针刺辨证治疗腹泻型肠易激综合征研究进展

Research Progress in Acupuncture Treating IBS-D Based on Syndrome Differentiation

腹泻型肠易激综合征(diarrhea-predominant irritable bowel syndrome,IBS-D)是一种慢性功能性胃肠疾病,是我国的常见病和多发病,由于其反复发作的特点,对患者生活质量有较大的影响,中医药治疗疗效显著。笔者检索针刺治疗IBS-D的相关文献发现,当前针刺辨证治疗主要为肝郁脾虚证及脾肾阳虚证的IBS-D患者,各证型取穴方法多样,未辨证多以调神针法治疗;针刺肝郁脾虚证IBS-D与调神针法治疗IBS-D的临床机制研究多聚焦于脑肠肽、肠道菌群及炎症因子;针刺辨证治疗IBS-D尚缺乏高质量的研究,不同取穴疗效及机制探讨尚需进一步验证。

Diarrhea-predominant irritable bowel syndrome(IBS-D)is a chronic functional gastrointestinal disease,which is a common and frequently occurring disease in China and has a great impact on life quality of the patients. TCM has a significant curative effect on IBS-D. This study reviewed relevant literature about acupuncture therapy for IBS-D. At present,the main syndrome of IBS-D treated by acupuncture are Liver stagnation and Spleen deficiency,as well as Yang-deficiency of Spleen and Kidney. There are various of acupoints selection for different syndrome,and regulating Shen is applied to IBS-D without syndrome differentiation. The clinical mechanism mainly focuses on brain-gut peptide,intestinal flora and inflammatory factors. However,it still lacks of high-quality studies on the treatment of IBS-D by acupuncture based on syndrome differentiation,and the discussion on efficacy and mechanism of different points selection needs further verification.