西药联合健脾调神配穴法针刺治疗IBS-D 52例临床观察

Clinical Observation on 52 Cases of IBS-D Treated by Acupuncture Combined with Western Medicine

目的:观察西药联合健脾调神配穴法针刺治疗腹泻型肠易激综合征(IBS-D) 52例临床疗效。方法:选取103例IBS-D患者作为研究对象,随机分为对照组和观察组。对照组51例给予服用匹维溴铵片治疗,观察组52例给予联合健脾调神配穴法针刺治疗,对比两组症状改善效果、实验室指标、HPA轴相关因子水平。结果:两组治疗2个月后排便满意度、腹胀程度、生活干扰、腹痛程度、腹痛频率、肠易激综合征症状严重程度量表(IBS-SSS)评分水平较治疗前均降低,且观察组低于对照组(P <0. 05)。两组治疗2个月后胃动素(MTL)水平较治疗前均降低,且观察组低于对照组;脑源性神经营养因子(BDNF)水平较治疗前均升高,且观察组高于对照组(P <0. 05)。两组治疗2个月后促肾上腺皮质激素释放因子(CRF)、促肾上腺皮质激素(ACTH)、皮质酮(CORT)水平较治疗前均降低,且观察组低于对照组;分泌型免疫球蛋白A (SIg A)水平较治疗前均升高,且观察组高于对照组(P <0. 05)。结论:西药联合健脾调神配穴法针刺治疗IBS-D患者,通过拮抗HPA轴活化,调节HPA轴相关因子水平,调控症状改善结果,改善实验室指标,提高临床疗效。

Objective To explore the clinical observation of 52 cases of diarrhea-type irritable bowel syndrome( IBS-D) treated by acupuncture combined with Western medicine. Methods 103 patients with IBS-D in our hospital were selected as research objects,and divided into control group and observation group according to different treatment methods. Fifty-one patients in the control group were treated with Piveronium bromide tablets,and 52 patients in the observation group were treated with acupuncture combined with spleen-invigorating tiaoshen acupoint method. The improvement effect,laboratory indicators and HPA axis related factors of the two groups were compared. Results Compared with before treatment,the satisfaction of defecation,degree of abdominal distention,life disturbance,degree of abdominal pain,frequency of abdominal pain and IBS-SSS score of patients in 2 groups after 2 months were decreased,and the observation group was lower than the control group( P < 0. 05). The level of motilin( MTL) in 2 groups was lower than that before treatment after 2 months,and the observation group was lower than the control group. The level of brain-derived neurotrophic factor( BDNF) was higher than that before treatment,and the observation group was higher than the control group( P <0. 05). The levels of adrenocorticotropin-releasing factor( CRF),adrenocorticotropin( ACTH) and corticosterone( CORT) in 2groups after 2-months-treatment were lower than before,and the observation group was lower than the control group. The level of secreted immunoglobulin A( SIg A) was higher than that before treatment,and the observation group was higher than the control group( P < 0. 05). Conclusion Spleen-invigorating shen-tonifying acupoint acupuncture treatment for PATIENTS with IBS-D can antagonize HPA axis activation,regulate HPA axis related factors,regulate symptom improvement results,improve laboratory indicators,and improve clinical efficacy.