循经络穴位推拿联合速刺八髎穴治疗卒中后便秘临床研究

Clinical Study on Massage Along Meridians, Collaterals and Points Combined with Quick Needling at Baliao Point for Post-stroke Constipation

目的:观察循经络穴位推拿联合速刺八髎穴治疗卒中后便秘的临床疗效及对胃肠功能的影响。方法:采用随机数字表法将94例脑卒中后便秘患者分为对照组、治疗组各47例。2组均给予常规方法治疗,对照组联用速刺八髎穴治疗,治疗组在对照组基础上联用循经络穴位推拿治疗。比较2组临床疗效及治疗前后中医证候积分、便秘患者症状自评量表(PAC-SYM)评分、双歧杆菌、胃动素(MTL)、胃泌素(GAS)、直肠静息压、肛门静息压、模拟排便动作肛门收缩压水平。结果:治疗后,治疗组总有效率91.49%,高于对照组68.09%(P<0.05)。2组治疗后中医证候积分、PAC-SYM评分、MTL水平均较治疗前降低(P<0.05),双歧杆菌、GAS水平及直肠静息压、肛门静息压、模拟排便动作肛门收缩压升高(P<0.05);治疗组治疗后中医证候积分、PAC-SYM评分、MTL水平低于对照组(P<0.05),双歧杆菌、GAS及直肠静息压、肛门静息压、模拟排便动作肛门收缩压水平高于对照组(P<0.05)。结论:循经络穴位推拿联合速刺八髎穴治疗卒中后便秘疗效确切,能够调节患者胃肠激素水平,改善胃肠功能。

Objective:To observe the clinical effect of the therapy of massage along meridians,collaterals and points combined with quick needling at Baliao point on post-stroke constipation and its effect on the gastrointestinal function.Methods:A total of 94 patients with post-stroke constipation were divided into the control group and the treatment group according to the random number table method,with 47 cases in each group.The two groups were given routine treatment methods,the control group was additionally given quick needling at Baliao point and the treatment group was additionally treated with massage along meridians,collaterals and points based on the treatment of the control group.The clinical effects,traditional Chinese medicine(TCM)syndrome scores,scores of Patient Assessment of Constipation Symptoms(PAC-SYM),and levels of bifidobacteria,motilin(MTL),gastrin(GAS),rectal resting pressure,anal resting pressure and anal systolic blood pressure of simulated defecation before and after treatment were compared between the two groups.Results:After treatment,the total effective rate was 91.49%in the treatment group,higher than that of 68.09%in the control group(P<0.05).After treatment,the TCM syndrome scores,PAC-SYM scores and MTL levels in the two groups were decreased when compared with those before treatment(P<0.05),and the levels of bifidobacteria,GAS,rectal resting pressure,anal resting pressure and anal systolic blood pressure of simulated defecation were increased(P<0.05);the TCM syndrome score,PAC-SYM score and MTL level in the treatment group were lower than those in the control group(P<0.05),and the levels of bifidobacteria,GAS,rectal resting pressure,anal resting pressure and anal systolic blood pressure of simulated defecation were higher than those in the control group(P<0.05).Conclusion:The therapy of massage along meridians,collaterals and points combined with quick needling at Baliao point has a definite curative effect on post-stroke constipation,which can adjust the levels of gastrointestinal hormones and improve the gastrointestinal function.