电针治疗功能性便秘的临床研究

目的 观察电针对功能性便秘（functional constipation,FC）患者自主排便次数、大便性状、焦虑抑郁和胃肠蠕动的影响,探讨电针治疗FC的疗效。方法 将符合罗马Ⅲ标准的FC患者按21的比例,随机分为电针组和药物组。电针组取双侧曲池、上巨虚穴,治疗4周,前两周每周治疗5次,后两周每周治疗3次;药物组口服枸橼酸莫沙必利,每次5mg,每天3次,连续服药4周。对两组每周自主排便次数、正常性状大便比例、焦虑自评量表（SAS）、抑郁自评量表（SDS）、胃泌素（GAS）、生长抑素（SST）进行评估。结果 对比基线期,电针和药物均能增加自主排便次数（P〈0.01）,改善大便性状（P〈0.01）;电针组SAS、SDS评分（P〈0.01）和血清SST水平（P〈0.05）显著下降,血清GAS水平显著上升（P〈0.01）;药物组SAS、SDS评分和血清SST水平无显著变化,血清GAS水平显著上升（P〈0.01）。结论 电针治疗可增加FC患者的自主排便次数,改善大便性状,降低焦虑和抑郁状况及血清SST水平,提高血清GAS水平,从而有效治疗FC。     

电针治疗严重功能性便秘的临床观察

目的观察电针治疗严重功能性便秘的临床疗效。方法选取2012年9月-2013年10月武汉市中西医结合医院针灸科门诊的严重功能性便秘患者80例,采用电针双侧天枢穴、腹结穴配双侧上巨虚穴进行治疗。观察患者治疗前后证候积分及疗效指数、血浆一氧化氮合酶(NOS)、血浆五羟色胺(5-HT)的变化。结果 80例中,治愈47例,显效19例,有效8例,未愈6例,总有效率92.5%.治疗前后血浆NOS的含量分别为:(1.70±0.08)ng/m L和(0.83±0.22)ng/m L,血浆5-HT的含量分别为:(394.36±20.38)ng/m L和(496.97±25.53)ng/m L,治疗前后比较差异具有显著统计学意义(P<0.05)。结论电针疗法对严重功能性便秘疗效显著,值得临床深入研究并推广应用。     

天枢穴浅、深2种刺法治疗功能性便秘的临床研究

目的 以症状评分观察天枢穴浅、深2种刺法治疗功能性便秘的疗效.方法 临床选取功能性便秘患者65例,随机分为3组,口服药物组20例、天枢浅刺组21例、天枢深刺组24例,每周治疗5次,共治疗4周,观察治疗前、治疗后及治疗后随访1周、4周、12周、6个月便秘症状评分.结果 天枢深刺组在治疗后及治疗后随访第1、4、12周便秘症状评分分值明显低于天枢浅刺组(P<0.01);治疗后随访6个月时,3组相比无统计学意义,但天枢深刺组与治疗前相比,有统计学意义(P<0.05).结论 在治疗功能性便秘时,对天枢穴进行深刺,近期疗效明显优于浅刺,远期仍有效.     

电针治疗严重功能性便秘疗效观察

目的评价电针治疗严重功能性便秘的近期和远期临床疗效。方法将70例严重功能性便秘患者随机分为电针组和假电针组,每组35例。电针组患者接受双侧天枢、腹结、上巨虚深刺,假电针组患者接爱双侧天枢旁、腹结旁、上巨虚旁非穴点浅刺。于基线期、治疗8周末和随访12周末,分别观察两组患者每周完全自主排便(complete spontaneous bowel movements,CSBM)次数、自主排便(spontaneous bowel movements,SBM)次数,以及Bristol粪便性状(Bristol Stool Scale,BSS)评分、排便困难程度评分。结果与基线期比较,治疗期和随访期两组每周CSBM次数均显著增加(P<0.01),但电针组每周CSBM次数增加值显著大于假电针组(P<0.01)。在随访期,电针组每周CSBM次数≥3的病例数增加率显著大于假电针组(P<0.05)。在次要结局指标方面,电针组每周SBM次数和BSS评分增加值以及排便困难程度评分降低值均显著大于假电针组。结论电针治疗严重功能性便秘疗效确切,远期疗效较好。     

