膀胱功能锻炼必要性的Meta分析

目的 观察“调神健脾”配穴针刺治疗腹泻型肠易激综合征（diarrhea-predominant irritable bowel syndrome，IBS-D）的临床疗效及其对脑-肠肽水平变化的影响。方法 选取2020年9月至2022年12月嘉兴市中医医院就诊的66例IBS-D患者，采用随机数字表法分为针刺组（n=33）与药物组（n=33）。药物组接受常规药物治疗，针刺组选取百会、印堂及太冲等穴位针刺治疗，疗程均为4周。测定两组患者治疗前后血清脑-肠肽水平变化，比较两组患者在治疗前、治疗后及随访时IBS-D临床症状积分与肠易激综合征生活质量量表（irritable bowel syndrome quality of life，IBS-QOL）评分，评估两组疗效。结果 治疗前两组患者脑-肠肽水平比较，差异无统计学意义（P>0.05），治疗后两组均有所下降，差异无统计学意义（P>0.05）。针刺组在临床症状与IBS-QOL部分维度改善程度方面优于药物组，差异有统计学意义（P<0.05）；针刺组临床疗效优于对照组，差异有统计学意义（P<0.05）。结论 “调神健脾”配穴针刺治疗IBS-D疗效显著，可明显缓解腹痛，提高生活质量，调适负面情绪和焦虑等情绪障碍，可能与针刺通过降低脑-肠肽水平、调节体内脑-肠互动紊乱失衡状态、下调内脏高敏感性有关。

Meta-analysis of the need for functional bladder exercise

Objective To observe the clinical efficacy on patients with diarrhea-predominant irritable bowel syndrome (IBS-D) with acupuncture for regulating shen and strengthening spleen and its influence on the level of brain-intestinal peptide. Methods A total of 66 patients with IBS-D admitted to Jiaxing Hospital of Traditional Chinese Medicine from September 2020 to December 2022 were selected and divided into the acupuncture group (n=33) and the drug group (n=33) according to the random number table method. The drug group received conventional drug treatment and the acupuncture group selected acupuncture points of Baihui, Yin Tang and Tai Chong for 4 weeks. Serum brain-gut peptide levels were measured before and after treatment, and the clinical symptom scores of IBS-D and the irritable bowel syndrome quality of life (IBS-QOL) scores were compared between the two groups before and after treatment, and at follow-up to assess the efficacy of the two groups. Results Compared with the level of brain-gut peptide in the two groups before treatment, the difference was not statistically significant (P>0.05) and decreased in both groups after treatment, the difference was not statistically significant (P>0.05). The acupuncture group outperformed the drug group in terms of improvement in clinical symptoms and some dimensions of IBS-QOL, with a statistically significant difference (P<0.05); the clinical efficacy of the acupuncture group was better than that of the control group, with a statistically significant difference (P<0.05). Conclusion The treatment of acupuncture for regulating shen and strengthening spleen has a significant effect on IBS-D, which can significantly relieve abdominal pain, improve quality of life, adjust negative emotions, anxiety and other emotional disorders, this may be related to the fact that acupuncture regulates the imbalance of brain-gut interaction and down-regulates visceral hypersensitivity by lowering brain-gut peptide levels.