南京中医药大学学报
南京中醫藥大學學報
남경중의약대학학보
Journal of Nanjing University of Traditional Chinese Medicine
2015年
5期
416-419
,共4页
裴丽霞%朱莉%陈璐%吴晓亮%周俊灵%耿昊%孙建华
裴麗霞%硃莉%陳璐%吳曉亮%週俊靈%耿昊%孫建華
배려하%주리%진로%오효량%주준령%경호%손건화
针刺%IBS-C%5-HT%NPY%CGRP
針刺%IBS-C%5-HT%NPY%CGRP
침자%IBS-C%5-HT%NPY%CGRP
acupuncture%IBS-C%5-HT%NPY%CGRP
目的:观察针刺对便秘型肠易激综合征(IBS?C)患者血浆中5?羟色胺(5?HT)、神经肽 Y(NPY)和降钙素基因相关肽(CGRP)水平的影响,从脑?肠轴的角度阐述针刺治疗 IBS?C 的效应机制。方法60例 IBS?C 患者随机分为针刺组和西药组。针刺组30例,予针刺治疗,取天枢、足三里、上巨虚、太冲、三阴交、印堂、百会,每日1次,每周5次,4周为1个疗程;西药组30例,予口服乳果糖口服溶液,15 mL 每次,每日3次,4周为1个疗程。观察2组治疗前后临床症状改善情况。同时采集2组患者治疗前后及30名健康志愿者外周静脉血,采用 Elisa 法检测患者血浆中的5?HT、CGRP 和 NPY 的水平,探讨针刺对 IBS?C患者血浆5?HT、NPY 和 CGRP 的影响。结果①针刺及西药均能显著改善 IBS?C 患者的临床症状(P <0.01),针刺组疗效均优于西药组(P <0.01)。②2组 IBS?C 患者血浆5?HT、NPY 和 CGRP 水平均明显高于健康志愿者,差异有统计学意义(P <0.01)。治疗后2组 IBS?C 患者血浆5?HT、NPY 和 CGRP 水平均下降,针刺组患者血浆5?HT、NPY 和 CGRP 水平较治疗前有显著差异(P <0.01);西药组患者血浆5?HT、NPY 水平较治疗前也有显著差异(P <0.01),CGRP 水平与治疗前比较无统计学意义(P >0.05)。2组治疗后组间比较血浆5?HT、NPY 无统计学差异(P >0.05),血浆 CGRP 有统计学差异(P <0.01),针刺组下降趋势优于西药组。结论①针刺可显著改善 IBS?C 患者的临床症状,疗效均优于西药组。②IBS?C 患者血浆5?HT、NPY 和 CGRP 水平均升高,说明脑肠肽水平异常与 IBS?C 症状密切相关。③针刺能明显降低患者血浆5?HT、NPY 和 CGRP水平,缓解腹痛与腹部不适程度,表明针刺对 IBS?C 患者血浆脑肠肽水平的良性调控作用可能是其治疗本病的效应机制之一。
目的:觀察針刺對便祕型腸易激綜閤徵(IBS?C)患者血漿中5?羥色胺(5?HT)、神經肽 Y(NPY)和降鈣素基因相關肽(CGRP)水平的影響,從腦?腸軸的角度闡述針刺治療 IBS?C 的效應機製。方法60例 IBS?C 患者隨機分為針刺組和西藥組。針刺組30例,予針刺治療,取天樞、足三裏、上巨虛、太遲、三陰交、印堂、百會,每日1次,每週5次,4週為1箇療程;西藥組30例,予口服乳果糖口服溶液,15 mL 每次,每日3次,4週為1箇療程。觀察2組治療前後臨床癥狀改善情況。同時採集2組患者治療前後及30名健康誌願者外週靜脈血,採用 Elisa 法檢測患者血漿中的5?HT、CGRP 和 NPY 的水平,探討針刺對 IBS?C患者血漿5?HT、NPY 和 CGRP 的影響。結果①針刺及西藥均能顯著改善 IBS?C 患者的臨床癥狀(P <0.01),針刺組療效均優于西藥組(P <0.01)。②2組 IBS?C 患者血漿5?HT、NPY 和 CGRP 水平均明顯高于健康誌願者,差異有統計學意義(P <0.01)。治療後2組 IBS?C 患者血漿5?HT、NPY 和 CGRP 水平均下降,針刺組患者血漿5?HT、NPY 和 CGRP 水平較治療前有顯著差異(P <0.01);西藥組患者血漿5?HT、NPY 水平較治療前也有顯著差異(P <0.01),CGRP 水平與治療前比較無統計學意義(P >0.05)。2組治療後組間比較血漿5?HT、NPY 無統計學差異(P >0.05),血漿 CGRP 有統計學差異(P <0.01),針刺組下降趨勢優于西藥組。結論①針刺可顯著改善 IBS?C 患者的臨床癥狀,療效均優于西藥組。②IBS?C 患者血漿5?HT、NPY 和 CGRP 水平均升高,說明腦腸肽水平異常與 IBS?C 癥狀密切相關。③針刺能明顯降低患者血漿5?HT、NPY 和 CGRP水平,緩解腹痛與腹部不適程度,錶明針刺對 IBS?C 患者血漿腦腸肽水平的良性調控作用可能是其治療本病的效應機製之一。
목적:관찰침자대편비형장역격종합정(IBS?C)환자혈장중5?간색알(5?HT)、신경태 Y(NPY)화강개소기인상관태(CGRP)수평적영향,종뇌?장축적각도천술침자치료 IBS?C 적효응궤제。방법60례 IBS?C 환자수궤분위침자조화서약조。침자조30례,여침자치료,취천추、족삼리、상거허、태충、삼음교、인당、백회,매일1차,매주5차,4주위1개료정;서약조30례,여구복유과당구복용액,15 mL 매차,매일3차,4주위1개료정。관찰2조치료전후림상증상개선정황。동시채집2조환자치료전후급30명건강지원자외주정맥혈,채용 Elisa 법검측환자혈장중적5?HT、CGRP 화 NPY 적수평,탐토침자대 IBS?C환자혈장5?HT、NPY 화 CGRP 적영향。결과①침자급서약균능현저개선 IBS?C 환자적림상증상(P <0.01),침자조료효균우우서약조(P <0.01)。②2조 IBS?C 환자혈장5?HT、NPY 화 CGRP 수평균명현고우건강지원자,차이유통계학의의(P <0.01)。치료후2조 IBS?C 환자혈장5?HT、NPY 화 CGRP 수평균하강,침자조환자혈장5?HT、NPY 화 CGRP 수평교치료전유현저차이(P <0.01);서약조환자혈장5?HT、NPY 수평교치료전야유현저차이(P <0.01),CGRP 수평여치료전비교무통계학의의(P >0.05)。2조치료후조간비교혈장5?HT、NPY 무통계학차이(P >0.05),혈장 CGRP 유통계학차이(P <0.01),침자조하강추세우우서약조。결론①침자가현저개선 IBS?C 환자적림상증상,료효균우우서약조。②IBS?C 환자혈장5?HT、NPY 화 CGRP 수평균승고,설명뇌장태수평이상여 IBS?C 증상밀절상관。③침자능명현강저환자혈장5?HT、NPY 화 CGRP수평,완해복통여복부불괄정도,표명침자대 IBS?C 환자혈장뇌장태수평적량성조공작용가능시기치료본병적효응궤제지일。
