Anti-irritable Bowel Syndrome Syrup Improves Constipation-Predominant Irritable Bowel Syndrome: A Randomized, Placebo-Controlled Trial

Objective: To evaluate the efficacy and safety of administration of the formulated Persian herbal syrup on improving the symptoms of patients with constipation-predominant irritable bowel syndrome (IBS-C). Methods: This study was conducted in 70 patients with IBS-C, who were recruited from 3 medical centers in Mashhad, Iran, from November 2017 to August 2018. Seventy patients were randomly assigned to 2 groups including treatment and placebo groups by block randomization, 35 cases in each group. Patients in the treatment group received 15 mL of anti-IBS syrup, thrice daily for 6 weeks and followed up for 4 weeks. Placebo syrup was also prepared through similar instruction, BP syrup without plant extract was used. Primary outcome induding IBS Symptom Severity Scale (IBS-SSS) questionnaire and secondary outcomes in terms of Hospital Anxiety and Depression (HADS) questionnaires, the Bristol Stool Form Scale (BSFS) were completed and evaluated at weeks 6 and 10, respectively. Safety indices were collected at the end of the treatment and Common Terminology Criteria for Adverse Events v4.0 (CTCAE) was used to evaluate the adverse events. Results: The response to treatment was 84.4% (27/32) in the treatment group and 46.4% (13/28) in the placebo group, respectively (P= 0.002). Compared with pre-treatment, a significant decrease was found on the IBS-SSS and BSFS scores after 6-week intervention in both groups (P<0.001). Moreover, IBS-SSS and BSFS scores in the treatment group were lower than the placebo group after the intervention (P=0.041). There was no significant difference in the anxiety and depression scores after treatment in both groups (P>0.05). Side effects reported in the treatment group included 2 cases of headache during the first week of the onset of the treatment, 1 case of drowsiness, 1 case of increase in menstrual bleeding, which did not result in discontinuation of the treatment. In the placebo group, 1 case of exacerbation of the disease was reported. Conclusions: Anti-IBS syrup significantly reduced the severity of IBS symptoms compared to placebo. However, there was a need for further investigation regarding the anxiety and depression scores. (Registration No. IRCT2017061034446N1).     

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

Objective:To compare the effects of electroacupuncture(EA) and moxibustion therapies on patients with diarrhea-predominant irritable bowel syndrome(D-IBS).Methods:A total of 60 D-IBS patients were randomly allocated to the EA group(30 cases) and moxibustion group(30 cases).Before and after treatment,the gastrointestinal symptoms and psychological symptoms were scored by Visual Analogue Scale,Bristol Stool Form Scale,Hamilton Anxiety Rating Scale(HAMA),and Hamilton Depression Rating Scale(HAMD);the expressions of 5-hydroxytryptamine(5-HT),5-HT_3 receptor(5-HT3R),and 5-HT_4 receptor(5-HT4R) in the sigmoid mucosal tissue were measured by immunohistochemical staining.Additionally,the effects on the functional brain areas of the anterior cinguiate cortex(ACC),insular cortex(IC) and prefrontal cortex(PFC)were observed by functional magnetic resonance imaging.Results:Compared with before treatment,both EA and moxibustion groups reported significant improvements in abdominal pain and abdominal bloating after treatment(P0.01 or P0.05).The moxibustion group reported greater improvements in defecation emergency,defecation frequency,and stool feature than the EA group(P0.01).Both HAMA and HAMD scores were significantly decreased in the moxibustion group than in the EA group(P0.01).Both groups demonstrated significantly reduced expressions of 5-HT,5-HT3 R and 5-HT4 R in the colonic mucosa after treatment(P0.01),with a greater reduction of 5-HT in the moxibustion group(P0.05).Finally,decreased activated voxel values were observed in the left IC,right IC and PFC brain regions of patients in the moxibustion group under stimulation with 150 mL colorectal distension after treatment(P0.05 or P0.01),while in the EA group only PFC area demonstrated a reduction(P0.05).Conclusion:Moxibustion can significantly improve the symptoms of D-IBS,suggesting that moxibustion may be a more effective therapy than EA for D-IBS patients.     

