电针与艾灸对腹泻型肠易激综合征患者脑-肠功能影响的比较：一项随机对照试验
Comparison of electroacupuncture and moxibustion on brain-gut function in patients with diarrhea-predominant irritable bowel syndrome: A randomized controlled trial.
作者信息
Zhao Ji-meng, Lu Jin-hua, Yin Xiao-jun, Chen Xing-kui, Chen Yue-hua, Tang Wei-jun, Jin Xiao-ming, Wu Lu-yi, Bao Chun-hui, Wu Huan-gan, Shi Yin
机构信息
Yueyang Clinical School of Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China.
Medical Imaging Department, Jinhua Municipal Central Hospital, Jinhua, Zhejiang Province, 321000, China.
出版信息
Chin J Integr Med. 2015 Nov;21(11):855-65. doi: 10.1007/s11655-015-2049-x. Epub 2015 Apr 6.
OBJECTIVE
To compare the effects of electroacupuncture (EA) and moxibustion therapies on patients with diarrhea-predominant irritable bowel syndrome (D-IBS).
METHODS
A total of 60 D-IBS patients were randomly allocated to the EA group (30 cases) and moxibustion group (30 cases). Before and after treatment, the gastrointestinal symptoms and psychological symptoms were scored by Visual Analogue Scale, Bristol Stool Form Scale, Hamilton Anxiety Rating Scale (HAMA), and Hamilton Depression Rating Scale (HAMD); the expressions of 5-hydroxytryptamine (5-HT), 5-HT3 receptor (5-HT3R), and 5-HT4 receptor (5-HT4R) in the sigmoid mucosal tissue were measured by immunohistochemical staining. Additionally, the effects on the functional brain areas of the anterior cingulate cortex (ACC), insular cortex (IC) and prefrontal cortex (PFC) were observed by functional magnetic resonance imaging.
RESULTS
Compared with before treatment, both EA and moxibustion groups reported significant improvements in abdominal pain and abdominal bloating after treatment (P<0.01 or P<0.05). The moxibustion group reported greater improvements in defecation emergency, defecation frequency, and stool feature than the EA group (P<0.01). Both HAMA and HAMD scores were significantly decreased in the moxibustion group than in the EA group (P<0.01). Both groups demonstrated significantly reduced expressions of 5-HT, 5-HT3R and 5-HT4R in the colonic mucosa after treatment (P<0.01), with a greater reduction of 5-HT in the moxibustion group (P<0.05). Finally, decreased activated voxel values were observed in the left IC, right IC and PFC brain regions of patients in the moxibustion group under stimulation with 150 mL colorectal distension after treatment (P<0.05 or P<0.01), while in the EA group only PFC area demonstrated a reduction (P<0.05).
CONCLUSION
Moxibustion can significantly improve the symptoms of D-IBS, suggesting that moxibustion may be a more effective therapy than EA for D-IBS patients.
目的
比较电针（EA）与艾灸疗法对腹泻型肠易激综合征（D-IBS）患者的疗效。
方法
将60例D-IBS患者随机分为电针组（30例）和艾灸组（30例）。治疗前后，采用视觉模拟评分法、布里斯托大便形状量表、汉密尔顿焦虑量表（HAMA）和汉密尔顿抑郁量表（HAMD）对胃肠道症状和心理症状进行评分；采用免疫组织化学染色法检测乙状结肠黏膜组织中5-羟色胺（5-HT）、5-HT3受体（5-HT3R）和5-HT4受体（5-HT4R）的表达。此外，通过功能磁共振成像观察对前扣带回皮质（ACC）、岛叶皮质（IC）和前额叶皮质（PFC）等脑功能区的影响。
结果
与治疗前相比，电针组和艾灸组治疗后腹痛、腹胀均有明显改善（P<0.01或P<0.05）。艾灸组在排便急迫感、排便频率和大便性状方面的改善优于电针组（P<0.01）。艾灸组的HAMA和HAMD评分均显著低于电针组（P<0.01）。两组治疗后结肠黏膜中5-HT、5-HT3R和5-HT4R表达均显著降低（P<0.01），艾灸组5-HT降低更明显（P<0.05）。最后，治疗后艾灸组患者在150 mL结直肠扩张刺激下，左侧IC、右侧IC和PFC脑区的激活体素值降低（P<0.05或P<0.01），而电针组仅PFC区有降低（P<0.05）。
结论
艾灸能显著改善D-IBS症状，提示艾灸对D-IBS患者可能是比电针更有效的治疗方法。
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