尺肤针结合中药疗法治疗腹泻型肠易激综合征临床研究

Clinical Study of Irritable Bowel Syndrome with Diarrhea Treated with Chifu Acupuncture Combined with Chinese Medicine

目的:分析探讨尺肤针介入中药疗法对腹泻型肠易激综合征(IBS-D)患者的临床效果及对其疼痛管理、血清γ-干扰素(IFN-γ)、5-羟色胺(5-HT)水平的影响。方法:选取2019年7月至2021年7月邯郸市中医院收治的351例IBS-D患者为治疗对象,按随机数字表法分为针药组、中药组、西药组,每组患者117例。西药组以匹维溴铵片治疗,中药组在西药组基础上以痛泻逍遥方内服治疗,针药组在中药组基础上以尺肤针介入治疗。比较三组患者临床疗效、症状及疼痛程度评分、血清学指标水平、肠道屏障功能指标、治疗安全性。结果:针药组总有效率为91.45%(107/117),高于中药组的82.05%(96/117),且高于西药组的75.21%(88/117)(P<0.05)。治疗后针药组患者中医证候评分、腹胀评分、腹泻评分、腹痛评分均低于中药组、西药组(P<0.05)。治疗后与治疗前比较,三组IFN-γ、5-HT水平均有降低(P<0.01),且治疗后针药组IFN-γ、5-HT表达水平均低于中药组、西药组(P<0.05)。治疗后针药组患者的D-乳酸(D-LA)、二胺氧化酶(DAO)、细菌内毒素(ET)水平均低于中药组、西药组(P<0.05)。治疗期间三组患者的不良反应发生率为9.40%(11/117)、6.84%(8/117)、5.98%(7/117)(P>0.05)。结论:尺肤针介入中药疗法对IBS-D患者有良好的治疗效果,能有效缓解患者的症状和疼痛程度,抑制患者IFN-γ、5-HT表达,改善患者肠道黏膜屏障功能,有较好的安全性。

Objective:To analyze and explore the clinical effect of Chifu acupuncture combined with Chinese medicinal treatment on irritable bowel syndrome with diarrhea(IBS-D),and influence on pain management and levels of serum interferon-γ(IFN-γ)and 5-hydroxytryptamine(5-HT).Methods:From July 2019 to July 2021,351 patients with IBS-D hospitalized in Handan Hospital of Traditional Chinese Medicine were divided into three groups,acupuncture and drug group,Chinese medicinal group and western medicine group by random number table method,117 patients in each group.The western medicine group was treated with naverium bromide tablets,the Chinese medicinal group was treated with Tongxie Xiaoyao Formula besides the medicine in western medicine group,and the acupuncture drug group was treated with Chifu acupuncture besides the treatment in the Chinese medicinal group.The clinical efficacy,symptom and pain degree score,intestinal mucosal barrier function index,serological index level and treatment safety of the three groups were statistically compared.Results:In the acupuncture and drug group,total effective rate was 91.45%(107/117),higher than that in Chinese medicinal group,82.05%(96/117),and higher than that in western medicine group,75.21%(88/117)(P<0.05).The symptom scores of the three groups were improved compared with those before treatment,and the traditional Chinese medicine(TCM)symptom score,abdominal distension score,diarrhea score and abdominal pain score in the acupuncture and drug group were lower than those in the Chinese medicinal group and western medicine group after treatment(P<0.05).The levels of IFN-γand 5-HT in the three groups decreased after treatment compared with before treatment(P<0.01),and the expression levels of IFN-γand 5-HT in the acupuncture drug group were lower than those in the Chinese medicinal group and western medicine group(P<0.05).After treatment,the levels of D-lactic acid(D-LA),diamine oxidase(DAO)and bacterial endotoxin in the acupuncture and drug group were lower than those in the Chinese medicinal group and the western medicine group(P<0.05).The incidence of adverse reactions in the three groups during treatment was 9.40%(11/117),6.84%(8/117)and 5.98%(7/117),respectively(P>0.05).Conclusions:Chifu acupuncture combined with Chinese medicinal treatment is of good therapeutic effect on IBS-D.It could effectively alleviate the symptoms and pain degree of patients,inhibit the expression level of IFN-γ,5-HT,and improve the intestinal mucosal barrier function,with high safety.