艾灸治疗腹泻型肠易激综合征临床研究

目的观察艾灸对腹泻型肠易激综合征的临床疗效。方法将符合纳入标准的60例患者随机分为2组：治疗组（30例）和对照组（30例）分别采用艾灸和西药洛哌丁胺治疗。观察两组临床疗效、治疗前后症状积分变化。结果治疗组总体临床疗效显著优于对照组（P〈0.05）。治疗后对照组腹痛、腹胀或不适、大便性状、大便次数积分显著降低（P〈0.01）,治疗组腹痛、腹胀或不适、大便性状、大便次数、黏液便、胃纳减少、大便不尽感积分均显著降低（P〈0.05,或P〈0.01）。治疗前后胃纳减少、大便不尽感、腹痛、腹胀或不适的积分差值比较,治疗组显著高于对照组（P〈0.05,或P〈0.01）。结论艾灸对腹泻型肠易激综合征的临床疗效优于西药洛哌丁胺。     

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.     

穴位敷贴治疗腹泻型肠易激综合征的系统评价

目的 系统评价中医穴位敷贴治疗腹泻型肠易激综合征(IBS-D)的有效性及安全性.方法 检索建库至2016年12月间CNKI、VIP、CBM、SCI、PubMed、Embase、Cochrane等中英文数据库中采用穴位敷贴治疗IBS-D的临床随机对照试验,并辅以手工检索.按照纳入排除标准筛选文献,RevMan 5.3软件进行系统评价.结果 (1)最终纳入11项临床随机对照研究,合计803例患者,其中,穴位敷贴治疗组402例,西药对照组401例;(2)文献方法质量学方面,3分以上文献7篇,文献质量普遍较高;(3)有效性方面,与西医对照组相比,穴位敷贴治疗组临床总有效率的总优势比OR[95％CI]为3.29[2.25,4.82],差异有统计学意义(P<0.05).其中,穴位使用频次前5位的依次是神阙、中脘、脾俞、足三里及肝俞穴;(4)安全性方面,除1项研究外,其余穴位敷贴治疗组不良反应发生率均低于西药对照组.结论 穴位敷贴可以提高IBS-D临床效果且不良反应少,但仍需更多高质量的多中心、大样本随机对照试验证实.     

肠易激综合征脑-肠互动机制及艾灸调节作用概述

综述脑-肠轴与脑-肠互动、orexin、脑-肠互动与肠易激综合征（IBS）三者的密切关系,艾灸调节胃肠动力和镇痛作用机制。认为orexin及脑-肠互动对IBS的发生发展具有重要意义,脑-肠轴是艾灸治疗IBS机制的重要途径。     

Effectiveness and Safety of Moxibustion Robots on Primary Dysmenorrhea: A Randomized Controlled Pilot Trial

Objective: To conduct a pilot trial to explore the effectiveness and safety of moxibustion robots in treating primary dysmenorrhea (PD) and evaluate its feasibility in clinic. Methods: A total of 70 participants with PD were allocated to either moxibustion robot (MR) group (35 cases) or manual moxibustion (MM) group (35 cases) using computer-generated randomization. One acupoint Guanyuan (CV 4) was selected to receive moxa heat stimulation. Two groups of participants were given 3 menstrual cycles of MM and MR treatment respectively (once a day, 5 days a session) and received another 3 menstrual cycles follow-up. The degree of pain was evaluated by short-form McGill pain questionnaire (SF-MPQ) and the symptoms of dysmenorrhea were evaluated by Cox Menstrual Symptom Scale (CMSS). The safety was measured by the occurrence rate of adverse events (AEs), including burns (blisters, red and swollen), itching, bowel changes, menstrual cycle disorder, menorrhagia and fatigue, etc. Results: A total of 62 patients completed the trial, 32 in MR group and 30 in MM group. Compared with baseline, scores of SF-MPQ and CMSS significantly decreased in both groups (P<0.05), and no significant difference was observed between the two groups in the 3rd and 6th menstrual cycles (P>0.05). The total occurrence rate of AEs in MR group was 2.1%, which was significantly lower than MM group (7.2%, P<0.05). Conclusion: MR has the same effect as MM at SF-MPQ and CMSS in patients with PD. However, MR is safer than MM (Trial registration No. ChiCTR1800018236).     

