温肾健脾法联合耳穴埋豆对腹泻型肠易激综合征的疗效观察

Clinical Observation of Warming Kidney and Strengthening Spleen Method Combined with Seed-Embedding at Ear Acupoints in Patients with Diarrhea-Type Irritable Bowel Syndrome

目的探讨温肾健脾法联合耳穴埋豆对腹泻型肠易激综合征(diarrhea-predominant irritable bowel syndrome,IBS-D)患者的临床疗效。方法选择中国中医科学院望京医院于2020年6月—2022年6月收治的IBS-D患者104例为研究对象,依据随机数表法,分为对照组和观察组各52例。对照组接受温肾健脾法治疗,观察组在对照组的基础上接受耳穴埋豆。治疗4周后,比较两组临床疗效、症状评分、肠易激综合征生活质量评分(irritable bowel syndrome-quality of life,IBS-QOL)及胃肠激素[包括血清5-羟色胺(5-hydroxy tryptamine,5-HT)、血管活性肠肽(vasoactive intestinal peptide,VIP)、P物质(substance P,SP)、生长抑素(somatostatin,SS)、胆囊收缩素(cholecystokinin,CCK)]水平。结果观察组总有效率明显高于对照组,差异有统计学意义(P<0.05);治疗前,两组症状及IBS-QOL评分相比,差异无统计学意义(P>0.05);治疗后,两组症状评分明显低于治疗前,IBS-QOL评分明显高于治疗前,且观察组症状评分明显低于对照组,IBS-QOL评分明显高于对照组,差异有统计学意义(P<0.05);治疗前,两组5-HT、VIP、SP、SS、CCK水平相比,差异无统计学意义(P>0.05);治疗后,观察组5-HT、VIP、SP、CCK水平明显低于对照组,SS水平明显高于对照组,差异有统计学意义(P<0.05)。结论温肾健脾法联合耳穴埋豆应用于IBS-D患者可显著提升临床疗效,改善症状及生活质量评分,同时还能有效改善胃肠激素水平,值得推广应用。

Objective To investigate the clinical effect of warmingkidney and strengtheningspleen method combined with seed-embedding at ear acupoints on diarrhea-predominant irritable bowel syndrome(IBS-D).Methods A total of 104 patients with IBS-D who were admitted to Wangjing Hospital ofChinese Academy of Chinese Medical Sciences from March 2021 to June 2022 were selected as the research subjects,and were divided into a control group and an observation group according to the random number table method,with 52 cases in each group.The control group received the intervention of warmingkidney and strengtheningspleen,and the observation group received the intervention of seed-embedding at ear acupoints on the basis of the control group.After 4 weeks of treatment,the clinical efficacy,symptom score,IBS quality of life score(IBS-QOL)and gastrointestinal hormones[serotonin(5-HT),vasoactive intestinal peptide(VIP),substance P(SP)],somatostatin(SS)and cholecystokinin(CCK)]were compared between the two groups.Results The total effective rate in the observation group was significantly higher than that in the control group,and the difference was statistically significant(P<0.05).Before treatment,there were no significant difference in symptoms or IBS-QOL scores between the two groups(P>0.05).The symptom scores of the two groups were significantly lower than those before treatment,and the IBS-QOL scores were significantly higher than those before treatment,and the symptom scores of the observation group were significantly lower than those of the control group,and the IBS-QOL scores were significantly higher than those of the control group(P<0.05).Before treatment,there were no significant difference in the levels of 5-HT,VIP,SP,SS or CCK between the two groups(P>0.05).After treatment,the levels of 5-HT,VIP,SPand CCK in the observation group were significantly lower than the control group,the level of SS was significantly higher than that in the control group,and the difference were statistically significant(P<0.05).Conclusion The combination of warmingkidney and strengtheningspleen combined with seed-embedding at ear acupoints in patients with IBS-D can significantly improve the clinical efficacy,the symptoms and the quality of lifeand canalso effectively improve the levels of gastrointestinal hormones,worthy of popularization and application.