混元灸治疗脾肾阳虚证腹泻型肠易激综合征：随机对照试验

耿乐乐; 黄辉; 宣逸尘; 万基伟; 余希婧; 聂小峰; 胡秀武

doi:10.13703/j.0255-2930.20220219-k0001

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混元灸治疗脾肾阳虚证腹泻型肠易激综合征：随机对照试验

临床研究 | 更新时间：2024-06-03

- 混元灸治疗脾肾阳虚证腹泻型肠易激综合征：随机对照试验
- Hunyuan moxibustion for diarrhea-predominant irritable bowel syndrome of spleen and kidney yang deficiency: a randomized controlled trial
- 中国针灸 2023年43卷第9期页码：1028-1032
- 作者机构：
  
  1.南昌市洪都中医院针灸科，江西南昌330006
  2.江西省针灸医学临床研究中心，南昌330006
  3.南昌市长蛇灸效应机制和督脉特异性重点实验室，江西南昌330006
  4.南昌医学院中医学院
- 作者简介：
  
  胡秀武，副主任中医师。E-mail：569892702@qq.com
- 基金信息：
  
  江西省卫生健康委科技计划项目(20204072)
- DOI：10.13703/j.0255-2930.20220219-k0001
  中图分类号： R 246.1
- 收稿：2022-02-19，
  
  网络首发：2022-11-04，
  
  纸质出版：2023-09-12
- 稿件说明：
移动端阅览
耿乐乐,黄辉,宣逸尘等.混元灸治疗脾肾阳虚证腹泻型肠易激综合征：随机对照试验[J].中国针灸,2023,43(09):1028-1032.

GENG Le-le,HUANG Hui,XUAN Yi-chen,et al.Hunyuan moxibustion for diarrhea-predominant irritable bowel syndrome of spleen and kidney yang deficiency: a randomized controlled trial[J].Chinese Acupuncture & Moxibustion,2023,43(09):1028-1032.
耿乐乐,黄辉,宣逸尘等.混元灸治疗脾肾阳虚证腹泻型肠易激综合征：随机对照试验[J].中国针灸,2023,43(09):1028-1032. DOI： 10.13703/j.0255-2930.20220219-k0001.

GENG Le-le,HUANG Hui,XUAN Yi-chen,et al.Hunyuan moxibustion for diarrhea-predominant irritable bowel syndrome of spleen and kidney yang deficiency: a randomized controlled trial[J].Chinese Acupuncture & Moxibustion,2023,43(09):1028-1032. DOI： 10.13703/j.0255-2930.20220219-k0001.

摘要

目的

比较混元灸与口服西药治疗脾肾阳虚证腹泻型肠易激综合征（IBS-D）的临床疗效。

方法

将60例脾肾阳虚证IBS-D患者随机分为混元灸组和西药组，每组30例。混元灸组予关元穴混元灸治疗，每次约40 min，每天1次；西药组予口服盐酸洛哌丁胺胶囊（2 mg/次，每天3次）和地衣芽孢杆菌活菌胶囊（0.5 g/次，每天3次）。两组均治疗20 d，观察两组患者治疗前后IBS病情严重程度量表（IBS-SSS）评分、IBS生活质量量表（IBS-QOL）评分及中医症状分级量化评分，并评定两组临床疗效及安全性。

结果

治疗后，两组患者IBS-SSS各项评分及总评分均低于治疗前、IBS-QOL总评分均高于治疗前（

0.05），混元灸组IBS-SSS各项评分及总评分均低于西药组、IBS-QOL总评分高于西药组（

0.05）。治疗后，混元灸组中医症状分级量化各项评分及总评分均低于治疗前（

0.05），西药组腹痛、腹泻、不思饮食及总评分均低于治疗前（

0.05）；混元灸组腹痛、腰膝酸软、畏寒肢冷及总评分均低于西药组（

0.05）。混元灸组总有效率高于西药组［90.0%（27/30）

73.3%（22/30），

0.05］。治疗期间两组患者均未出现不良反应。

结论

混元灸可有效改善脾肾阳虚证IBS-D患者病情严重程度，提高患者生活质量，尤其在改善腹痛、腰膝酸软和畏寒肢冷症状及总体疗效方面优于口服西药。

Abstract

Objective

To compare the therapeutic effect between

Hunyuan

moxibustion and oral western medication on diarrhea-predominant irritable bowel syndrome（IBS-D）of spleen and kidney

yang

deficiency.

