针刺治疗气机郁滞型慢性功能性便秘60例
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摘要
目的:探讨针刺联合生物反馈治疗气机郁滞型慢性功能性便秘的疗效。方法:将120例气机郁滞型慢性功能性便秘患者随机分为治疗组和对照组,对照组给予单纯生物反馈治疗,治疗组给予针刺联合生物反馈治疗,治疗前和治疗后1周、1个月、3个月应用便秘患者症状自评量表(PAC-SYM)和便秘的生活质量量表(PAC-QOL)评价两组临床疗效和生活质量,并比较两组患者治疗后的有效率。结果:治疗组和对照组在治疗后三个时间点较治疗前均有改善;治疗组治疗后1周排便费力和腹部胀满评分分别是(1.92±0.29)分和(1.88±0.29)分,显著优于对照组的(2.32±0.24)分和(2.19±0.16)分(P<0.05),且治疗后1个月、3个月变化同治疗后1周;治疗组治疗后1周生理状态和心理状态评分分别是(1.92±0.29)分和(1.89±0.31)分,显著优于对照组的(2.32±0.24)分和(2.31±0.31)分(P<0.05),且治疗后1个月、3个月的变化同治疗后1周;治疗组有效率为91.7%,对照组为76.6%,两组比较有显著性差异(P<0.05)。结论:针刺联合生物反馈治疗气机郁滞型慢性功能性便秘,疗效确切,成本低廉,可有效改善便秘症状,提高患者生活质量。
Objective To observe the efficacy of acupuncture combined with biofeedback for the treatment of chronic functional constipation with depression and stagnation of Qi. Methods Total 120 cases with chronic functional constipation with depression and stagnation of Qi were randomly divided into treatment group and control group. The patients in control group received biofeedback therapy, and the patients in treatment group received acupuncture combined with biofeedback therapy. Before treatment and after 1 week, 1 month and 3 months of treatment, the clinical efficacy and quality of life of the two groups were evaluated by patient assessment of constipation symptom(PAC-SYM) and patient assessment of constipation quality of life(PAC-QOL), and the effectiveness of the two groups of patients were compared after treatment. Resluts The symptoms of treatment group and control group were improved at three time points after treatment compared with those before treatment; the defecation effort and abdominal fullness scores of the treatment group at 1 week after treatment were(1.92±0.29) points and(1.88±0.29) points, which were significantly better than those of control group [(2.32±0.24) points and(2.19±0.16) points](P<0.05). The changes of 1 month and 3 months after treatment were the same as that of 1 week after treatment; the physiological state and mental state scores of the treatment group at 1 week after treatment were(1.92±0.29) points and(1.89±0.31) points, which were significantly better than those of the control group [(2.32±0.24) points and(2.31±0.31) points](P<0.05). The changes of 1 month and 3 months after treatment were the same as that of 1 week after treatment. The effective rates were 91.7% in the treatment group and 76.6% in the control group. There was a significant difference between the two groups(P<0.05). Conclusion Acupuncture combined with biofeedback for chronic functional constipation with depression and stagnation of Qi is effective and with low cost, which can effectively improve the symptoms of constipation and improve the quality of life of patients.
Objective To observe the efficacy of acupuncture combined with biofeedback for the treatment of chronic functional constipation with depression and stagnation of Qi. Methods Total 120 cases with chronic functional constipation with depression and stagnation of Qi were randomly divided into treatment group and control group. The patients in control group received biofeedback therapy, and the patients in treatment group received acupuncture combined with biofeedback therapy. Before treatment and after 1 week, 1 month and 3 months of treatment, the clinical efficacy and quality of life of the two groups were evaluated by patient assessment of constipation symptom(PAC-SYM) and patient assessment of constipation quality of life(PAC-QOL), and the effectiveness of the two groups of patients were compared after treatment. Resluts The symptoms of treatment group and control group were improved at three time points after treatment compared with those before treatment; the defecation effort and abdominal fullness scores of the treatment group at 1 week after treatment were(1.92±0.29) points and(1.88±0.29) points, which were significantly better than those of control group [(2.32±0.24) points and(2.19±0.16) points](P<0.05). The changes of 1 month and 3 months after treatment were the same as that of 1 week after treatment; the physiological state and mental state scores of the treatment group at 1 week after treatment were(1.92±0.29) points and(1.89±0.31) points, which were significantly better than those of the control group [(2.32±0.24) points and(2.31±0.31) points](P<0.05). The changes of 1 month and 3 months after treatment were the same as that of 1 week after treatment. The effective rates were 91.7% in the treatment group and 76.6% in the control group. There was a significant difference between the two groups(P<0.05). Conclusion Acupuncture combined with biofeedback for chronic functional constipation with depression and stagnation of Qi is effective and with low cost, which can effectively improve the symptoms of constipation and improve the quality of life of patients.
引文
[1]孔凡彪,邓巧明,邓洪强,等.六磨汤高位灌肠联合生物反馈治疗混合型功能性便秘45例临床观察[J].中医杂志, 2017,58(19):1654-1657.
[2]叶韵怡,张鸣生,李新平,等.表面肌电信号评价呼吸电刺激治疗功能性便秘的疗效[J].中国临床解剖学杂志, 2017,35(3):327-330.
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[5]徐燕,刘遵勇,唐跃华.中医特色疗法治疗慢性功能性便秘的临床研究[J].中华中医药学刊, 2017, 35(2):463-465.
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[8]中华医学会消化病学会胃肠动力学组,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,武汉)[J].胃肠病学, 2013, 18(10):605-612.
