通过肠道菌群变化探讨隔姜隔药灸治疗腹泻型肠易激综合征的疗效及机制

Study on the efficacy and mechanism of ginger moxibustion in treating diarrhea-predominant irritable bowel syndrome by changes of intestinal flora

[目的]观察神阙穴隔姜隔药灸对腹泻型肠易激综合征(D-IBS)患者肠道菌群的影响,进而探讨其作用机理。[方法]随机将60例D-IBS患者分成2组,每组各30例。治疗组采用神阙穴隔姜隔药灸,1次/d,每次持续30min;对照组采用双歧杆菌三联活菌肠溶胶囊(培菲康)840mg,2次/d,口服治疗;疗程共3个月。观察2组患者治疗前后肠易激综合征症状严重性量表(IBS-SSS)总积分、粪便球杆比、肠道双歧杆菌/大肠杆菌(B/E)比值的变化。[结果]治疗后2组患者在各个治疗时间点IBS-SSS总积分均呈逐渐下降趋势,而粪便涂片中杆菌比例、肠道双歧杆菌的含量及肠道B/E值均呈逐渐上升趋势,与治疗前比较差异有统计学意义(P<0.001);其中治疗组在各个治疗时间点IBS-SSS总积分的改善、肠道双歧杆菌的增长及肠道B/E值升高均明显优于对照组(治疗1个月:P<0.001;治疗3个月:P=0.001)。[结论]神阙穴隔姜隔药灸可有效改善D-IBS患者的IBS-SSS总积分,提高D-IBS患者粪便杆菌比例及肠道B/E值,提示艾灸可能通过调节肠道菌群,进而改善D-IBS患者肠道微生物定植抗力,增强肠道抵抗病原菌侵袭能力,从而治疗D-IBS。

[Objective]To observe the efficacy of ginger moxibustion on diarrhea-type irritable bowel syndrome（D-IBS）,and the changes in intestinal flora.[Methods]60 patients were randomly divided into treatment group and control group,30 cases in each group.The treatment group was treated by ginger moxibustion on Shenque for 3 months.The control group was given oral Bifidobacterium triple live mushroom capsules for 3 months.The IBS-SSS score,the changes in Bifidobacterium enteritidis and the intestinal B/E values were monitored.[Results]The total score of IBS-SSS in the two groups was gradually decreased at the time of treatment,and the content of Bifidobacterium enteritidis and the intestinal B/E values were gradually increased（P 0.001）.The improvement of total score of IBS-SSS and the growth of Bifidobacterium enteritidis and the intestinal B/E values in the treatment group were significantly better than those in the control group（P0.001,P=0.001）.[Conclusion]Ginger moxibustion on Shengue can effectively improve the patient＇s clinical symptoms,the IBS-SSS score,and can significantly improve the intestinal bacteria-Bifidobacterium content and the intestinal B/E values.