ABSTRACTOBJECTIVE To explore the acupuncture treatment mechanism of constipation?predominant irritable bowel syn-dromeIBS?C from the perspective of brain?gut axisby observing the plasma 5HTCGRP and NPY level before and after the treatment.METHODS 60 patients with IBS?C were randomly divided into two groups.30 cases in the acupuncture groupAG were treated by acupuncture five times a weekwith such acupoints as TianshuZusanliShangjuxuTaichongSanyin-jiaoYintangBaihui being selected.The other 30 cases in the medicine groupMGwere treated with lactulose oral solution15 ml per time for three times a day.After 4 weeks treatmentenzyme?linked immunosorbent assayELISAwas used to de-tect the plasma 5HTNPY and CGRP level of 30 healthy volunteers and the two treatment groups and observe the improve-ment of clinical symptoms.RESULTS ①Both groups could significantly improve the clinical symptoms in patients with IBS?CP <0.01while the curative effect in the AG was superior to that in the MGP <0.01.②The levels of 5?HTNPY and CGRP in patients with IBS?C of two treatment groups were significantly higher than those in healthy volunteersand the differ-ence was statistically significantP <0.01.The plasma 5?HTNPY and CGRP levels all went down in both groups after treatmentand the differences of 5?HTNPY and CGRP levels were significant when compared to the levels before treatment in AGP <0.01.The differences of 5?HTNPY levels were also significant when compared to the levels before treatment in MGP <0.01while there was no significant difference on CGRPP <0.01.There were no significant differences of 5?HT and NPY levels between these two groups after treatmentP >0.05but the difference of CGRP was highly statistically sig-nificantP <0.01.The downward trend of 5?HTNPY and CGRP level was better in the AG.CONCLUSION ①Acupunc-ture treatment can significantly improve the clinical symptoms in patients with IBS?Cand the theraputic effect is superior to that in the MG.②The increase of 5?HTNPY and CGRP level in patients with IBS?C after treatment suggests a close relation-ship between the abnormal level of brain?gut peptide and IBS syndrome.③Acupuncture treatment can decrease the plasma lev-els of 5?HTNPY and CGRPalleviate the degree of abdominal pain and discomfortwhich indicates that benign regulation of brain?gut peptide level in patients with IBS?C by acupuncture may be one of the effective mechanisms in treatmenting this dis-ease.