通腑调神针法治疗便秘型肠易激综合征:随机对照试验

Objective To observe the effects of bowls-unblocking and mind-regulating acupuncture therapy on constipation,anxiety,depression and serum neuropeptide Y(NPY)content for the patients with constipation-predominant irritable bowel syndrome(IBS-C).Methods Forty-two IBS-C patients were randomly assigned either into a bowls-unblocking and mind-regulating acupuncture group(acupuncture group)or a mosapride citrate group(medication group)with 21 cases in each group.During the treatment,one patient in the medication group was excluded and 20 patients were included in final statistical analysis;while 21 patients completed the trial in the acupuncture group.Before treatment,after treatment and in follow-up(1 month after the whole treatment),the scores of the Cleveland clinical constipation scoring system(CCS),the self-rating anxiety scale(SAS),and the self-rating depression scale(SDS)were assessed in both groups.The changes in NPY content were compared before and after treatment.Results①Total score of CCS:after treatment,the total score in the acupuncture group and the medication group were(4.76±2.10)points and(5.60±1.88)points,respectively,which were significantly lower than those before treatment in both groups(both P<0.05);and the difference in the score was not significant for the between-group comparison(P>0.05).In the follow-up,the total scores were(4.19±1.69)points in the acupuncture group,and was(6.35±2.06)points in the medication group.The score in the medication group was higher than that after treatment in the same group(P<0.05),but there was no significant difference between acupuncture group and the medication group(P>0.05).②SAS score:after treatment,the SAS scores were(50.24±2.19)points and(53.45±2.46)points in the acupuncture group and the medication group,respectively,which was lower than that before treatment in the two groups(both P<0.05);and the difference in the score was significant between two groups(P<0.05).In the follow-up,the scores were(51.95±2.27)points and(54.55±1.67)points in the acupuncture group and the medication group,respectively;which was lower than that before treatment in the two groups(both P<0.05),and the difference in the score was significant between two groups(P<0.05).③SDS score:after treatment,the SDS scores were(50.71±2.70)points and(53.15±2.25)points in the acupuncture group and the medication group,respectively,which was significantly lower than that before treatment in the two groups(both P<0.05);and the difference in the score was significant between the two group(P<0.05).In the follow-up,the score of the acupuncture group was(52.57±3.72)points and it was(56.60±2.42)points in the medication group,which was significantly lower than that before treatment in the two groups(both P<0.05);and the difference in the score was significant between the two groups(P<0.05).④Comparison of serum NPY content:after treatment,the serum NPY content of the acupuncture group and the medication group were(7.08±3.02)mmol/L and(9.89±3.82)mmol/L,respectively,which was significantly lower than that before treatment within each group(both P<0.05).The difference was significant between the two groups(P<0.05).⑤Effective rate:after treatment,the total effective rate was 95.24%in the acupuncture group and 90.00%in the medication group,without statistically significant difference(P>0.05).Conclusions bowls-unblocking and mind-regulating acupuncture therapy relieved the defecation-related symptoms,anxiety,and depression in IBS-C patients;and it was more effective on abdominal pain compared with mosapride citrate.Acupuncture therapy also had some long-term effect,which may be related to its regulatory effect on the serum NPY content.