Methods

Sixty patients with IBS

-D of spleen and kidney

yang

deficiency were randomly divided into a Hunyuan moxibustion group and a western medication group

30 cases each group. The Hunyuan moxibustion group was treated with

Hunyuan

moxibustion at Guanyuan（CV 4），40 min each time

once a day; in the western medication group，loperamide hydrochloride capsules (2 mg each time

3 times a day) and bacillus licheniformis live capsules (0.5 g each time

3 times a day) were given orally.Both groups were treated for 20 days. The scores of irritable bowel syndrome（IBS）symptom severity scale（IBS-SSS）

IBS quality of life scale (IBS-QOL) and TCM symptom grading quantitative were observed before and after treatment

and the clinical efficacy and safety were evaluated in the two groups.

Results

After treatment，each item scores and total scores of IBS-SSS in the two groups were lower than those before treatment（

0.05）

and the total scores of IBS-QOL were higher than those before treatment (

0.05)；each item score and total score of IBS-SSS in the Hunyuan moxibustion group were lower than those in the western medication group (

0.05)

and the total score of IBS-QOL in the Hunyuan moxibustion group was higher than that in the western medication group (

0.05).After treatment

each item score and total score of TCM symptom grading quantitative in the Hunyuan moxibustion group were lower than those before treatment (

0.05)

the abdominal pain

diarrhea

lack of appetite scores and total score in the western medication group were lower than those before treatment (

0.05)；and the abdominal pain

soreness and weakness of waist and knees

fear to cold and cold limbs scores and total score in the Hunyuan moxibustion group were lower than those in the western medication group (

0.05).The total effective rate was 90.0%（27/30）in the Hunyuan moxibustion group

whi

ch was higher than 73.3%（22/30）in the western medication group (

0.05). No adverse reactions occurred in both groups during treatment.

Conclusion

Hunyuan

moxibustion can effectively improve the symptom severity and quality of life in patients with IBS-D of spleen and kidney

yang

deficiency

especially in improving the symptoms of abdominal pain

soreness and weakness of waist and knees

fear to cold and cold limbs.Its therapeutic effect is superior to western medication.

关键词

Keywords

references

Hillestad EMR , van der Meeren A , Nagaraja BH , et al . Gut bless you: the microbiota-gut-brain axis in irritable bowel syndrome [J ] . World J Gastroenterol , 2022 , 28 ( 4 ): 412 - 431 .

Sperber AD , Bangdiwala SI , Drossman DA , et al . Worldwide prevalence and burden of functional gastrointestinal disorders, results of Rome foundation global study [J ] . Gastroenterology , 2021 , 160 ( 1 ): 99 - 114.e3 .

Ballou S , Katon J , Rangan V , et al . Brief behavioral therapy for insomnia in patients with irritable bowel syndrome: a pilot study [J ] . Dig Dis Sci , 2020 , 65 ( 11 ): 3260 - 3270 .

Norlin AK , Walter S , Icenhour A , et al . Fatigue in irritable bowel syndrome is associated with plasma levels of TNF-α and mesocorticolimbic connectivity [J ] . Brain Behav Immun , 2021 , 92 : 211 - 222 .

Guo QQ , Lin H , Chen PC , et al . Dynamic changes of intestinal flora in patients with irritable bowel syndrome combined with anxiety and depression after oral administration of enterobacteria capsules [J ] . Bioengineered , 2021 , 12 ( 2 ): 11885 - 11897 .

Altomare A , di Rosa C , Imperia E , et al . Diarrhea predominant-irritable bowel syndrome (IBS-D): effects of different nutritional patterns on intestinal dysbiosis and symptoms [J ] . Nutrients , 2021 , 13 ( 5 ): 1506 .

顾景辉 , 李忠 . 四君子汤加味治疗腹泻型肠易激综合征临床疗效及对生活质量的影响 [J ] . 空军医学杂志 , 2020 , 36 ( 1 ): 79 - 82 .

宣逸尘 , 刘静 , 黄毅勇 , 等 . 长蛇灸联合西药治疗脾肾阳虚证腹泻型肠易激综合征疗效观察 [J ] . 中国针灸 , 2021 , 41 ( 2 ): 133 - 136 .

