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[针刺的双向调节作用:肠易激综合征针刺多中心随机对照试验的亚组分析]

[Bidirectional regulation of acupuncture: a subgroup analysis of multicenter randomized controlled trial of acupuncture with for irritable bowel syndrome].

作者信息

Guo Jing, Sun Jian-Hua, Chen Lu, Geng Hao, Yang Guo-Hui, Shen Rong-Rong, Ding Min, Lu Jin, Liu Lian, Fang Xiang-Dong, Pei Li-Xia

机构信息

Department of Acupuncture-Moxibustion and Rehabilitation, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing 210029, Jiangsu Province, China.

Shuyang Hospital of TCM.

出版信息

Zhongguo Zhen Jiu. 2021 Aug 12;41(8):845-50. doi: 10.13703/j.0255-2930.20201111-k0001.

Abstract

OBJECTIVE

To explore the bidirectional regulation of acupuncture based on a subgroup analysis of multicenter randomized controlled trial of acupuncture with for irritable bowel syndrome (IBS).

METHODS

A total of 519 patients were included in the analysis, including 137 patients with constipation type irritable bowel syndrome (IBS-C) (92 cases in the acupuncture group and 45 cases in the polyethylene glycol [PEG] group), and 382 patients with diarrhea type irritable bowel syndrome (IBS-D) (252 cases in the acupuncture group and 130 cases in the pinaverium group). The patients in the acupuncture group were given acupuncture at Baihui (GV 20), Yintang (GV 29), Tianshu (ST 25), Shangjuxu (ST 37), Zusanli (ST 36), Sanyinjiao (SP 6) and Taichong (LR 3) once every other day, 3 times a week. The patients in the PEG group received polyethylene glycol 4000 powder orally, and the pinaverium group received pinaverium bromide tablets orally. All were treated for 6 weeks. The IBS symptom severity score (IBS-SSS) was assessed at baseline, treatment period (2, 4, 6 weeks of treatment) and 12 weeks of follow-up, and the IBS quality of life (IBS-QOL) score was evaluated at the baseline period, 6 weeks of treatment and 12 weeks of follow-up.

RESULTS

The total IBS-SSS scores of the two groups of IBS-C patients at 2, 4, 6 weeks of treatment and follow-up of 12 weeks were lower than those in the baseline period (<0.01). The total IBS-SSS score in the IBS-C acupuncture group was lower than that in the PEG group at 12 weeks of follow-up (<0.05). The total IBS-SSS scores of the two groups of IBS-D patients at 2, 4, 6 weeks of treatment and 12 weeks of follow-up were lower than those in the baseline period (<0.01). The total IBS-SSS scores in the IBS-D acupuncture group were lower than those in the pinaverium group at 2, 4, 6 weeks of treatment and 12 weeks of follow-up (<0.05). The total IBS-QOL scores at 6 weeks of treatment and 12 weeks of follow-up were higher than those in the baseline period in both groups of patients with IBS-C (<0.01). The total IBS-QOL scores at 6 weeks of treatment and 12 weeks of follow-up were higher than those in the baseline period in both groups in patients with IBS-D (<0.01). The total IBS-QOL score in the IBS-D acupuncture group was higher than that in the pinaverium group at 18 weeks of follow-up (<0.05).

CONCLUSION

Acupuncture with can improve the clinical symptoms and quality of life of patients with IBS-C and IBS-D, which can regulate different functional states (constipation and diarrhea) of the same disease (irritable bowel syndrome), reflecting the bidirectional regulation of acupuncture.

摘要

目的

基于针刺治疗肠易激综合征(IBS)的多中心随机对照试验的亚组分析,探讨针刺的双向调节作用。

方法

共纳入519例患者进行分析,其中便秘型肠易激综合征(IBS-C)患者137例(针刺组92例,聚乙二醇[PEG]组45例),腹泻型肠易激综合征(IBS-D)患者382例(针刺组252例,匹维溴铵组130例)。针刺组患者隔日针刺百会(GV 20)、印堂(GV 29)、天枢(ST 25)、上巨虚(ST 37)、足三里(ST 36)、三阴交(SP 6)和太冲(LR 3),每周3次。PEG组患者口服聚乙二醇4000散,匹维溴铵组患者口服匹维溴铵片。均治疗6周。在基线期、治疗期(治疗2、4、6周)和随访12周时评估IBS症状严重程度评分(IBS-SSS),在基线期、治疗6周和随访12周时评估IBS生活质量(IBS-QOL)评分。

结果

两组IBS-C患者在治疗2、4、6周及随访12周时的IBS-SSS总分均低于基线期(<0.01)。随访12周时,IBS-C针刺组的IBS-SSS总分低于PEG组(<0.05)。两组IBS-D患者在治疗2、4、6周及随访12周时的IBS-SSS总分均低于基线期(<0.01)。在治疗2、4、6周及随访12周时,IBS-D针刺组的IBS-SSS总分均低于匹维溴铵组(<0.05)。两组IBS-C患者在治疗6周及随访12周时的IBS-QOL总分均高于基线期(<0.01)。两组IBS-D患者在治疗6周及随访12周时的IBS-QOL总分均高于基线期(<0.01)。随访18周时,IBS-D针刺组的IBS-QOL总分高于匹维溴铵组(<0.05)。

结论

针刺 可改善IBS-C和IBS-D患者的临床症状和生活质量,可调节同一种疾病(肠易激综合征)的不同功能状态(便秘和腹泻),体现了针刺的双向调节作用。

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