经皮穴位电刺激治疗出口梗阻型便秘疗效观察及对血清VIP、NO含量的影响

Efficacy Observation of Transcutaneous Electrical Acupoint Stimulation for Outlet Obstructive Constipation and Its Effects on Serum VIP and NO Contents

目的观察经皮穴位电刺激(TEAS)治疗出口梗阻型便秘(OOC)的临床疗效及对血清中血管活性肠肽(VIP)、一氧化氮(NO)含量影响。方法将90例OOC患者随机分为研究组和对照组,每组45例。研究组采用TEAS治疗,对照组口服聚乙二醇4000散。观察两组治疗前后便秘症状评分、直肠肛管测压指标及血清VIP和NO含量变化,并比较两组临床疗效。结果两组治疗后便秘症状评分均明显下降(P<0.05),且研究组低于对照组(P<0.05);两组治疗后直肠肛门压力差较治疗前明显增加(P<0.05),且研究组高于对照组(P<0.05);两组治疗后直肠初始感觉阈值和直肠排便感阈值均降低(P<0.05),且研究组低于对照组(P<0.05)。两组治疗后血清VIP、NO含量降低(P<0.05),且研究组低于对照组(P<0.05)。研究组总有效率为86.7%,高于对照组的66.7%(P<0.05)。结论TEAS通过降低OOC患者直肠初始感觉阈值、排便感觉阈值,增加直肠肛门压力梯度,改善便秘症状,可能与其调控血清VIP、NO的释放有关。

Objective To observe the clinical efficacy of transcutaneous electrical acupoint stimulation(TEAS)in treating outlet obstructive constipation(OOC)and its effects on the serum vasoactive intestinal peptide(VIP)and Nitric oxide(NO)contents.Method Ninety OOC patients were randomized into a research group and a control group,with 45 cases in each group.The research group was treated with TEAS,and the control group was given oral administration of Macrogol 4000 powder.Before and after treatment,the constipation symptom score,anorectal manometric assessment parameters and serum VIP and NO contents in both groups were observed.The clinical efficacy was also compared between the two groups.Result The constipation symptom score dropped notably after treatment in both groups(P<0.05),and was lower in the research group than in the control group(P<0.05);the anorectal pressure difference increased significantly after treatment in both groups(P<0.05),and was higher in the research group than in the control group(P<0.05);the initial perception threshold(IPT)and defecation sensation threshold of the rectum declined after treatment in both groups(P<0.05),and were lower in the research group than in the control group(P<0.05).The serum VIP and NO contents decreased after treatment in the two groups(P<0.05)and were lower in the research group than in the control group(P<0.05).The total effective rate was 86.7%in the research group,higher than 66.7%in the control group(P<0.05).Conclusion TEAS improves constipation symptoms via reducing the IPT and defecation sensation of the rectum,while increasing the anorectal pressure gradient in OOC patients,which may be associated with the regulation of the release of serum VIP and NO.