基于脑-肠相通理论观察醒脑调神针刺法治疗腹泻型肠易激综合征临床研究

Clinical Study on Xingnao Tiaoshen Acupuncture Method for Diarrhea-Predominant Irritable Bowel Syndrome Based on Brain-Intestine Connection Theory

目的:基于脑-肠相通理论观察醒脑调神针刺法治疗腹泻型肠易激综合征(IBS-D)的临床疗效。方法:选取110例脾肾阳虚证IBS-D患者,按随机数字表法分为对照组和观察组各55例。对照组给予常规西药治疗,观察组在对照组基础上给予醒脑调神针刺法治疗。比较2组临床疗效、肠易激综合征症状严重程度量表(IBS-SSS)评分、胃肠激素指标[生长抑素(SS)、血管活性肠肽(YIP)]、血清炎症因子[白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、白细胞介素-8(IL-8)]、肠道菌群变化、肠易激综合征生活质量量表(IBS-QOL)评分、不良反应总发生率。结果:观察组总有效率为96.36%,高于对照组74.55%(P<0.05)。治疗后,2组生活干扰度、排便满意度、腹胀程度、腹痛天数、腹痛程度评分及总分均较治疗前降低(P<0.05),且观察组各项评分均低于对照组(P<0.05)。治疗后,2组血清SS、VIP、IL-6、TNF-α、IL-8水平较治疗前降低(P<0.05),且观察组血清SS、VIP、IL-6、TNF-α、IL-8水平低于对照组(P<0.05)。治疗后,2组肠球菌、肠杆菌门丰度较治疗前降低,乳酸杆菌、双歧杆菌门丰度较治疗前升高(P<0.05);且观察组肠球菌、肠杆菌门丰度均低于对照组,乳酸杆菌、双歧杆菌门丰度均高于对照组(P<0.05)。治疗后,2组IBS-QOL评分较治疗前升高(P<0.05),且观察组IBS-QOL评分高于对照组(P<0.05)。2组不良反应总发生率比较,差异无统计学意义(P>0.05)。结论:醒脑调神针刺法可有效调节IBS-D患者肠道菌群及胃肠激素分泌,缓解腹痛等腹部不适症状,减轻炎症反应,提高生活质量,安全可靠。

Objective:To observe the clinical effect of the Xingnao Tiaoshen acupuncture method for diarrhea-predominant irritable bowel syndrome(IBS-D)based on brain-intestine connection theory.Methods:A total of 110 cases of IBS-D patients with spleen-kidney yang deficiency syndrome were selected and divided into the control group and the observation group according to the random number table method,with 55 cases in each group.The control group was given conventional western medicine treatment,and the observation group was additionally treated with the Xingnao Tiaoshen acupuncture method based on the treatment of the control group.Clinical effects,scores of Irritable Bowel Syndrome Severity Scoring System(IBS-SSS),gastrointestinal hormone indicators[somatostatin(SS)and vasoactive intestinal peptide(YIP)],serum inflammatory factors[interleukin-6(IL-6),tumor necrosis factor-α(TNFα),and Interleukin-8(IL-8)],changes in the intestinal flora,scores of Irritable Bowel Syndrome Quality of Life(IBS-QOL)questionnaire,and the total incidence of adverse reactions were compared between the two groups.Results:The total effective rate was 96.36%in the observation group,higher than that of 74.55%in the control group(P<0.05).After treatment,the scores of interference with life,dissatisfaction with bowel habits,the severity of abdominal distension,presence of abdominal pain,and severity of abdominal pain,as well as the total scores in the two groups were decreased when compared with those before treatment(P<0.05),and each score in the observation group was lower than that in the control group(P<0.05).After treatment,the levels of SS,VIP,IL-6,TNF-α,and IL-8 in serum in the two groups were decreased when compared with those before treatment(P<0.05),and the levels of SS,VIP,IL-6,TNF-α,and IL-8 in serum in the observation group were lower than those in the control group(P<0.05).After treatment,the abundance of Enterococcus and Enterobacteriaceae in the two groups was decreased when compared with that before treatment,and the abundance of Lactobacillus and Bifidobacteria was increased when compared with that before treatment(P<0.05);the abundance of Enterococcus and Enterobacteriaceae in the observation group was lower than that in the control group,and the abundance of Lactobacillus and Bifidobacteria in the observation group was higher than that in the control group(P<0.05).After treatment,the IBS-QOL scores in the two groups were increased when compared with those before treatment(P<0.05),and the IBS-QOL scores in the observation group were higher than those in the control group(P<0.05).There was no significant difference in the comparison of the total incidence of adverse reactions between the two grorups(P>0.05).Conclusion:The Xingnao Tiaoshen acupuncture method can effectively regulate the intestinal flora and secretion of gastrointestinal hormones in IBS-D patients,alleviate abdominal discomfort symptoms such as abdominal pain,relieve inflammatory reactions,and improve quality of life.It is safe and reliable.