[不同穴位处方电针治疗功能性便秘的疗效比较:一项随机对照试验]
[Comparison of efficacy on functional constipation treated with electroacupuncture of different acupoint prescriptions: a randomized controlled pilot trial].
作者信息
Wu Jia-Ni, Zhang Bi-Ying, Zhu Wen-Zeng, Du Ruo-Sang, Liu Zhi-Shun
出版信息
Zhongguo Zhen Jiu. 2014 Jun;34(6):521-8.
OBJECTIVE
To evaluate preliminarily the efficacy on functional constipation treated with electroacupuncture of different acupoint prescriptions.
METHODS
One hundred and four patients were randomized into a front-mu and back-shu points group (19 cases), a he-sea points group (34 cases), a he-sea, front-mu and back-shu points group (26 cases) and a western medication control group (25 cases). In the front-mu and back-shu points group, electroacupuncture was applied at bilateral Tianshu (ST 25) and Dachangshu (BL 25). In the he-sea points group, electroacupuncture was applied at bilateral Quchi (LI 11) and Shangjuxu (ST 37). In the he-sea, front-mu and back-shu points group, electroacupuncture was applied at unilateral Tianshu (ST 25), Dachangshu (BL 25), Quchi (LI 11) and Shangjuxu (ST 37). In the three groups above, the treatment was given 5 times a week in the first two weeks and 3 times a week in the next two weeks. In the western medication control group, mosapride citrate tablets were prescribed for oral administration, 1 table (5 mg) each time, 3 times a day, continuously for 4 weeks. The period of research was 9 weeks, including 1 week for baseline evaluation, 4 weeks for treatment and 4 weeks for follow-up. The weekly defecation frequency was taken as primary index, while the defecation difficulty and life quality score were taken as the secondary indices for the efficacy evaluation after treatment and in follow-up.
RESULTS
According to the intention-to-treat (ITT) analytic principle, 104 cases were all enrolled in the final analysis. (1) After treatment, the weekly frequency of defecation was all increased significantly in the four groups (P < 0.05, P < 0.01). The efficacy of the three electroacupuncture groups was similar to that of western medication control group (P > 0.05). In follow-up, the increasing effect on the weekly frequency of defecation was maintained in the he-sea points group (P < 0.01), superior to the front-mu and back-shu points group and the western medication control group (P < 0.05, P < 0.01); the weekly frequency of defecation was not improved in the rest three groups (P > 0.05). (2) After treatment, defecation difficulty was relieved in the he-sea points group, the he-sea, front-mu and back-shu points group and the western medication control group (P < 0.05, P < 0.01). In follow-up, the improvements were still significant in the he-sea points group and the he-sea, front-mu and back-shu points group (both P < 0.01). (3) After treatment, the life quality score was significantly improved in the patients of the he-sea points group (P < 0.05). The difference was not significant in the rest three groups as compared with that before treatment (all P > 0.05).
CONCLUSION
The weekly frequency of defecation is increased effectively after treatment in the three electroacupuncture groups and the efficacy is similar to mosapride citrate tablets. The bilateral Quchi (LI 11) and Shangjuxu (ST 37) in he-sea acupoints increase significantly the weekly frequency of defecation, relieve defecation difficulty and improve life quality. Acupuncture efficacy is sustained for 4 weeks. This acupoints prescription is the best in the treatment of functional constipation.
目的
初步评价不同穴位处方电针治疗功能性便秘的疗效。
方法
将104例患者随机分为募合配穴组(19例)、合穴组(34例)、募合配穴与俞募配穴组(26例)和西药对照组(25例)。募合配穴组取双侧天枢(ST25)、大肠俞(BL25)行电针治疗;合穴组取双侧曲池(LI11)、上巨虚(ST37)行电针治疗;募合配穴与俞募配穴组取单侧天枢(ST25)、大肠俞(BL25)、曲池(LI11)、上巨虚(ST37)行电针治疗。上述三组均在治疗的前两周每周治疗5次,后两周每周治疗3次。西药对照组给予枸橼酸莫沙必利片口服,每次1片(5mg),每日3次,连续服用4周。研究周期共9周,其中基线评估1周,治疗4周,随访4周。以每周排便次数为主要指标,以排便困难程度及生活质量评分作为治疗后及随访时疗效评价的次要指标。
结果
按意向性分析(ITT)原则,104例患者均纳入最终分析。(1)治疗后,四组患者每周排便次数均显著增加(P<0.05,P<0.01)。三组电针治疗组的疗效与西药对照组相似(P>0.05)。随访时,合穴组每周排便次数仍维持增加效果(P<0.01),优于募合配穴组和西药对照组(P<0.05,P<0.01);其余三组每周排便次数无改善(P>0.05)。(2)治疗后,合穴组、募合配穴与俞募配穴组及西药对照组排便困难均得到缓解(P<0.05,P<0.01)。随访时,合穴组及募合配穴与俞募配穴组改善仍显著(均P<0.01)。(3)治疗后,合穴组患者生活质量评分显著提高(P<0.05)。其余三组与治疗前比较差异无统计学意义(均P>0.05)。
结论
三组电针治疗组治疗后每周排便次数均有效增加,疗效与枸橼酸莫沙必利片相似。合穴中的双侧曲池(LI11)、上巨虚(ST37)显著增加每周排便次数,缓解排便困难,改善生活质量。针刺疗效可持续4周。该穴位处方治疗功能性便秘最佳。