深刺天枢穴治疗功能性便秘机制的研究思路

通过对目前针灸治疗慢性功能性便秘现状的分析,探索深刺天枢穴治疗慢性功能性便秘的可能机制以及其优势,对于提高临床疗效及形成规范化治疗方案有很大的意义。     

深刺天枢治疗功能性便秘远期疗效观察

目的:观察深刺天枢穴治疗功能性便秘的远期疗效。方法:采用随机对照前瞻性研究方法,试验共入选病例65例,其中入选深刺天枢穴治疗组24例,常规针刺天枢穴对照组21例,口服乳果糖药物(15mL,qn)对照组20例。所有病例1周治疗5次,共治疗4周。结果:深刺组在治疗结束后第1、4、12周便秘症状评分明显低于常规针刺组及口服乳果糖药物组,3组相比差异有统计学意义(P<0.01)。结论:深刺天枢穴治疗功能性便秘有较好的远期累积效应。     

针灸治疗不同类型功能性便秘

目的观察对比针灸对不同类型功能性便秘的临床疗效。方法将4型各30例功能性便秘患者随机分为针灸组和对照组,每组各15例。针灸组辨证取穴(天枢、足三里、上巨虚、大肠俞、四神聪等)针灸治疗10 d为1疗程,共治疗2疗程;对照组口服复方聚乙二醇电解质散通便,辅以麻仁丸口服调理。对比2组治疗前后便秘症状评分改善情况及临床疗效。结果结肠慢传输型及IBS便秘型针灸组总有效率100%,对照组为93%,2组比较,P<0.05;针灸治疗后临床症状评分均明显改善,与对照组比较,P<0.05;随访时针灸组复发率低于对照组。结论针灸治疗功能性便秘能显著改善临床症状,疗效优于口服药物治疗。     

电针深刺对女性严重功能性便秘患者自主排便次数及生活质量的影响

目的 观察电针深刺对女性严重功能性便秘患者自主排便次数及生活质量的影响。方法 将53例女性严重功能性便秘患者随机分成深刺组和浅刺组2组,观察2组治疗后第4周及第8周的自主排便次数和生活质量量表总分以及各项评分的差异。结果 2组患者治疗后自主排便次数均有改善（P<0.01）,且深刺组明显大于浅刺组（P＜0.01）;治疗4周及8周后,深刺组在生活质量总分及各项评分改善均明显优于浅刺组（P＜0.01）。结论 电针深刺与浅刺均能改善女性严重功能性便秘患者的自主排便次数及生活质量,深刺组疗效更佳。      

经皮电刺激治疗帕金森病患者功能性便秘的临床研究

目的：探讨经皮电刺激(transcutaneous electrical stimulation,TES)对帕金森病(Parkinson disease,PD)患者功能性便秘的治疗作用。方法：选取2021年7-12月镇江市第四人民医院神经内科的PD患者76例,采用随机数字表法将患者分为对照组和试验组,每组38例。对照组给予常规治疗,试验组在对照组的基础上给予TES治疗,治疗时间为2周。比较两组每周完全自主排便(complete spontaneous bowel movements,CSBMs)次数;比较两组胃动素和胃泌素水平、胃窦运动指数及患者便秘状况评估问卷(patient assessment of constipation quality of life questionnaire,PAC-QOL)评分。结果：治疗后第2周,试验组CSBMs次数多于对照组;治疗2周后,试验组胃动素水平高于对照组(P<0.05),两组胃泌素水平比较,差异无统计学意义(P>0.05);治疗2周后,试验组胃窦运动指数高于对照组(P<0.05);治疗2周后,试验组PAC-QOL评分低于...     

