调神健脾针刺法对腹泻型肠易激综合征患者下丘脑—垂体—肾上腺轴的影响

发布时间：2018-02-27 09:12

本文关键词： 腹泻型肠易激综合征调神健脾针刺 HPA轴应激　出处：《南京中医药大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:研究调神健脾针刺法对D-IBS患者HPA轴的影响,探讨调神健脾针刺法治疗D-IBS的可能机制。方法:本研究共收治34例D-IBS患者,试验组22例及对照组12例。试验组予调神健脾针刺法治疗,每周3次,连续治疗6周,共计18次;对照组服用匹维溴铵片(得舒特,雅培公司,50mg)每次1片,每天3次,共治疗6周。分别运用IBS-SSS量表、HAM-D量表评价患者治疗前后临床症状变化,并运用酶联免疫测定法(enzyme-linked immunosorbent assay,ELISA)检测两组患者治疗前后血清CRF、ACTH、CORT及粪便SIgA变化。结果:1.针刺总有效率90.91%,大于药物总有效率75.00%,两组总有效率对比差异具有统计学意义(P0.05)。2.两组患者IBS-SSS评分与治疗前进行组内对比,差异均具有统计学意义(均P0.05);两组治疗后评分组间差异无统计学意义(P0.05);试验组患者HAM-D量表积分治疗后较治疗前降低,差异具有统计学意义(P0.05);而对照组患者HAM-D量表积分治疗后较治疗前比较,差异无统计学意义(p0.05)。3.试验组患者血清CRF、ACTH、CORT含量针刺后较针刺前降低,差别具有统计学意义(P0.05);而对照组患者血清CRF、ACTH、CORT含量用药六周后较用药前比较,差异无统计学意义(均P0.05)。4.两组患者肠内容物SIgA含量干预后较干预前升高,组内差异均具有统计学意义(均P0.05)。两组组间比较无明显差异(P0.05)。结论:调神健脾针刺法能够明显缓解D-IBS患者临床症状,改善患者精神状态,作用机制可能是通过调节HPA轴,下调血清CRF、ACTH、CORT,促进SIgA分泌,改善患者肠道功能及精神状态而发挥临床疗效。
[Abstract]:Objective: to study the effect of regulating spirit and strengthening spleen acupuncture on HPA axis of D-IBS patients, and to explore the possible mechanism of treating D-IBS with acupuncture therapy of regulating spirit and strengthening spleen. Methods: 34 patients with D-IBS were treated in this study. There were 22 cases in the experimental group and 12 cases in the control group. The experimental group was treated with the acupuncture of tonifying the spirit and strengthening the spleen 3 times a week for 6 weeks for a total of 18 times, while the control group took one tablet of pivemine bromide (Dexuter, 50 mg of Abbott) three times a day. The patients were treated for 6 weeks. The changes of clinical symptoms were evaluated by IBS-SSS scale and HAM-D scale before and after treatment. The changes of serum CRF ACTHCORT and fecal SIgA were detected by enzyme-linked immunosorbent assaysa before and after treatment. Results: 1. The total effective rate of acupuncture was 90.91 1, which was larger than 75.00% of the total effective rate of drugs. The difference of total effective rate between the two groups was statistically significant (P0.05. 2). The IBS-SSS scores of the two groups were compared with those before treatment. The difference was statistically significant (all P0.05A; there was no significant difference between the two groups after treatment; the scores of the patients in the trial group were lower after treatment than before treatment, and the scores of the patients in the test group were lower than those before the treatment. The difference was statistically significant (P 0.05), but there was no significant difference between the control group and the control group after the treatment with HAM-D scale. The serum CRFN ACTHCORT content of the patients in the experimental group was lower than that before acupuncture. The difference was statistically significant (P 0.05), but the serum level of SIgA in the control group was not significantly higher than that before treatment after six weeks (all P 0.05. 4). After intervention, the content of SIgA in the intestinal contents of the two groups was higher than that before the intervention, and there was no significant difference between the two groups in the content of SIgA in the intestinal contents after intervention, and there was no significant difference between the two groups after 6 weeks of treatment. There was no significant difference between the two groups (P 0.05). Conclusion: the acupuncture method of regulating spirit and invigorating spleen can obviously relieve the clinical symptoms and improve the mental state of the patients with D-IBS. The mechanism of action may be by adjusting the HPA axis. The clinical curative effect was brought into play by down-regulating the serum CRF ACTH Cort, promoting the secretion of SIgA and improving the intestinal function and mental state of the patients.
【学位授予单位】：南京中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R246.1

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