艾灸腹部穴位治疗慢性肾脏病合并功能性便秘的临床研究

Clinical study of moxibustion on abdominal acupoints in the treatment of chronic kidney disease combined with functional constipation

目的探讨艾灸腹部穴位治疗慢性肾脏病合并功能性便秘的临床效果。方法选取2015年1月~2016年2月在广东省中医院就诊的慢性肾脏病合并功能性便秘患者50例,按照随机数字表法分为观察组和对照组,每组各25例。对照组给予常规基础治疗,并给予枸橼酸莫沙必利片口服治疗,观察组在对照组基础上给予艾灸腹部穴位治疗。治疗后1个月,采用便秘症状及疗效评估问卷对两组患者的主要临床症状积分进行比较,并比较两组患者胃电图检查指标及胃肠道激素水平。结果治疗前两组排便困难,粪便性状,排便时间,下坠、不尽、胀感,排便频度及腹胀等症状积分比较,差异无统计学意义(P>0.05)。治疗后两组上述积分均低于治疗前,且观察组明显低于对照组(均P<0.05)。治疗前两组升结肠、横结肠波幅与平均频率比较,差异无统计学意义(P>0.05)。治疗后两组上述指标均高于治疗前,且观察组明显高于对照组,差异有统计学意义(均P<0.05)。治疗前两组MTL、SP、NO水平比较,差异无统计学意义(P>0.05)。治疗后两组MTL和SP水平均显著高于治疗前,NO显著降低于治疗前,差异有统计学意义(均P<0.05),且观察组变化更加显著,差异有统计学意义(P<0.05)。结论艾灸腹部穴位治疗慢性肾脏病合并功能性便秘效果较好,能够调节患者胃肠道激素紊乱状态,改善胃肠道功能,从而缓解便秘症状。

Objective To explore the clinical effects of moxibustion on abdominal acupoints in the treatment of chronic kidney disease combined with functional constipation. Methods From January 2015 to February 2016, a total of 50 pa- tients with chronic kidney disease combined with functional constipation diagnosed in Guangdong Province Traditional Chinese Medical Hospital were divided into the observation group and the control group by random number table, with 25 cases in each group. The control group was given routine treatment with mosapride citrate tablets by oral treatment and the observation group was given abdominal acupoints with moxibustion on the basis of the control group. After treatment for 1 month, the main clinical symptoms of the two groups were evaluated by the constipation symptom and efficacy evaluation questionnaire. The indexes of electrogastrography and the levels of gastrointestinal hormones were compared between the two groups. Resuts Before treatment, there were no statistically significant differences in the scores of defecation difficulty, stool character, defecation time, abnormal feeling, defecation frequency and bloating be- tween the two groups （P 〉 0.05）. After treatment, the scores of the symptoms above in the two groups were all lower than those of before treatment, and those above in the observation group were all lower than those of control group, with sta- tistically significant differences （all P 〈 0.05）. Before treatment, there were no statistically significant differences in the ascending colon amplitude and frequency and transverse colon amplitude and frequency between the two groups （P 〉 0.05）. After treatment, the indexes above were all higher than those of control group, and those in the observation group were much higher than those of control group, with statistically significant differences （all P 〈 0.05）. Before treatment, there were no statistically significant differences in the serum MTL, NO and SP levels （all P 〉 0.05）.After treatment, the MTL and SP were much higher than those of before treatment, the NO was much lower than that of before treatment, and those indexes above changed much more significant, with statistically significant differences （all P 〈 0.05）. Conclusion The clinical effects of moxibustion on abdominal acupoints in the treatment of chronic kidney disease combined with functional constipation is good, can regulate the patients＇ gastrointestinal hormone disorder, im- prove the gastrointestinal function, relieve the constipation symptoms.