疏肝调神通腑法针刺治疗便秘型肠易激综合征的疗效观察
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摘要
研究目的：观察疏肝调神通腑法针刺治疗对便秘型肠易激综合征患者的临床症状及生活质量的改善情况,论证其临床疗效,为临床实践寻找一种疗效满意而全面的治疗方法。
研究方法：将符合本研究纳入标准的41例便秘型肠易激综合征患者按随机数字表分为两组,针刺组21人,口服非比麸组20人,观察两组患者在治疗前,治疗1周后、治疗2周后、治疗4周后、疗程结束1月后,这5个时间点症状评分量表总分变化,其中包括主要症状(腹部疼痛或不适、腹胀、大便性状、排便频率)和次要症状(排便困难、排便不尽感、粘液便、精神问题)共八个项目；以及患者治疗前后生活质量评分量表(IBS-QOL)八个维度的积分变化,比较两组临床疗效的差异。
研究结果：
(1)在综合疗效方面,针刺治疗对IBS-C总体症状的改善优于口服非比麸,其后续效应能减轻症状复发程度,远期疗效好。
(2)在单项症状方面,针刺治疗对腹部疼痛或不适、排便困难的改善有显著的时效性优势,起效快,近、远期疗效好；对排便不尽感、腹胀、精神问题的改善程度优于西药组,对腹胀、粘液便、精神问题的远期疗效好。口服非比麸对患者大便性状及排便频率的改善起效快、疗效优于针刺治疗,但停药后易复发。
(3)在生活质量方面,针刺治疗能显著改善并提高患者的生活质量。
结论：疏肝调神通腑法针刺治疗可显著改善便秘型肠易激综合征患者的临床症状,提高其生活质量,远期疗效好。
Objective:To explore a treatment of constipation-predominan irritable bowel syndrome which is effective and comprehensive for clinical practice based on observe the curative effect of acupuncture with the principle of soothing the liver regulating shen and purgating fu-organs.
Method:41 cases of IBS-C conforming to the criteria of this subject were randomly divided into two groups.Treatment group (21 cases) were treated with acupuncture,control group (20cases) were treated by taking fiberform orally.Before treatment,1 week,2 weeks,4 weeks after treatment and 1 month after the end of treatment, the change of two group's IBS-C symptom rating scale scores was observed and compared,which include cardinal symptom (abdomnalgia or abdominal discomfort, abdominal distention,Bristol score,stool frequency)and minor symptom (difficult defecation, non-complet defecation,mucous stool, mental pro-blems),eight projects totally.And observed the changes of IBS-QOL scores(eight items) before and after treatment.
Result:
(1)In terms of general therapeutic effect,the improvement on general symptom by acupunctrue treatment is better than taking fiberform orally, Follow-up effects of acupuncture can reduce the degree of symptom recurrence, which can bring good prostecdtive efficacy.
(2) In terms of Individual symptoms, the improvement of abdominal pain or discomfort, difficult defecation has significant chronergy advantages by Acupuncture treatment,which has advantage of faster onset,better short-term and prostecdtive efficacy.The group treating by acupunctrue has better improvement of non-complet defecation, abdominal distention and mental problems,also has better prostecdtive efficacy on the symptoms of abdominal distention, mucous stool and mental problems.Taking fiberform can improve patients'stool description and stool frequency quickly,which is more effective than acupuncture, but easy to relapse after drug withdrawal.
(3) In terms of quality of life, acupuncture treatment can significantly improve and enhance patients' quality of life.
Conclusion:Acupuncture treatment with the principle of soothing the liver purgating fu-organs and regulating shen can significantly improve clinical symptoms of patients with constipation-predominant irritable bowel syndrome,also improve their quality of life, shows a good long-term effect.
研究方法：将符合本研究纳入标准的41例便秘型肠易激综合征患者按随机数字表分为两组,针刺组21人,口服非比麸组20人,观察两组患者在治疗前,治疗1周后、治疗2周后、治疗4周后、疗程结束1月后,这5个时间点症状评分量表总分变化,其中包括主要症状(腹部疼痛或不适、腹胀、大便性状、排便频率)和次要症状(排便困难、排便不尽感、粘液便、精神问题)共八个项目；以及患者治疗前后生活质量评分量表(IBS-QOL)八个维度的积分变化,比较两组临床疗效的差异。
研究结果：
(1)在综合疗效方面,针刺治疗对IBS-C总体症状的改善优于口服非比麸,其后续效应能减轻症状复发程度,远期疗效好。
(2)在单项症状方面,针刺治疗对腹部疼痛或不适、排便困难的改善有显著的时效性优势,起效快,近、远期疗效好；对排便不尽感、腹胀、精神问题的改善程度优于西药组,对腹胀、粘液便、精神问题的远期疗效好。口服非比麸对患者大便性状及排便频率的改善起效快、疗效优于针刺治疗,但停药后易复发。
(3)在生活质量方面,针刺治疗能显著改善并提高患者的生活质量。
结论：疏肝调神通腑法针刺治疗可显著改善便秘型肠易激综合征患者的临床症状,提高其生活质量,远期疗效好。
Objective:To explore a treatment of constipation-predominan irritable bowel syndrome which is effective and comprehensive for clinical practice based on observe the curative effect of acupuncture with the principle of soothing the liver regulating shen and purgating fu-organs.
Method:41 cases of IBS-C conforming to the criteria of this subject were randomly divided into two groups.Treatment group (21 cases) were treated with acupuncture,control group (20cases) were treated by taking fiberform orally.Before treatment,1 week,2 weeks,4 weeks after treatment and 1 month after the end of treatment, the change of two group's IBS-C symptom rating scale scores was observed and compared,which include cardinal symptom (abdomnalgia or abdominal discomfort, abdominal distention,Bristol score,stool frequency)and minor symptom (difficult defecation, non-complet defecation,mucous stool, mental pro-blems),eight projects totally.And observed the changes of IBS-QOL scores(eight items) before and after treatment.
Result:
(1)In terms of general therapeutic effect,the improvement on general symptom by acupunctrue treatment is better than taking fiberform orally, Follow-up effects of acupuncture can reduce the degree of symptom recurrence, which can bring good prostecdtive efficacy.
(2) In terms of Individual symptoms, the improvement of abdominal pain or discomfort, difficult defecation has significant chronergy advantages by Acupuncture treatment,which has advantage of faster onset,better short-term and prostecdtive efficacy.The group treating by acupunctrue has better improvement of non-complet defecation, abdominal distention and mental problems,also has better prostecdtive efficacy on the symptoms of abdominal distention, mucous stool and mental problems.Taking fiberform can improve patients'stool description and stool frequency quickly,which is more effective than acupuncture, but easy to relapse after drug withdrawal.
(3) In terms of quality of life, acupuncture treatment can significantly improve and enhance patients' quality of life.
Conclusion:Acupuncture treatment with the principle of soothing the liver purgating fu-organs and regulating shen can significantly improve clinical symptoms of patients with constipation-predominant irritable bowel syndrome,also improve their quality of life, shows a good long-term effect.
引文
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