浮针联合西药治疗肠易激综合征的临床观察

Clinical Study on the Fu’s Subcutaneous Needling Combined with WesternMedicine in the Treatment of Irritable Bowel Syndrome

【目的】观察浮针联合西药治疗肠易激综合征(IBS)的临床疗效。【方法】将112例肠易激综合征患者随机分为观察组和对照组,每组各56例,对照组给予常规西药治疗,观察组在对照组治疗的基础上联合中医浮针治疗。连续治疗4周。治疗1个月后,评价2组临床疗效,观察2组患者治疗前后肠易激综合征严重程度评测(IBS-SSS)量表评分的变化情况,以及治疗后2组患者腹痛、腹胀与腹泻症状消退的时间,比较2组患者治疗前后排便阈值、疼痛阈值、感觉阈值的变化情况,以及双歧杆菌、乳杆菌、肠杆菌、拟杆菌等肠道菌群数量的变化情况。观察2组患者血管活性肠肽、胃动素、P物质水平的变化情况。并评价2组的安全性及不良反应的发生情况。【结果】(1)观察组总有效率为96.43%(54/56),对照组为83.93%(47/56)。观察组疗效优于对照组,差异有统计学意义(P<0.05)。(2)观察组患者腹痛、腹胀与腹泻症状消退时间明显短于对照组,与对照组比较,差异有统计学意义(P<0.05)。(3)治疗后,2组患者排便阈值、疼痛阈值、感觉阈值均明显改善(P<0.05),且观察组改善排便阈值、疼痛阈值、感觉阈值方面明显优于对照组,差异有统计学意义(P<0.05)。(4)治疗后,2组患者双歧杆菌、乳杆菌、肠杆菌、拟杆菌数量均明显改善(P<0.05),且观察组改善双歧杆菌、乳杆菌、肠杆菌、拟杆菌数量方面明显优于对照组,差异有统计学意义(P<0.05)。(5)治疗后,2组患者血管活性肠肽、胃动素、P物质水平均明显改善(P<0.05),且观察组在改善血管活性肠肽、胃动素、P物质水平方面明显优于对照组,差异均有统计学意义(P<0.05)。(6)2组不良反应发生率比较,差异无统计学意义(P>0.05)。【结论】浮针联合西药治疗肠易激综合征,可明显缩短患者临床症状的缓解时间,强化患者的胃肠道功能,调节肠道菌群数量并改善胃肠黏膜屏障的功能,疗效显著。

Objective To explore the clinical effect of Fu’s subcutaneous needling combined with western medicine in the treatment of irritable bowel syndrome(IBS).Methods A total of 112 patients with IBS were randomly divided into the observation group and the control group,with 56 patients in each group.The control group was given conventional western medicine treatment,and the observation group was treated with Chinese medicine Fu’s subcutaneous needling on the basis of the treatment in the control group.Both groups were treated for 4 consecutive weeks.After 1 month of treatment,the clinical efficacy of the two groups was evaluated,and the changes in the IBS system severity system(IBS-SSS)scores were observed before and after the treatment,as well as the time of the symptoms of abdominal pain,bloating and diarrhoea subsiding in the two groups,and the changes in the defecation thresholds,pain thresholds,sensory thresholds and the changes in the numbers of intestinal flora such as Bifidobacterium,Lactobacillus,Enterobacteriaceae,and Bacteriodendrobacteriaceae in the two groups were compared.The changes in the levels of vasoactive intestinal peptide,gastric motility and substance P were observed in the two groups.The safety and occurrence of adverse reactions were also evaluated in the two groups.Results(1)The total effective rate of the observation group was 96.43%(54/56),and the control group was 83.93%(47/56).The efficacy of the observation group was superior to that of the control group,and the difference was statistically significant(P<0.05).(2)The time for abdominal pain,abdominal distension and diarrhoea to subside was significantly shorter in the observation group than in the control group,and the difference was statistically significant when compared with the control group(P<0.05).(3)After treatment,the defecation threshold,pain threshold,and sensation threshold of patients in the two groups were significantly improved(P<0.05),and the observation group was significantly superior to the control group in terms of improving defecation threshold,pain threshold,and sensation threshold,and the difference was statistically significant(P<0.05).(4)After treatment,the numbers of Bifidobacterium,Lactobacillus,Enterobacter,Bacteroides were significantly improved in the two groups(P<0.05),and the observation group was significantly superior to the control group in terms of improving the numbers of Bifidobacterium,Lactobacillus,Enterobacter and Bacteroides,and the difference was statistically significant(P<0.05).(5)After treatment,the levels of vasoactive intestinal peptide,gastric actin,and substance P of the patients in the two groups were significantly improved(P<0.05),and the observation group was significantly superior to the control group in improving the levels of vasoactive intestinal peptide,gastric actin,and substance P,and the differences were all statistically significant(P<0.05).(6)There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Fu’s subcutaneous needling combined with western medicine in the treatment of IBS can significantly shorten the relief time of patients’clinical symptoms,strengthen patients’gastrointestinal function,regulate the number of intestinal flora and improve the function of gastrointestinal mucous membrane barrier,and the therapeutic efficacy is remarkable.