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不同强度电针治疗功能性便秘患者的临床研究

Clinical study of electro-acupuncture treatment with different intensities for functional constipation patients.

作者信息

Xiong Fan, Wang Ying, Li Shi-Qi, Tian Man, Zheng Cui-Hong, Huang Guang-Ying

机构信息

Institute of Integrative Traditional Chinese and Western Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.

出版信息

J Huazhong Univ Sci Technolog Med Sci. 2014 Oct;34(5):775-781. doi: 10.1007/s11596-014-1351-8. Epub 2014 Oct 16.

Abstract

Functional constipation (FC) is a common functional bowel disorder disease that affects life quality of a large number of people. This study aimed to explore the impact of different intensities of electro-acupuncture (EA) treatment for FC patients. Totally, 111 patients with FC meeting the Rome III criteria were randomly assigned to different intensities of EA groups (low and high intensity of EA groups) and medicine-controlled (MC) group. In EA groups, patients were treated with EA at quchi (LI11) and shangjuxu (ST37) bilaterally for 4 weeks, 5 times/week in the first 2 weeks, and 3 times/week in the last 2 weeks. In MC group, 5 mg mosapride citrate was administered orally 3 times/day for 4 weeks. Spontaneous bowel movement frequency each day was recorded using a constipation diary. Self-rating anxiety scale (SAS) and self-rating depression scale (SDS) were used to assess the patients' psychological state. Cortisol (CORT), substance P (SP), and vasoactive intestinal polypeptide (VIP) were evaluated at baseline and at the end of 4 weeks after treatment. As compared with the baseline, there was statistically significant increase in stool frequency every week (P<0.01), but there was no statistically significant difference among the three groups. As compared with the baseline, after 4 weeks of EA therapy, the scores of SDS and serum levels of CORT were decreased significantly in low intensity of EA group (P<0.01), and the serum levels of SP and VIP were increased significantly (P<0.05); the scores of SAS and SDS and serum levels of CORT were decreased significantly in high intensity of EA group (P<0.05), and the serum levels of SP and VIP were increased significantly (P<0.05); the serum levels of CORT and VIP were increased significantly in MC group (P<0.05). As compared with MC group, after 4 weeks of treatment, the serum levels of SP were signifcicantly increased in low intensity of EA group (P<0.01). Low and high intensities of EA could increase the stool frequency, improve the FC patient's anxiety and depression, reduce the serum levels of CORT, and increase the serum levels of SP and VIP effectively. It is concluded that both low and high intensities of EA are effective for FC patients, but there is no significant difference between the low and high intensities of EA.

摘要

功能性便秘(FC)是一种常见的功能性肠病,影响着大量人群的生活质量。本研究旨在探讨不同强度电针(EA)治疗对FC患者的影响。共有111例符合罗马III标准的FC患者被随机分为不同强度EA组(低强度和高强度EA组)和药物对照组(MC组)。在EA组中,患者双侧曲池(LI11)和上巨虚(ST37)接受电针治疗4周,前2周每周5次,后2周每周3次。在MC组中,口服5mg枸橼酸莫沙必利,每日3次,共4周。使用便秘日记记录每天的自发排便频率。采用自评焦虑量表(SAS)和自评抑郁量表(SDS)评估患者的心理状态。在基线和治疗4周结束时评估皮质醇(CORT)、P物质(SP)和血管活性肠肽(VIP)。与基线相比,每周排便频率有统计学显著增加(P<0.01),但三组之间无统计学显著差异。与基线相比,EA治疗4周后,低强度EA组SDS评分和CORT血清水平显著降低(P<0.01),SP和VIP血清水平显著升高(P<0.05);高强度EA组SAS和SDS评分及CORT血清水平显著降低(P<0.05),SP和VIP血清水平显著升高(P<0.05);MC组CORT和VIP血清水平显著升高(P<0.05)。与MC组相比,治疗4周后,低强度EA组SP血清水平显著升高(P<0.01)。低强度和高强度EA均可增加排便频率,改善FC患者的焦虑和抑郁,降低CORT血清水平,有效提高SP和VIP血清水平。结论是低强度和高强度EA对FC患者均有效,但低强度和高强度EA之间无显著差异。

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