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针刺对腹泻型肠易激综合征患者内脏高敏感性的影响及其作用:一项随机对照试验的研究方案。

Effect of acupuncture and its influence on visceral hypersensitivity in IBS-D patients: Study protocol for a randomized controlled trial.

作者信息

Pei Lixia, Chen Hao, Guo Jing, Chen Lu, Wu Xiaoliang, Xu Wanli, Weng Shengjie, Yang EunMee, Hammer Trine, Sun Jianhua

机构信息

Department of acupuncture, Jiangsu Province Hospital of Traditional Chinese Medicine, Affiliated Hospital of Nanjing University of Traditional Chinese Medicine, Hanzhong Road, Qinhuai District Nanjing University of Traditional Chinese Medicine, Xianlin Road, Qixia District, Nanjing, China.

出版信息

Medicine (Baltimore). 2018 May;97(21):e10877. doi: 10.1097/MD.0000000000010877.

Abstract

BACKGROUND

Irritable bowel syndrome (IBS) is a common functional gastrointestinal disorder associated with visceral hypersensitivity. Increased expression of colonic TRPV1 and decreased expression of microRNA-199 are implicated in the pathogenesis of visceral hypersensitivity in IBS-D patients. Acupuncture is one of the frequently used complementary and alternative therapies for the treatment of IBS. The existing clinical studies mostly use IBS-SSS or other subjective scales, so there is a lack of objective biochemical evidence regarding the effect of acupuncture on IBS. Therefore, we designed this study to investigate whether acupuncture alleviate visceral hypersensitivity by influencing the expression of TRPV1 and microRNA-199.

METHOD

This study is a randomized, sham-controlled trial involving 40 patients and 10 healthy volunteers. A total of 40 eligible patients with IBS-D will be randomly assigned to a traditional acupuncture group or sham acupuncture group in a 1:1 ratio. Patients will receive 3 acupuncture treatment sessions per week for 12 consecutive weeks, for a total of 36 sessions during the study. The primary outcome measure is the IBS-Symptom Severity Score (IBS-SSS). Secondary outcomes are Visceral Pain Scale and levels of TRPV1 and microRNA-199 in colonic tissues. Healthy volunteers will not receive any clinical intervention. The safety of interventions will be assessed at every visit.

DISCUSSION

The purpose of this trial is to evaluate the efficacy of acupuncture for IBS-D through IBS-SSS and Visceral Pain Scale. Furthermore, we want to explore the intervention mechanism of acupuncture in improving visceral hypersensitivity by analyzing the colonic TRPV1 and microRNA-199.

TRIAL REGISTRATION

This trial is registered with Chinese Clinical Trials Register, ChiCTR-IOR- 17010860(http://www.chictr.org.cn/showproj.aspx?proj=18445).

摘要

背景

肠易激综合征(IBS)是一种常见的功能性胃肠疾病,与内脏高敏感性相关。结肠瞬时感受器电位香草酸亚型1(TRPV1)表达增加和微小RNA-199(microRNA-199)表达降低与腹泻型肠易激综合征(IBS-D)患者内脏高敏感性的发病机制有关。针灸是治疗IBS常用的补充和替代疗法之一。现有的临床研究大多使用IBS症状严重程度评分(IBS-SSS)或其他主观量表,因此缺乏关于针灸对IBS疗效的客观生化证据。因此,我们设计了本研究,以探讨针灸是否通过影响TRPV1和microRNA-199的表达来减轻内脏高敏感性。

方法

本研究是一项随机、假针刺对照试验,纳入40例患者和10名健康志愿者。总共40例符合条件的IBS-D患者将按1:1的比例随机分配到传统针刺组或假针刺组。患者将每周接受3次针刺治疗,连续12周,研究期间共36次。主要结局指标是IBS症状严重程度评分(IBS-SSS)。次要结局指标是内脏疼痛量表以及结肠组织中TRPV1和microRNA-199的水平。健康志愿者不接受任何临床干预。每次就诊时评估干预措施的安全性。

讨论

本试验的目的是通过IBS-SSS和内脏疼痛量表评估针灸治疗IBS-D的疗效。此外,我们想通过分析结肠TRPV1和microRNA-199来探索针灸改善内脏高敏感性的干预机制。

试验注册

本试验已在中国临床试验注册中心注册,注册号为ChiCTR-IOR-17010860(http://www.chictr.org.cn/showproj.aspx?proj=18445)。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/078e/6392752/96646b4efa65/medi-97-e10877-g001.jpg

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