温针灸对功能性便秘患者临床症状及焦虑抑郁的改善作用
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摘要
目的:探讨温针灸对功能性便秘(FC)患者临床症状及焦虑抑郁的改善作用。方法:选取2017年1月至2017年12月中国中医科学院广安门医院南区收治的FC患者70例作为研究对象,随机分为观察组和对照组,每组35例。对照组采用常规针刺治疗,观察组采用温针灸治疗,比较治疗前后2组患者便秘临床症状积分、首次排便时间、中医证候评分、焦虑自评量表(SAS)、抑郁自评量表(SDS)评分。结果:观察组有效率96. 00%,对照组有效率68. 00%,差异有统计学意义(P<0. 05)。治疗后2组患者的周排便次数、粪便性状积分和排便困难程度均改善,中医证候评分、SAS和SDS评分下降,较治疗前差异有统计学意义(P <0. 05)。治疗后,观察组患者的周排便次数、粪便性状积分高于对照组,中医证候评分、SDS和SAS评分、首次排便时间以及排便困难程度积分小于对照组,差异有统计学意义(P <0. 05)。结论:温针灸治疗能调节胃肠道运动、润湿肠道、显著改善便秘等临床症状,对FC患者有显著临床效果。
Objective: To evaluate the improvement of clinical symptoms and anxiety-depression in patients with functional constipation( FC) using warming acupuncture. Methods: A total of 70 patients with FC in Guang'anmen Hospital South District,China Academy of Chinese Medical Sciences from January 2017 to December 2017 were randomly divided into the observation group and the control group,with 35 cases in each group. The observation group was treated with warming acupuncture,while the control group was treated with conventional acupuncture. The constipation clinical symptom score,first defecation time,TCM syndrome score,SAS and SDS score were compared between the 2 groups before and after treatment. Results: The total effective rate was 96. 00% in the observation group,and 68. 00% in the control group,with statistically significant difference( P < 0. 05). After treatment,the weekly defection times,fecal character score,the difficulty in defecation of the 2 groups were improved. The TCM syndrome score,SAS and SDS score in the 2 groups were decreased than before treatment,with statistically significant difference( P < 0. 05). After treatment,the weekly defection times and fecal character score of the observation group were higher than the control group. TCM syndrome score,SAS and SDS score,first defecation time,and the difficulty in defecation in the observation group were significantly lower than those in the control group,with statistically significant difference( P < 0. 05). Conclusion: Warm acupuncture can regulate gastrointestinal movement,moisten the intestines and significantly improve the constipation and other clinical symptoms. Also,it has significant clinical effect on FC.
Objective: To evaluate the improvement of clinical symptoms and anxiety-depression in patients with functional constipation( FC) using warming acupuncture. Methods: A total of 70 patients with FC in Guang'anmen Hospital South District,China Academy of Chinese Medical Sciences from January 2017 to December 2017 were randomly divided into the observation group and the control group,with 35 cases in each group. The observation group was treated with warming acupuncture,while the control group was treated with conventional acupuncture. The constipation clinical symptom score,first defecation time,TCM syndrome score,SAS and SDS score were compared between the 2 groups before and after treatment. Results: The total effective rate was 96. 00% in the observation group,and 68. 00% in the control group,with statistically significant difference( P < 0. 05). After treatment,the weekly defection times,fecal character score,the difficulty in defecation of the 2 groups were improved. The TCM syndrome score,SAS and SDS score in the 2 groups were decreased than before treatment,with statistically significant difference( P < 0. 05). After treatment,the weekly defection times and fecal character score of the observation group were higher than the control group. TCM syndrome score,SAS and SDS score,first defecation time,and the difficulty in defecation in the observation group were significantly lower than those in the control group,with statistically significant difference( P < 0. 05). Conclusion: Warm acupuncture can regulate gastrointestinal movement,moisten the intestines and significantly improve the constipation and other clinical symptoms. Also,it has significant clinical effect on FC.
引文
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[16]谢振年,李东冰,贾小强,等.焦虑和抑郁在慢传输型便秘患者发病过程中的作用评估初探[J].世界中医药,2013,8(9):1033-1035.
[2]Yacob D,Di LC,Bridge JA,et al.Prevalence of pain-predominant functional gastrointestinal disorders and somatic symptoms in patients with anxiety or depressive disorders[J].J Pediatr,2013,163(3):767-770.
[3]陆春霞,余芝,徐斌.针刺治疗慢传输型便秘的研究进展[J].中国老年学杂志,2016,36(1):208-210.
[4]中华医学会消化病学分会胃肠动力学组,中华医学会外科学分会结直肠肛门外科学组.中国慢性便秘诊治指南(2013年,武汉)[J].中华消化杂志,2013,33(5):291-297.
[5]国家食品药品监督管理局.中药新药临床研究指导原则[S].北京:中国医药科技出版社,2002.
[6]李军祥,陈誩,柯晓.功能性便秘中西医结合诊疗共识意见(2017年)[J].中国中西医结合消化杂志,2018,26(1):18-26.
[7]中国中西医结合学会消化系统疾病专业委员会.胃肠疾病中医证候评分表[J].世界华人消化杂志,2004,12(11):2701-2703.
[8]郝艳冰,陶华洁,乔秋阁.结肠慢传输型便秘患者焦虑、抑郁状况及生命质量调查[J].中国医药导报,2015,12(32):53-56.
[9]De Giorgio R,Ruggeri E,Stanghellini V,et al.Chronic constipation in the elderly:a primer for the gastroenterologist[J].BMC Gastroenterol,2015,15:130.
[10]Koloski NA,Jones M,Young M,et al.Differentiation of functional constipation and constipation predominant irritable bowel syndrome based on Rome III criteria:a population-based study[J].Aliment Pharmacol Ther,2015,41(9):856-866.
[11]席作武,吴耀宗,李培培,等.针刺联合便通饮治疗阴虚津亏型便秘患者30例疗效观察[J].中医杂志,2015,56(6):503-505.
[12]Andromanakos NP,Pinis SI,Kostakis AI.Chronic severe constipation:current pathophysiological aspects,new diagnostic approaches,and therapeutic options[J].Eur J Gastroenterol Hepatol,2015,27(3):204-214.
[13]李玉琴,余芝,徐斌.针刺调节慢传输型便秘的肠神经系统机制进展[J].中国针灸,2015,35(3):309-312.
[14]叶彬,陈春晓.老年住院慢性便秘患者的焦虑抑郁状态和睡眠状况[J].中国老年学杂志,2016,36(8):1996-1998.
[15]Ruiz-López MC,Coss-Adame E.Quality of life in patients with different constipation subtypes based on the Rome III criteria[J].Rev Gastroenterol Mex,2015,80(1):13-20.
[16]谢振年,李东冰,贾小强,等.焦虑和抑郁在慢传输型便秘患者发病过程中的作用评估初探[J].世界中医药,2013,8(9):1033-1035.