逍遥丸治疗儿童肠易激综合征随机对照研究

目的:观察逍遥丸治疗儿童肠易激综合征的临床疗效。方法:观察组32例采用逍遥丸治疗,与空白对照组31例相比较,观察8周。结果:观察组和对照组的总有效率分别为84.38%,38.71%(P<0.01);逍遥丸在改善腹痛、腹胀及大便次数增多、排便不尽感及大便性状等方面均优于对照组,差异具有显著性意义;而在改善黏液便方面,两组差异不具显著性意义(P>0.05);逍遥丸能明显改善患儿肝郁脾虚证候,治疗前后证候积分比较具有显著性差异。结论:逍遥丸对于儿童肠易激综合征具有较好的临床疗效,并能有效改善肠易激综合征患者症状。     

基于CONISORT和STRICTA评价针灸治疗肠易激综合征临床随机对照试验报告质量

目的：采用CONSORT声明和STRICTA标准评价国内针灸治疗肠易激综合征临床随机对照试验质量。方法：利用计算机检索与手工检索。检索CNKI、CBM、VIP和万方4个数据库,结合手工检索相关期刊,筛选出符合研究标准的文献,采用CONSORT声明和STRICTA标准进行质量评价。结果：共纳入合格文献42篇。大部分文献存在随机方法描述不清和无随机隐藏、盲法使用率低、无样本量计算、无意向治疗分析、针刺细节报道不充分、无针刺治疗医生的资历等问题。结论：目前针灸治疗肠易激综合征的临床随机对照试验质量普遍较低,影响报道的可靠性和同质可比性。为提高针灸临床随机试验可靠性和质量,应该将CONSORT声明和STRICTA标准引入针灸临床随机试验设计并严格执行。     

盐酸帕罗西汀治疗肠易激综合征疗效观察

目的评价小剂量抗抑郁药物盐酸帕罗西汀治疗肠易激综合征的疗效。　方法 36例符合罗马I诊断标准的肠易激综合征患者每日一次服用盐酸帕罗西汀 10mg,疗程 12周 ,治疗前后自身配对比较。　结果在胃肠道症状方面 ,对腹痛程度和腹痛天数 ,腹胀程度和腹胀天数及大便性状 (便秘或腹泻 )的改善具有明显疗效 (P <0 .0 5 )。但大便次数改善不明显。在精神和躯体症状方面 ,除了明显改善焦虑症状外 ,其它如抑郁、不愉快、疲惫、头痛及腰背痛症状改善不明显。　结论小剂量盐酸帕罗西汀能明显改善肠易激综合征患者的胃肠道症状 ,但在改善精神和躯体症状方面 ,有待进一步研究     

腧穴热敏化悬灸治疗腹泻型肠易激综合征临床研究

【目的】比较腧穴热敏化悬灸与口服西药治疗腹泻型肠易激综合征(IBS-D)的临床疗效差异。【方法】采用随机数字表法将80例符合纳入标准的IBS-D患者随机分为治疗组和对照组各40例,治疗组采用腧穴热敏化悬灸治疗,对照组采用口服马来酸曲美布汀胶囊治疗,2组治疗时间均为4周,观察并记录治疗前后IBS-D主要症状体征(腹痛、腹胀、排便次数、稀烂便)积分变化,评价2组临床疗效及安全性。【结果】(1)治疗4周后,2组患者的各项主要临床症状评分及总积分均较治疗前显著改善(P0.01),且治疗组在改善患者的各项主要临床症状评分及总积分方面均优于对照组(P0.05或P0.01)。(2)在疗效方面,治疗组的总有效率为85.0%,优于对照组的67.5%,差异有统计学意义(P0.05)。(3)在安全性方面,2组在治疗后均未出现任何不良反应。【结论】腧穴热敏化悬灸疗法治疗IBS-D临床疗效显著,安全性良好。     

再普乐治疗肠易激综合征的临床观察

目的:观察再普乐治疗肠易激综合征(IBS)的临床疗效。方法:IBS 64例随机分成对照组[32例。口服谷维素10mg,tid]和治疗组[32例。口服再普乐1.25 mg,qn],每组疗程2周;观察治疗前、后嗳气、纳差、腹胀、腹痛、腹泻、失眠等症状的变化。结果:治疗组总有效率(86.4%)明显高于对照组(53.2%)(P<0.01),且无明显不良反应。结论:再普乐可迅速控制抑郁、焦虑和躯体性消化道症状,是治疗IBS的有效药物。     

Comparison of Electroacupuncture and Body Acupuncture on Gastrocnemius Muscle Tone in Children with Spastic Cerebral Palsy: A Single Blinded, Randomized Controlled Pilot Trial