电针治疗功能性便秘23例临床分析

便秘是消化系统最为常见的临床症状之一。当粪便排空障碍，排便次数减少，排便困难．粪便过硬且持续3个月以上就可考虑便秘的存在。导致便秘的原因十分复杂，既有器质性的也有功能性的原因。器质性原因包括结直肠占位性病变、炎症、狭窄或梗阻等。需外科手术治疗。功能性便秘过去多认为是内科疾病引起，诊断多采用“罗马Ⅱ标准”。目前将功能性便秘分为以下三型：慢性传输型、功能性出口处梗阻型和混合型。因便秘的病因复杂，症状顽同，所以始终是临床医生面对的一个难题。     

Efficacy of Electroacupuncture in the Treatment of Functional Constipation: A Randomized Controlled Pilot Trial

Objective: To evaluate the efficacy and safety of electroacupuncture at Tianshu (ST25) for patients with functional constipation (FC). Methods: Ninety-six patients with FC were randomized to receive deep needling on bilateral ST25 (group A, 48 cases) or shallow needling on bilateral ST25 (group B, 48 cases) with electroacupuncture once daily for 4 weeks. The proportion of patients with four or more complete spontaneous bowel movements (CSBMs) per week, and scores of constipation symptoms and satisfaction with treatment were compared between two groups. Safety was also assessed. Results: The proportion of patients with four or more CSBMs per week was 52.1% in group A, significantly higher than 25.0% in group B during the 4-week treatment (P<0.05). The constipation symptom score of patients were significantly improved in group A as compared with group B at week 2–4 (P<0.05). Patients in group A were more satisfied with their treatment compared with those in group B at week 1–4 (P<0.05). Five patients in group A felt significant pain and discomfort. No other adverse reaction was observed in both groups. Conclusion: Using electroacupuncture at ST25 to treat patients with FC is effectively, and deep needling had more stable effect than shallow needling.     

针刺联合硬膜外麻醉在胸腔镜肺切除手术中应用的随机对照研究

目的:观察针刺联合硬膜外麻醉在胸腔镜肺切除手术围手术期应用的临床效果。方法:40例择期行胸腔镜肺切除手术患者随机分为硬膜外麻醉组(简称"硬膜外组")和硬膜外麻醉+针刺镇痛组(简称"联合麻醉组"),每组20例。所有患者均行胸腔镜肺切除手术治疗,术中采用常规硬膜外麻醉,联合麻醉组在硬膜外麻醉基础上加用电针针刺镇痛,硬膜外组加用模拟电针。观察两组术后疼痛、恶心程度及追加杜冷丁情况,比较两组患者术中麻醉药物用量及术后住院天数、住院总费用。结果:术后24 h、48 h、72 h,联合麻醉组患者的疼痛、恶心情况均优于硬膜外组,两组比较差异均有统计学意义(P0.05)。术后硬膜外组追加杜冷丁人数为7例,联合麻醉组为1例,联合麻醉组追加杜冷丁人数明显少于硬膜外组(P0.05)。术中两组患者利多卡因、甲磺酸罗哌卡因用量比较,差异无统计学意义(P0.05),硬膜外组右美托咪定用量明显多于联合麻醉组(P0.05)。两组患者的术后住院天数及住院总费用比较,差异均无统计学意义(P0.05)。结论:针刺镇痛能够有效减轻硬膜外麻醉下胸腔镜肺切除手术患者的术后疼痛和恶心程度,改善术后不良应激。     

Comparison of Electroacupuncture and Mild-Warm Moxibustion on Brain-Gut Function in Patients with Constipation-Predominant Irritable Bowel Syndrome: A Randomized Controlled Trial

Objective

To compare the effects of electroacupuncture (EA) and mild-warm moxibustion (Mox) therapies for constipation-predominant irritable bowel syndrome (C-IBS) patients.

Methods

Sixty C-IBS patients were assigned to 2 groups by simple randomized method, i.e. EA group (30 cases) and Mox group (30 cases). Both EA and Mox treatments were performed on bilateral Tianshu (ST 25) and Shangjuxu (ST 37) for 30 min each time, 6 times per week, for 4 consecutive weeks. The gastrointestinal symptoms and psychological symptoms of the two groups were scored before and after treatment. The effects on the corresponding functional brain areas, namely the anterior cingulate cortex (ACC), insular cortex (IC) and prefrontal cortex (PFC) were observed by functional magnetic resonance imaging (fMRI) before and after treatment.