郝丽君 , 石志敏 . 筋缩八阵穴隔药灸治疗肝郁脾虚证腹泻型肠易激综合征疗效观察 [J ] . 中国针灸 , 2020 , 40 ( 7 ): 702 - 706 .

Hertzog MA . Considerations in determining sample size for pilot studies [J ] . Res Nurs Health , 2008 , 31 ( 2 ): 180 - 191 .

Hellström PM , Benno P . The Rome IV: irritable bowel syndrome - A functional disorder [J ] . Best Pract Res Clin Gastroenterol , 2019 , 40 / 41 : 101634 .

中华中医药学会脾胃病分会 . 泄泻中医诊疗专家共识意见(2017) [J ] . 中医杂志 , 2017 , 58 ( 14 ): 1256 - 1260 .

Betz C , Mannsdörfer K , Bischoff SC . Validation of the IBS-SSS [J ] . Z Gastroenterol , 2013 , 51 ( 10 ): 1171 - 1176 .

Torkzadeh F , Danesh M , Mirbagher L , et al . Relations between coping skills, symptom severity, psychological symptoms, and quality of life in patients with irritable bowel syndrome [J ] . Int J Prev Med , 2019 , 10 : 72 .

郑筱萸 . 中药新药临床研究指导原则(试行) [M ] . 北京 : 中国医药科技出版社 , 2002 : 141 - 142 .

中国中西医结合学会消化系统疾病专业委员会 . 肠易激综合征中西医结合诊疗共识意见 [J ] . 中国中西医结合杂志 , 2011 , 31 ( 5 ): 587 - 590 .

李中玉 , 陈婷 , 王阳 , 等 . 经方辨治腹泻型肠易激综合征的理论与方法研究 [J ] . 中国中西医结合杂志 , 2022 , 42 ( 1 ): 107 - 111 .

白竹君 , 李聚林 . 腹泻型肠易激综合征脾肾阳虚证中医研究进展 [J ] . 山西中医学院学报 , 2019 , 20 ( 2 ): 149 - 151 .

陈佳利 , 姚艳玲 , 刘昊 , 等 . 四神丸联合督灸治疗脾肾阳虚型腹泻型肠易激综合征疗效观察 [J ] . 山东中医杂志 , 2021 , 40 ( 6 ): 572 - 576, 623 .

邓剑勇 , 朱慧君 . 针刺联合隔盐隔姜灸神阙穴治疗脾肾阳虚型腹泻型肠易激综合征临床研究 [J ] . 河北中医 , 2019 , 41 ( 9 ): 1415 - 1418 .

蔡辉 . 基于TRPV1的不同灸温脊髓背角响应之量效研究 [D ] . 南京 : 南京中医药大学 , 2018 .

Fajrin FA , Nugroho AE , Susilowati R , et al . Molecular docking analysis of ginger active compound on transient receptor potential cation channel subfamily V member 1 (TRPV 1 ) [J ] . Indones J Chem , 2018 , 18 ( 1 ): 179 .

Ford AC , Sperber AD , Corsetti M , et al . Irritable bowel syndrome [J ] . Lancet , 2020 , 396 ( 10263 ): 1675 - 1688 .

Camilleri M . Management options for irritable bowel syndrome [J ] . Mayo Clin Proc , 2018 , 93 ( 12 ): 1858 - 1872 .

Colomier E , Algera J , Melchior C . Pharmacological therapies and their clinical targets in irritable bowel syndrome with diarrhea [J ] . Front Pharmacol , 2020 , 11 : 629026 .

杨芳 , 严晶 , 刘丽娜 , 等 . 加味交泰丸联合地衣芽孢杆菌活菌治疗腹泻型肠易激综合征临床疗效及对血清IL-6、IL-8、TNF-α水平影响 [J ] . 中华中医药学刊 , 2021 , 39 ( 10 ): 155 - 159 .

郭静 , 孙建华 , 陈璐 , 等 . 针刺双向调节效应: “调神健脾”法针刺治疗肠易激综合征多中心随机对照试验亚组分析 [J ] . 中国针灸 , 2021 , 41 ( 8 ): 845 - 850 .

孙远征 , 王仕林 , 于天洋 . “调神针法”联合电针治疗腹泻型肠易激综合征:随机对照研究 [J ] . 中国针灸 , 2021 , 41 ( 1 ): 13 - 16 .

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