中医外治法治疗虚寒型功能性消化不良重叠腹泻型肠易激综合征临床研究

Clinical Study on Chinese Medicine External Therapy for Functional Dyspepsia Overlapping with Diarrhea-predominant Irritable Bowel Syndrome of Deficiency Cold Type

目的:观察中医外治法治疗虚寒型功能性消化不良(FD)重叠腹泻型肠易激综合征(D-IBS)的临床疗效以及对胃肠激素的影响。方法:将虚寒型FD重叠D-IBS患者50例随机分为2组,对照组25例采用常规西药治疗,观察组25例在对照组治疗的基础上加用隔药饼灸、穴位贴敷及温针灸综合中医外治法治疗;疗程为3个月,观察比较2组治疗后临床疗效、症状改善情况以及治疗前后胃肠激素[包括5-羟色胺(5-HT)、生长抑素(SS)、血管活性肠肽(VIP)]水平变化。结果:总有效率观察组为96.0%,对照组为76.0%,2组比较,差异有统计学意义(P<0.05)。治疗后,2组症状积分均较治疗前降低(P<0.05);且观察组症状积分明显低于对照组(P<0.05)。治疗后,2组患者5-HT水平较治疗前明显降低(P<0.05),SS、VIP水平较治疗前明显升高(P<0.05);且观察组各项指标改善较对照组更显著(P<0.05)。结论:中医外治法联合传统西药治疗虚寒型FD重叠DIBS临床疗效显著,能明显改善胃肠激素水平,值得临床推广应用。

Objective:To observe the clinical effect of Chinese medicine external therapy for functional dyspepsia(FD)overlapping with diarrhea-predominant irritable bowel syndrome(D-IBS)of deficiency cold type,and its effect on gastrointestinal hormones.Methods:Divided 50 cases of patients with FD overlapping with D-IBS of deficiency cold typeinto two groups randomly,25 cases in each group.The control group received routine western medicine,while the observation group additionally received such Chinese medicine external therapies as herbal cake-separated moxibustion,point application and warming acupuncture.The course of treatment lasted for three months.Observed and compared the clinical effect and the improvements of symptoms after treatment,and the changes in levels of gastrointestinal hormones[5-hydroxytryptamine(5-HT),somatostatin(SS)and vasoactive intestinal peptide(VIP)]before and after treatment in the two groups.Results:The total effective rate was 96.0%in the observation group and 76.0%in the control group,difference being significant(P<0.05).After treatment,the symptom scores in both groups were decreased when compared with those before treatment(P<0.05);the symptom scores in the observation group were obviously lower than those in the control group(P<0.05).After treatment,the levels of 5-HT in both groups were evidently decreased when compared with those before treatment,and the levels of SS and VIP were evidently increased when compared with those before treatment(P<0.05);each index in the observation group was more improved more significantly than those in the control group(P<0.05).Conclusion:The application ofexternal therapy in Chinese medicine combined with traditional western medicine has significant clinical effect in treating FD overlapping with D-IBS of deficiency cold type.It can significantly improve the levels of gastrointestinal hormones,which is worthy of clinical promotion and application.