艾灸疗法对脾肾阳虚型腹膜透析患者胃肠功能障碍的影响

Effect of Moxibustion Therapy on Gastrointestinal Dysfunction in Peritoneal Dialysis Patients with Spleen and Kidney Yang Deficiency Type

目的:观察艾灸疗法对脾肾阳虚型腹膜透析患者胃肠功能障碍的疗效,并探讨相关机制。方法:将72例脾肾阳虚型腹膜透析胃肠功能障碍患者按随机数字表法分为对照组和艾灸组各36例,最终69例患者完成研究,对照组35例,艾灸组34例。两组患者均接受西医常规基础治疗,艾灸组患者在此基础上接受艾灸足三里、三阴交治疗。两组均以4周为1个疗程,持续治疗3个疗程。比较两组治疗前后的胃肠道症状分级量表(GSRS)评分、主观整体营养评估(SGA)评分及血清胃泌素(GAS)、胃动素(MOT)、胆囊收缩素(CCK)水平,评价两组胃肠道症状疗效。结果:治疗后,两组GSRS评分均较治疗前降低,SGA评分均较治疗前升高,血清GAS、MOT、CCK水平均较治疗前降低,差异均有统计学意义(P<0.01)。治疗后,艾灸组GSRS评分低于对照组,SGA评分高于对照组,血清GAS、MOT、CCK水平低于对照组,差异均有统计学意义(P<0.05)。艾灸组胃肠道症状总有效率高于对照组,两组胃肠道症状疗效比较,差异有统计学意义(P<0.05)。结论:艾灸疗法能缓解脾肾阳虚型腹膜透析患者的胃肠道症状,改善其营养状态,作用机制可能与调节GAS、MOT、CCK水平有关。

Objective:To observe the curative efficacy of moxibustion therapy on gastrointestinal dysfunction in peritoneal dialysis patients with spleen and kidney yang deficiency type,and explore the related mechanisms.Methods:A total of 72 peritoneal dialysis patients with gastrointestinal dysfunction(spleen and kidney yang deficiency type)were randomly divided into the control group and the moxibustion group,with 36 patients in each group.In the end,69 patients completed the study,including 35 in the control group and 34 in the moxibustion group.The patients in both groups received conventional basic treatment in western medicine,supplemented with moxibustion at Zusanli(ST36)and Sanyinjiao(SP6)acupoints for the moxibustion group.The two groups were treated for three courses,with each course lasting 4 weeks.Comparisons were made between the two groups in the scores of the Gastrointestinal Symptom Rating Scale(GSRS),Subjective Global Assessment(SGA),and levels of serum gastrin(GAS),motilin(MOT),and cholecystokinin(CCK)before and after treatment.The curative efficacy for gastrointestinal symptoms was evaluated in both groups.Results:After treatment,the GSRS score and serum levels of GAS,MOT,and CCK in both groups were lower than those before treament(P<0.01),and the SGA score in both groups was higher than that before treament(P<0.01).After treatment,the GSRS score in the moxibustion group was lower than that in the control group(P<0.01),while the SGA score was higher.The serum levels of GAS,MOT,and CCK were also lower in the moxibustion group compared to those in the control group.All the above differences were statistically significant(P<0.05).The total effective rate of gastrointestinal symptoms in the moxibustion group was higher than that in the control group,and there was a statistically significant difference between the two groups in terms of curative efficacy on gastrointestinal symptoms(P<0.05).Conclusions:Moxibustion therapy can alleviate gastrointestinal symptoms and improve nutritional status in peritoneal dialysis patients with gastrointestinal dysfunction(spleen and kidney yang deficiency type).Its mechanisms may be related to the regulation of serum levels of GAS,MOT,and CCK.