Results

Compared with the Mox group, greater improvements in abdominal distension, defecation frequency, diffificulty in defecation and stool features were observed in the EA group (all P<0.01), both Hamilton Anxiety Rating Scale and Hamilton Depression Rating Scale scores were signifificantly decreased in the EA group (all P<0.01). Finally, decreased activated voxel values were observed in the ACC, right IC and PFC brain regions of EA group with 150 mL colorectal distension stimulation (P<0.05 or P<0.01).

Conclusions

Both EA and Mox could signifificantly improve some of the most intrusive symptoms of C-IBS patients, and EA was more effective than Mox. The therapeutic effect of these two therapies might through modulating of the brain-gut axis function. (Registration No. ChiCTRTRC-11001349).

     

Effect of Zhizhu Kuanzhong Capsules(枳术宽中胶囊) on Treatment of Functional Dyspepsia: A Meta-Analysis of Randomized Controlled Trials

Objective: To evaluate the effect of Zhizhu Kuanzhong Capsules(枳术宽中胶囊, ZKC) for functional dyspepsia(FD) through meta-analysis. Methods: Online databases, including PubMed, EM base, China National Knowledge Infrastructure, Wanfang Data, VIP database and Cochrane Library, were searched for randomized controlled trials(RCTs) of ZKC for FD from the inception to April, 2016. Trials were selected according to inclusion criteria and were evaluated with quality assessment standards in the Cochrane Handbook for Systematic Reviews of Interventions and Jadad scale. RevMan 5.3 and GRADEprofiler 3.6 were used for statistical analysis and evidence quality assessment. Results: Twenty-three trials with 2,496 patients were included and most of them were of poor methodological quality. ZKC alone or ZKC combined with routine Western medicine(WM) showed a better clinical effect rate compared with the control group of WM [odds ratio(OR)=3.32, 95% confidence interval(2.66, 4.15), P0.00001]. No serious adverse reactions were reported. Conclusions: ZKC alone or ZKC combined with routine WM could significantly improve the clinical effective rate in the treatment of FD. The quality of the evidence is low, so it is necessary to design multicenter, strictly randomized and double-blind controlled trials with large samples to validate the conclusions.     

Progressive Muscle Relaxation Combined with Chinese Medicine Five-Element Music on Depression for Cancer Patients: A Randomized Controlled Trial

Objectives

To evaluate the effects of progressive muscle relaxation training (PMRT) combined with fifive elements music therapy of Chinese medicine (CM) for improving anxiety and depression of cancer patients.

Methods

From June 2015 to March 2016, 60 cancer patients were included into the study. The patients were randomly assigned to a control group and a treatment group by envelope randomization, receiving PMRT and PMRT plus CM five elements music therapy, respectively, for 8 weeks. Hospital Anxiety and Depression Scale (HADS), Benefit Finding Scales (BFS), Functional Assessment of Chronic Illness Therapy-Spiritual (FACIT-Sp), and Intervention Expectations Questionnaire (IEQU) were adopted to assess the depression of the two groups before and after the treatment.

Results

Four cases dropped out during the study, and 29 cases in the treatment group and 27 in the control group were included in the fifinal analysis. Prior to the treatments, the baselines of the 4 questionnaires in the two groups showed no difference. After the 8-week treatment, the treatment group presented better levels of HADS, BFS and FACIT-Sp scores compared with the control group (P<0.05). Among the single items of HADS, 4 items involving vexation, feeling fifidgeted, pleasure and prospecting the future in the treatment group were improved compared with the control group (P<0.05).

Conclusions

As a simple and reliable and effective intervention, PMRT combined with fifive elements music therapy mitigated anxiety and depression of cancer patients. Cancer patients have been found to respond well to psychological intervention in areas regarding stabilisation of emotions, disease awareness, and therapeutic compliance. This brings about a great difference in improving their quality of life and psychological state, offers an effective approach to better self-management in cancer treatment.