive points. The acupuncture treatments were conducted 3 times a week（the practitioner would make appointment with patient at a convenient time if Gongsun had multiple activation time points according to Ling Gui Ba Fa）, 10 sessions as a course of treatment. Before and after the intervention, the two groups of patients were evaluated by using the traditional Chinese medicine symptoms and syndromes scale and irritable bowel syndrome quality of life questionnaire（IBS-QOL）, and clinical efficacy was also observed. Result The control rate was 86.7% in Ling Gui Ba Fa group versus 73.3% in the ordinary acupuncture group, and the therapeutic efficacy of Ling Gui Ba Fa group was significantly better than that of the ordinary acupuncture group（P〈0.01）; after the treatment, the scores in rating symptoms such as diarrhea, abdominal bloating and abdominal pain were significantly lower than those before the treatment in both groups（P〈0.01）, and the declines of scores in Ling Gui Ba Fa group were more significant than those in the ordinary acupuncture group（P〈0.01）. Conclusion Ling Gui Ba Fa time-based points selection method can produce a more significant efficacy than ordinary acupuncture in treating irritable bowel syndrome.