Objective: To compare the immediate effects of electroacupuncture(EA) and body acupuncture(BA) on gastrocnemius muscle tone in children with spastic cerebral palsy(CP). Methods: Children with spastic CP, age from 24 to 60 months, who all received rehabilitation treatment in the Department of Developmental and Behavioral Pediatrics, the First Hospital of Jilin University from April 2016 to May 2017 were enrolled in this trial and assigned to EA group and BA group through a random number table. Both EA and BA therapies were performed on acupoints of Zusanli(ST 36), Shangjuxu(ST 37), Sanyinjiao(SP 6), and Xuanzhong(GB 39) for 30 min once. The root mean square(RMS), integrated electromyogram(iEMG) of the gastrocnemius of surface electromyography(sEMG), and Modified Tardieu Scale(MTS) of the two groups were evaluated before and after treatment. All adverse events were accurately recorded. Results: Thirty-six children with spastic CP completed the study(18 cases and 32 legs in the EA group; 18 cases and 31 legs in the BA group). There was no significant difference in RMS, iEMG and MTS between the two groups before treatment(P0.05). After treatment, compared with before treatment, RMS and iEMG significantly reduced and MTS(R2–R1) significantly increased in both EA and BA groups(P0.05), and EA was more effective than BA in RMS and MTS(P0.05). However, the iEMG between the two groups were not statistically significant after treatment(P0.05). There was no serious adverse event during this clinical trial. Conclusion: Both EA and BA could significantly relieve the gastrocnemius muscle tone in spastic CP, and EA was more effective than BA.(Registration No. ChiCTRONC-15007633)     

肠易激综合征患者的护理研究

目的：探讨对肠易激综合征的护理干预效果。方法：将川北医学院附属医院2011年5月-2013年4月收治的肠易激综合征患者45例纳入本研究,均在对症治疗的同时实施系统护理干预。对比护理干预前后患者情绪状态和生活质量的变化。结果：与护理干预前对比发现,护理干预后SAS评分、SDS评分明显下降,SF-36评分明显提高,差异有统计学意义（P〈0.05）。结论：对肠易激综合征患者治疗期间实施优质的系统护理干预,有助于改善情绪状态、提高生活质量。     

匹维溴铵联合氟哌噻吨美利曲辛治疗肠易激综合征的系统评价

目的 了解匹维溴铵联合氟哌噻吨美利曲辛与单用匹维溴铵治疗肠易激综合征(IBS)的疗效和安全性,为临床实践提供证据.方法 检索Cochrane图书馆、Pubmed数据库、维普中刊数据库、万方数据库、中国生物医学文献数据库等,检索出匹维溴铵联合氟哌噻吨美利曲辛与单用匹维溴铵治疗IBS的研究,进行资料提取及方法学质量评价,并采用Revman5.3软件对总有效率、不良反应发生率、汉密尔顿焦虑及抑郁评分进行Meta分析.结果 共检索出16个符合纳入标准的研究,包括1 688例患者进入本系统评价.14个试验的Meta分析提示,匹维溴铵联合氟哌噻吨美利曲辛治疗IBS与单用匹维溴铵比较,联合治疗总有效率优于单用匹维溴铵(P＜0.000 01).3个研究的汉密尔顿焦虑及抑郁评分的Meta分析提示,联合治疗组低于单用匹维溴铵组(P＜0.000 01).6个试验研究了不良反应发生率,联合治疗组高于单用匹维溴铵组(P=0.008).结论 匹维溴铵与氟哌噻吨美利曲辛联合治疗IBS的疗效优于单用匹维溴铵,且能改善精神情绪障碍,但还需进一步高质量、多中心的研究.     

痛泻要方合四君子汤加减对腹泻型肠易激综合征患者脑肠肽的影响

目的 探讨痛泻要方合四君子汤治疗腹泻型肠易激综合征（IBS-D）患者的临床疗效及其对血浆脑肠肽的影响。方法 53例患者符合Rome Ⅲ制定的IBS-D的诊断标准,随机分为2组:治疗组27例,予痛泻要方合四君子汤加减;对照组26例,予得舒特片联合思连康片;疗程4周,观察2组患者治疗前后的临床症状积分、生活质量量表（IBS-QOL）、神经肽Y（NPY）、降钙素基因相关肽（CGRP）及血管活性肠肽（VIP）水平的变化。结果 治疗组总有效率为92.6%,明显高于对照组76.9%( P ＜0.05);治疗后治疗组的临床症状评分明显低于对照组（ P ＜0.05）;治疗组IBS-QOL量表积分高于对照组( P ＜0.05)。治疗后2组血浆NPY水平显著升高,CGRP和VIP水平显著下降（ P ＜0.05~0.01）,2组间差异有统计学意义（ P ＜0.05）。结论 痛泻要方合四君子汤能显著改善IBS-D患者的临床症状,提高生活质量,其作用机制可能通过升高血浆NPY水平,降低CGRP和VIP水平,调节脑肠肽分泌平衡相关。      

