针刺对功能性便秘患者临床疗效及情绪障碍的影响＊

目的 观察针刺治疗功能性便秘的临床疗效及其对情绪障碍的影响。方法 将符合纳入标准的64例功能性便秘患者按照随机对照的方法,分为治疗组（针刺组,n=32例）和对照组（安慰剂假针刺组,n=32例）。治疗组完成31例,脱落1例;对照组完成30例,脱落2例。治疗组取大肠俞、三焦俞、心俞、天枢、足三里和上巨虚,均取双侧穴位。对照组选用安慰剂假针刺的方法,选取非经非穴处。两组患者均进行正面和背面两次治疗,每次治疗持续20 min,共40 min,每周3次,治疗连续4周。分别在治疗前、治疗中（2周）,治疗后（4周）和随访（治疗结束后4周）时,对患者进行自主排便次数（Spontaneous Bowel Movement,SBM）、便秘患者临床评分量表（Cleveland Clinic Score,CCS）、匹兹堡睡眠质量指数（Pittsburgh Sleep Quality Index,PSQI）和抑郁自评量表（Self-Rating Depression Scale,SDS）的评估,观察并记录针刺出现的不良反应。结果 治疗组的SBM、PSQI和SDS评分与对照组比较,在治疗中、治疗后和随访时均较对照组有明显改善（P<0.01）,CCS评分在治疗后和随访时较对照组有明显改善（P<0.01）。治疗组SBM、CCS、PSQI和SDS评分在治疗中、治疗后和随访时与治疗前比较均有明显改善（P<0.01）;对照组的SBM、CCS、PSQI和SDS评分在治疗后与治疗前比较均有明显改善（P<0.01）,其中,对照组的CCS和SDS评分在治疗中与治疗前比较亦有改善（P<0.01）。结论 针刺治疗功能性便秘临床有效,不仅能够改善功能性便秘患者排便的相关症状,而且可以改善患者失眠和抑郁相关情绪障碍,提高患者的生活质量。

Effects of Acupuncture on the Clinical Efficacy and Mood Disorders of Patients with Functional Constipation

Objective To observe the effects of acupuncture on mood disorders and its clinical efficacy in the treatment of functional constipation.Methods In this study, a randomized controlled research method was used to divide 64 eligible patients with functional constipation into a therapy group (acupuncture group, n=32) and a control group (placebo sham acupuncture group, n=32). The treatment group completed 31 cases and dropped 1 case whereas the control group completed 30 cases and dropped 2 cases. The treatment group selected bilateral Tianshu (ST25), Zusanli (ST36), Shangjuxu (ST37), Dachangshu (BL25) and Sanjiaoshu (BL22), Xinshu (BL15). The control group was intervened by sham acupuncture by selecting non-meridian nonacupoint spots. Both groups of patients received two treatments on the front and back, with each treatment lasting 20 minutes for a total of 40 minutes, 3 times a week, and the treatment continued for 4 weeks. We will conduct four visits to the following evaluation scale. The patients on the Spontaneous Bowel Movements (SBM), Cleveland Clinic Score, Pittsburgh Sleep Quality Index (PSQI), and Self-Rating Depression Scale (SDS) were assessed before treatment, 2 weeks after the first treatment, 4 weeks after the first treatment, and 4 weeks after the final treatment, and adverse reactions after acupuncture were observed and recorded.Results Compared with the control group, the SBM, PSQI and SDS scores of the treatment group improved significantly during treatment, after treatment and during follow-up (P<0.01), and the CCS score in the treatment group improved significantly, compared with that in the control group after treatment and during follow-up (P<0.01). The SBM, CCS, PSQI and SDS scores of the treatment group all had a significant improvement during treatment, after treatment and during follow-up, compared with before treatment (P<0.01) while the SBM, CCS, PSQI and SDS scores of the control group also experienced a great amount of improvement after and before treatment. Among them, the CCS and SDS scores of the control group also improved during treatment compared with pretreatment (P<0.01).Conclusion Acupuncture is effective in the treatment of functional constipation. It can not only improve the clinical symptoms of patients with functional constipation, but also regulate related emotional disorders such as insomnia and depression, and further improve the life quality of patients.