灸法对肠易激综合征慢性内脏痛镇痛效应的研究与展望

背景：慢性内脏痛是肠易激综合征患者最主要的临床表现之一，患者的生活质量受到严重影响。近年研究表明，灸法对肠易激综合征患者慢性内脏痛的治疗取得了一定的进展。 目的：全面了解灸法对肠易激综合征患者慢性内脏痛镇痛效应的临床疗效，并对今后灸法镇痛在此领域的应用与研究发展趋势进行思考和展望，以期为今后灸法的进一步推广和应用提供一定的理论依据。 方法：以“灸法，肠易激综合征患者，内脏痛，腹痛”为中文检索词，以“moxibustion，irritable bowel syndrome，visceral pain，abdominal pain”为英文检索词，应用计算机在中国知网、维普、万方和PubMed数据库检索1990年1月至2014年10月的临床研究文献，并进行筛选、归纳与总结。 结果与结论：灸法对肠易激综合征腹泻型和便秘型患者慢性腹痛症状均有较好的镇痛效应。灸法对肠易激综合征慢性内脏痛的镇痛效应的可能是通过调节其内脏高敏感、胃肠动力障碍、脑-肠轴和神经-内分泌系统失调、免疫功能紊乱和肠道低度炎症、精神心理异常以及肠道菌群失调等产生。今后还需要更严格的随机对照试验设计同时借助现代科学定量评定内脏痛的先进设备和技术，进一步验证灸法镇痛的临床疗效并深入探讨其作用原理。 中国组织工程研究杂志出版内容重点：组织构建；骨细胞；软骨细胞；细胞培养；成纤维细胞；血管内皮细胞；骨质疏松；组织工程全文链接：

Moxibustion therapy for chronic abdominal pain due to irritable bowel syndrome

BACKGROUND:Chronic visceral pain is one of major complaints of irritable bowel syndrome which seriously affects patient’s quality of life. Recent researches have shown that moxibustion therapy has positive effects on alleviating chronic visceral pain in irritable bowel syndrome patients. OBJECTIVE:To study the clinical utility of moxibustion in coping with chronic visceral pain of irritable bowel syndrome patients, and shed light on the theoretical basis of moxibustion analgesia, thereby to give insights into the further research and application on moxibustion. METHODS:With the key words of “moxibustion, irritable bowel syndrome, visceral pain, abdominal pain” in Chinese and in English, respectively, a computer-based search was performed in CNKI, VIP, Wanfang and PubMed databases for articles published from January 1990 to October 2014. After the initial screening, the remained articles went through further selection and categorization. RESULTS AND CONCLUSION:The result shows promising results of moxibustion on relieving chronic visceral pain for both two subtypes of irritable bowel syndrome patients, diarrhea type and constipation type. Moxibustion may exert an analgesic effect on chronic visceral pain in irritable bowel syndrome patients through regulation of visceral hypersensitivity, gastrointestinal motility disorders, brain-gut axis and neuroendocrine system disorders, immune dysfunction and low-grade inflammation in the gut, psychological abnormalities, and alteration of intestinal flora. However, to fully understand the analgesia effect of moxibustion and elucidate its mechanism, more standardized randomized controlled trials employing advanced scientific techniques and equipments will still be needed in the future.