[9]DrossmanDA,HaslerWL.RomeVI-functionGIdisorders:disordersofgut-braininteraction[J].Gastroenterology,2016,150(6):1257-1261.
[10]何艳红,贺平.功能性便秘的精神心理因素研究[J].结直肠肛门外科, 2008, 1(6):400-402.
[11]姚新艳,刘朝圣,李点,等.熊继柏教授辨证论治便秘经验[J].中华中医药杂志, 2015, 30(11):3990-3992.
[12]裴斌,苏娟萍.素娟萍教授行气润肠发治疗功能性便秘临床经验[J].中医临床研究, 2014, 6(11):84-85.
[13]李春日,荆秦,刘林,等.麦粒灸结合针刺于单纯针刺治疗慢性功能性便秘的疗效比较[J].世界华人消化杂志, 2013,21(23):2359-2363.
[14]彭敬师,吴楠.自制通便贴治疗老年功能性便秘120例[J].中国中医药现代远程教育, 2012, 10(26):13.
[15]王成伟,何洪波,李宁,等.电针针刺天枢穴治疗功能性便秘随机对照研究[J].中国针灸, 2010, 30(5):705-708.
[16]刘田田,周国华,陈叶青,等.生物反馈联合抗焦虑抑郁药物治疗慢性功能性便秘合并焦虑抑郁的临床疗效研究[J].中国全科医学, 2017, 7(20):254-256.
[17]宋玉磊,林征,林琳,等.生物反馈治疗功能性便秘的远期疗效及影响因素分析[J].中华消化杂志, 2013, 33(1):42-46.
[18]刘梅娟,程凤平,邹莹莹,等.功能性排便障碍患者生物反馈治疗的依从性及相关因素分析[J].护理学报, 2014, 21(16):41-43.
[19]张琼,倪敏,樊志敏.针灸治疗功能性便秘作用机制探讨[J].针灸临床杂志, 2014, 30(11):79-81.
[20]陈朝明,金洵,蒋亚文.针灸对女性排便功能障碍两个亚型的治疗作用研究[J].上海针灸杂志, 2008, 27(6):3-5.
[21]王艳英.针刺治疗便秘疗效观察[J].包头医学, 2010,34(3):157-158.
[2]叶韵怡,张鸣生,李新平,等.表面肌电信号评价呼吸电刺激治疗功能性便秘的疗效[J].中国临床解剖学杂志, 2017,35(3):327-330.
[3]刘新光.解读功能性肠病罗马Ⅲ诊断标准[J].中国实用内科杂志,2006, 26(21):1691-1693.
[4]梁晓春,孙华.北京协和医院医疗诊疗常规-中医科诊疗常规[M].北京:人民卫生出版社, 2012:73-76.
[5]徐燕,刘遵勇,唐跃华.中医特色疗法治疗慢性功能性便秘的临床研究[J].中华中医药学刊, 2017, 35(2):463-465.
[6]邓罡,徐丽姝,覃铁和.老年功能性便秘患者盆底表面肌电特征及生物反馈治疗[J].实用医学杂志, 2018, 34(8):1316-1319.
[7]中华中医药学会脾胃病分会,便秘中医诊疗专家共识意见(2017)[J].中医杂志, 2017, 58(15):1345-1350.
[8]中华医学会消化病学会胃肠动力学组,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,武汉)[J].胃肠病学, 2013, 18(10):605-612.
[9]DrossmanDA,HaslerWL.RomeVI-functionGIdisorders:disordersofgut-braininteraction[J].Gastroenterology,2016,150(6):1257-1261.
[10]何艳红,贺平.功能性便秘的精神心理因素研究[J].结直肠肛门外科, 2008, 1(6):400-402.
[11]姚新艳,刘朝圣,李点,等.熊继柏教授辨证论治便秘经验[J].中华中医药杂志, 2015, 30(11):3990-3992.
[12]裴斌,苏娟萍.素娟萍教授行气润肠发治疗功能性便秘临床经验[J].中医临床研究, 2014, 6(11):84-85.
[13]李春日,荆秦,刘林,等.麦粒灸结合针刺于单纯针刺治疗慢性功能性便秘的疗效比较[J].世界华人消化杂志, 2013,21(23):2359-2363.
[14]彭敬师,吴楠.自制通便贴治疗老年功能性便秘120例[J].中国中医药现代远程教育, 2012, 10(26):13.
[15]王成伟,何洪波,李宁,等.电针针刺天枢穴治疗功能性便秘随机对照研究[J].中国针灸, 2010, 30(5):705-708.
[16]刘田田,周国华,陈叶青,等.生物反馈联合抗焦虑抑郁药物治疗慢性功能性便秘合并焦虑抑郁的临床疗效研究[J].中国全科医学, 2017, 7(20):254-256.
[17]宋玉磊,林征,林琳,等.生物反馈治疗功能性便秘的远期疗效及影响因素分析[J].中华消化杂志, 2013, 33(1):42-46.
[18]刘梅娟,程凤平,邹莹莹,等.功能性排便障碍患者生物反馈治疗的依从性及相关因素分析[J].护理学报, 2014, 21(16):41-43.
[19]张琼,倪敏,樊志敏.针灸治疗功能性便秘作用机制探讨[J].针灸临床杂志, 2014, 30(11):79-81.
[20]陈朝明,金洵,蒋亚文.针灸对女性排便功能障碍两个亚型的治疗作用研究[J].上海针灸杂志, 2008, 27(6):3-5.
[21]王艳英.针刺治疗便秘疗效观察[J].包头医学, 2010,34(3):157-158.