针刺配合雷火灸治疗脾虚泄泻型肠易激综合征临床疗效观察

目的:观察针刺配合雷火灸治疗脾虚泄泻型肠易激综合征(IBS)的临床疗效。方法:选取2017年9月—2018年6月我院肛肠科门诊收治脾虚泄泻型肠易激综合征患者90例,按随机法分为针灸组(针刺加雷火灸)、针刺组及西药组(匹维溴胺),每组30例。观察各组患者临床疗效、治疗前后症状积分、生活质量积分以及血清脑肠肽水平变化。结果:针灸组总体临床疗效优于针刺组及西药组(P<0.05),而针刺组总体有效率与针灸组相比未见明显差异(P>0.05)。治疗后各组患者IBS总体症状及生活质量评分较治疗前均有明显改善,其中针刺组效果最佳。与西药治疗组比较,针刺组、针灸组患者血清SP、5-HT表达水平明显下降(P<0.01),而血清VIP表达水平显著上升(P<0.01)。结论:针刺加雷火灸可能是通过降低IBS患者血清SP、5-HT表达水平,上调VIP表达水平,改善IBS患者症状,起到治疗的作用。

Clinical Observation on Acupuncture Combined with Thunder-Fire Moxibustion in Treating IBS of Spleen-Deficiency Diarrhea

Objective:To observe the clinical effect of acupuncture combined with thunder-fire moxibustion on irritable bowel syndrome(IBS)of spleen-deficiency diarrhea.Methods:90 IBS cases of spleen-deficiency diarrhea were randomly divided into the acupuncture group,the combination group(acupuncture and thunder-fire moxibustion)and the western medication group(piaverium bromide),with 30 cases in each group.The clinical efficacy,symptom scores,scores of quality of life and serum level of brain-gut peptide were observed in each group before and after the treatment.Results:The overall clinical effect of the combination group was better than that of the western medication group(P<0.05);however there was no statistical difference in the overall effective rate between the acupuncture group and the combination group(P>0.05).The overall symptoms of IBS and the scores of quality of life were significantly improved in the three groups after the treatment compared to those before the treatment;of which the acupuncture group had the best effect.The serum levels of SP and 5-HT were significantly decreased in the acupuncture group and in the combination group compared to those in the western medication group(P<0.01),whereas the serum level of VIP was significantly increased(P<0.01).Conclusion:Acupuncture combined with thunder-fire moxibustion may play a therapeutic role by reducing the serum levels of SP and 5-HT and increasing the VIP level to improve symptoms in IBS patients.