理气通便合剂配合电针治疗脾虚气滞型便秘型肠易激综合征临床观察

Clinical Observation of Liqi Tongbian Mixture Combined with Electroacupuncture for Constipation-predominant Irritable Bowel Syndrome with Spleen-deficiency and Qistagnation Syndrome

目的:观察理气通便合剂配合电针治疗脾虚气滞型便秘型肠易激综合征(IBS-C)的临床疗效。方法:将66例脾虚气滞型IBS-C患者随机分为实验组和对照组各33例,对照组采用乳果糖口服液治疗,实验组在对照组用药基础上增加理气通便合剂配合电针治疗,2组均连续治疗4周。治疗后评估临床疗效及症状积分的变化,检测2组血浆脑肠肽指标及肛肠动力学参数。结果:实验组总有效率为90.91%,高于对照组的66.67%(P<0.05)。治疗后,2组腹痛、腹胀、大便频率、大便性状及排便不尽感积分均较治疗前降低(P<0.05);实验组5项症状积分均低于对照组(P<0.05)。治疗后,2组血浆5-羟色胺(5-HT)、血清P物质(SP)及神经肽Y(NPY)水平均较治疗前降低(P<0.05);实验组的血浆5-HT、SP及NPY水平均低于对照组(P<0.05)。治疗后,2组肛管最大收缩压(MSP)及实验组肛管静息压(ARP)均较治疗前升高(P<0.05),2组直肠最大耐受容量(MTV)均较治疗前降低(P<0.05);实验组的MSP及ARP均高于对照组(P<0.05),MTV低于对照组(P<0.05)。结论:在乳果糖口服液基础上加用理气通便合剂配合电针治疗脾虚气滞型IBS-C,可降低患者的血浆脑肠肽指标水平,有效调节肛肠动力学指标,改善临床症状,效果显著。

Objective：To observe the clinical curative effect of Liqi Tongbian mixture combined with electroacupuncture for constipation-predominant irritable bowel syndrome（IBS-C） with spleen-deficiency and qi-stagnation syndrome. Methods：Divided 66 cases of IBS-C patients with spleen-deficiency and qi-stagnation syndrome into the experimental group and the control group, 33 cases in each group. Both groups were given actulose oral solution, while the experimental group additionally received Liqi Tongbian mixture combined with electroacupuncture for treatment. Treatment of both groups continuously lasted for four weeks. After treatment, evaluated clinical curative effect and changes of symptom score,detected brain-gut peptide level in plasma as well as anorectal dynamics parameters. Results：The total effective rate was90.91% in the experimental group,being higher than 66.67% in the control group（P〈0.05）. After treatment,the scores of abdominal pain,abdominal distension,defecation frequency,defecate character,and a sense of incomplete evacuation in two groups all reduced when compared with those before treatment（P〈0.05）;the 5 symptom scores in the experimental group were all lower than those in the control group（P〈0.05）. After treatment,levels of plasma 5-hydroxytryptamine（5-HT）,serum substance P（SP）,and neuropeptide Y（NPY） in two groups were all lower than those before treatment（P〈0.05）. Levels of plasma 5-HT,serum SP,and NPY in the experimental group were all lower than those in the control group（P〈0.05）.After treatment, the anal maximal squeezing pressure（MSP） of two groups and anal canal rest pressure（ARP） of the experimental group were all higher than those before treatment（P〈0.05）. The maximum tolerable volume（MTV） of rectum in two groups were lower than those before treatment（P〈0.05）. MSP and ARP in the experimental group were both higher than those in the control group,while MTV being lower than that in the control group（P〈0.05）. Conclusion：Based on therapy of lactulose oral solution,the additional application of Liqi Tongbian mixture combined with electroacupuncture for IBS-C with spleen-deficiency and qi-stagnation syndrome can reduce levels of plasma 5-HT, effectively regulate anorectal dynamics index and improve clinical syndromes,which shows significant effect.