穴位电刺激联合乳果糖治疗功能性便秘的临床疗效及对神经递质的影响

Clinical efficacy of transcutaneous electrical acupoint stimulation combine with lactulose in the treatment of functional constipation and its effect on neurotransmitters

目的探讨经皮穴位电刺激(transcutaneous electrical acupoint stimulation,TEAS)联合乳果糖治疗功能性便秘(functional constipation,FC)的临床效果及对神经递质的影响。方法选取2021年3月至2022年3月台州市第二人民医院收治的FC患者90例,采用随机数字表法分为乳果糖组(n=45)和联合组(n=45)。乳果糖组采用莫沙必利联合乳果糖治疗,联合组在乳果糖组基础上联合TEAS治疗,疗程均为4周。比较两组临床疗效、治疗前后便秘评分、中医症候积分和神经递质水平,观察两组治疗不良反应发生情况。结果治疗后,联合组疗效总有效率高于乳果糖组,差异有统计学意义(P<0.05);两组排便时间、大便性状、排便困难程度、肛门坠胀与不尽感、频率、腹胀评分均低于治疗前,且联合组低于乳果糖组,差异均有统计学意义(P<0.05);两组胸胁满闷、腹胀、肠鸣、排便不爽、矢气频评分低于治疗前,且联合组低于乳果糖组,差异均有统计学意义(P<0.05);两组的一氧化氮、血管活性肠肽、血清生长抑素水平均低于治疗前,且联合组低于乳果糖组,差异均有统计学意义(P<0.05);两组的不良反应发生率比较,差异无统计学意义(P>0.05)。结论TEAS联合乳果糖治疗FC效果肯定,能有效改善患者便秘严重程度,缓解临床症状,下调神经递质水平,安全性高。

Objective To investigate the clinical effect of transcutaneous electrical acupoint stimulation(TEAS)combine with lactulose in the treatment of functional constipation(FC)and its effect on neurotransmitters.Methods A total of 90 patients with FC admitted to Taizhou Second People's Hospital from March 2021 to March 2022 were selected and divided into the lactulose group(n=45)and the combined group(n=45)according to the random number table method.The lactulose group was treated with mosapride combined with lactulose,and the combination group was treated with TEAS on top of the lactulose group,and the duration of treatment was 4 weeks in both groups.The clinical efficacy,constipation score,traditional Chinese medicine(TCM)symptom score and neurotransmitter levels were compared between the two groups before and after treatment,and the occurrence of adverse effects were observed in both groups.Results After treatment,the overall efficacy of the combined group was higher than that in the lactulose group,with a statistically significant difference(P<0.05).The duration of defecation,stool properties,degree of difficulty in defecation,anal cramping and incompleteness,frequency and bloating scores were lower in both groups than before treatment,and the combined group was lower than those in the lactulose group,with statistically significant differences(P<0.05).The scores of chest fullness,abdominal distension,bowel rumbling,dyspareunia and sagittal frequency were lower in both groups than before treatment,and were lower in the combined group than those in the lactulose group,and the differences were statistically significant(P<0.05);the levels of nitric oxide,vasoactive intestinal peptide and serum growth inhibitory hormone were lower in both groups than before treatment,and were lower in the combined group than those in the lactulose group,with statistically significant differences(P<0.05);the incidence of adverse reactions in the two groups were compared The difference was not statistically significant(P>0.05).Conclusion TEAS combine with lactulose has a positive effect in treating FC,which can effectively improving the severity of constipation,relieving clinical symptoms,and downregulating neurotransmitter levels, with high safety.