莫沙必利联合选时穴位按摩与心理治疗对便秘型肠易激综合征的影响

[目的]探讨奠沙必利联合选时穴位按摩与心理治疗对便秘型肠易激综合征的影响。[方法]选择便秘型肠易激综合征患者86例,随机分为治疗组43例和对照组43例;对照组给予莫沙必利5mg／次,3次／d;治疗组在对照组治疗基础上予择时选穴按摩与心理治疗。[结果]治疗组便秘治疗的总有效率为86．0％,显著高于对照组60．5％,差异有统计学意义（P〈0．05）。[结论]莫沙必利联合选时穴位按摩与心理治疗治疗便秘型肠易激综合征疗效优于单用莫沙必利,适于临床应用和推广。     

Effect of Essential Oil on Patients with Chronic Prostatitis/Chronic Pelvic Pain Syndrome: A Pilot Randomized Controlled Trial

Objective: To evaluate the efficacy and safety of essential oil treatment for type Ⅲ chronic prostatitis/chronic pelvic pain syndrome(CP/CPPS). Methods: A randomized controlled trial was conducted from December 2014 to October 2015. Seventy type Ⅲ CP/CPPS patients were assigned to the essential oil group(35 cases) or almond placebo oil control group(35 cases) by a random number table. The oil was smeared by self-massage on the suprapubic and sacral region once a day for 4 weeks. The National Institutes of Health Chronic Prostatitis Syndrome Index(NIH-CPSI) and expressed prostatic secretions(EPS) were examined. The primary outcome was NIH-CPSI pain domain. The secondary outcomes included other NIH-CPSI domains and laboratory examinations of EPS. Adverse events were also observed. Results: Sixty-six subjects completed the full 4-week treatment. There was no significant difference between almond oil control and essential oil groups in terms of the total score of NIH-CPSI, pain, quality of life and urination domain scores of NIH-CPSI and EPS examinations(P0.05). In the essential oil group, pain between rectum and testicles(perineum) in the domain of pain or discomfort was significantly reduced at week 2 and week 4 compared with almond oil control group(P0.01). No serious adverse events occurred. Conclusion: The essential oil may reduce the pain or discomfort in the perineum region in patients with CP/CPPS.     

子午流注针法配合穴位贴敷治疗腹泻型肠易激综合征的临床观察

目的:评价子午流注针法配合穴位贴敷治疗腹泻型型肠易激综合征的疗效。方法:将120例腹泻型型肠易激综合征患者随机分为子午流注针法配合穴位贴敷组(观察组)和西药组(对照组),每组60例。观察组运用子午流注针法配合穴位贴敷治疗,28 d为1个疗程;对照组,马来酸曲美布汀胶囊(瑞健)口服,每次0.2 g,3次/d,28 d为1个疗程。治疗1个疗程后统计临床疗效。结果:2组治疗腹泻型型肠易激综合征患者的临床疗效差异有统计学意义(P0.05),针灸治疗该病证的总有效率为91.67%,优于药物对照组73.33%。2组治疗该病的主要单项症状疗效差异具有统计学意义(P0.05)。结论:子午流注针法配合穴位贴敷能够有效治疗腹泻型肠易激综合征患者的临床症状,提高其生活质量。值得推广及应用。     

电针治疗急性周围性面神经麻痹的随机对照研究*

目的 探讨基于不同参数下电针治疗急性周围性面神经麻痹的临床疗效,提供临床电针早期介入治疗面瘫的最佳参数的科学依据。方法 采用随机对照试验方法,将133例急性周围性面神经麻痹患者随机分为A组（2Hz＜疏密波≤5Hz组）;B组（1Hz＜疏密波≤2Hz组）;C组（2Hz＜连续波≤5Hz组）;D组（1Hz＜连续波≤2Hz组）;E组（普通针刺组）5个治疗组。并在入组前、治疗2疗程、治疗4疗程后采用House-Brackmann局部量化评分量表、中医症状积分量表以及总有效率进行临床疗效评价。结果 H-B局部量化评分量表及中医症状积分量表组内比较差异均具有统计学意义（P＜0.05）,组间比较无统计学意义（P＞0.05）。各组治疗总有效率分别为A组100%、B组95.7%、C组92.9%、D组94.8%、E组100%,5种治疗方案疗效比较差异没有统计学意义（P＞0.05）。结论 5种治疗方案均为急性周围性面神经麻痹的优势治疗方案;电针早期介入治疗有效。提示可能在临床上应用低频的电刺激也可促使面神经麻痹患者具有较良好的愈后。