针刺天枢穴联合莫沙必利治疗习惯性便秘及对血清VIP、MTL、5-HT的影响

Effects of Acupuncture at Tianshu( ST25) Combined with Mosapril Therapy on Serum VIP,MTL and 5-HT of Patients with Habitual Constipation

目的探讨针刺天枢穴联合莫沙必利治疗对习惯性便秘患者血清血管活性肠肽(VIP)、胃动素(MTL)、5-羟色胺(5-HT)的影响。方法选取诊治的习惯性便秘患者100例,随机分为对照组和观察组,每组50例,对照组给予枸橼酸莫沙必利片口服,观察组给与针刺天枢穴联合莫沙必利治疗,连续治疗2周,观察两组患者治疗前后中医证候积分、症状严重程度评分、VIP、MTL、5-HT变化,进行疗效判定。结果两组治疗前神疲乏力、神志、腹部胀满、舌苔、脉象积分比较差异无统计学意义(P>0.05),治疗后以上证候积分较治疗前降低(P<0.05),且观察组低于对照组(P<0.05);两组治疗前排便间隔、粪便形状、排便困难的严重程度评分比较差异无统计学意义(P>0.05),治疗后以上症状评分较治疗前降低(P<0.05),且观察组低于对照组(P<0.05);两组治疗前血清VIP、MTL、5-HT水平比较差异无统计学意义(P>0.05),治疗后VIP、5-HT较治疗前降低(P<0.05),且观察组低于对照组(P<0.05),治疗后MTL较治疗前升高(P<0.05),且观察组高于对照组(P<0.05);治疗总有效率观察组为92.00%(46/50)高于对照组76.00%(38/50)(P<0.05)。结论针刺天枢穴联合莫沙必利治疗治疗习惯性便秘能明显有助于症状及血清VIP、MTL、5-HT水平的改善,加速肠道功能的康复。

Objective To investigate the effects of acupuncture at Tianshu(ST25) combined with mosapril on serum levels of vasoactive intestinal peptide(VIP), motilin(MTL) and 5-hydroxytryptamine(5-HT) in patients with habitual constipation. Methods We collected 100 cases of patients with habitual constipation. They were randomly divided into control group and observation group, with 50 cases in each group. The control group received mosapride orally. The observation group was treated with acupuncture at Tianshu(ST25) combined with mosapride for 2 weeks. We observed TCM symptom scores, symptom severity score, levels of VIP, MTL and 5-HT before and after treatment and evaluated the efficacy. Results There was no statistically significant difference between the two groups in the scores of fatigue, consciousness, abdominal fullness, tongue coating or pulse before treatment(P>0.05). The above symptoms were lower after treatment(P<0.05). The observation group’s symptom score was lower than that of the control group(P<0.05). There was no statistically significant difference between the two groups in the scores of fecal septum, fecal shape or severity of defecation difficulty before treatment(P>0.05). The above symptoms were lower after treatment than those before treatment(P<0.05). The observation group’s symptom scores were lower than those of the control group(P<0.05). There was no statistically significant difference in serum levels of VIP, MTL or 5-HT between the two groups before treatment(P>0.05). VIP and 5-HT were lower after treatment than those before treatment(P<0.05). The observation group’s levels of VIP and 5-HT were lower than those of the control group(P<0.05). The level of MTL was higher after treatment than that before treatment(P<0.05). The observation group’s level of MTL was higher than that of the control group(P<0.05). The total effective rate of treatment in the observation group(92.00%,46/50) was higher than that in the control group(76.00%,28/50)(P<0.05). Conclusion Acupuncture at Tianshu(ST25) combined with mosapril on serum levels of VIP, MTL and 5-HT in patients with habitual constipation can significantly improve symptoms and serum levels of VIP, MTL and 5-HT and accelerate the recovery of intestinal function.