本文關(guān)鍵詞： 腹瀉型腸易激綜合征 調(diào)神健脾 針刺 HPA軸 應(yīng)激　出處：《南京中醫(yī)藥大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:研究調(diào)神健脾針刺法對(duì)D-IBS患者HPA軸的影響,探討調(diào)神健脾針刺法治療D-IBS的可能機(jī)制。方法:本研究共收治34例D-IBS患者,試驗(yàn)組22例及對(duì)照組12例。試驗(yàn)組予調(diào)神健脾針刺法治療,每周3次,連續(xù)治療6周,共計(jì)18次;對(duì)照組服用匹維溴銨片(得舒特,雅培公司,50mg)每次1片,每天3次,共治療6周。分別運(yùn)用IBS-SSS量表、HAM-D量表評(píng)價(jià)患者治療前后臨床癥狀變化,并運(yùn)用酶聯(lián)免疫測(cè)定法(enzyme-linked immunosorbent assay,ELISA)檢測(cè)兩組患者治療前后血清CRF、ACTH、CORT及糞便SIgA變化。結(jié)果:1.針刺總有效率90.91%,大于藥物總有效率75.00%,兩組總有效率對(duì)比差異具有統(tǒng)計(jì)學(xué)意義(P0.05)。2.兩組患者IBS-SSS評(píng)分與治療前進(jìn)行組內(nèi)對(duì)比,差異均具有統(tǒng)計(jì)學(xué)意義(均P0.05);兩組治療后評(píng)分組間差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05);試驗(yàn)組患者HAM-D量表積分治療后較治療前降低,差異具有統(tǒng)計(jì)學(xué)意義(P0.05);而對(duì)照組患者HAM-D量表積分治療后較治療前比較,差異無(wú)統(tǒng)計(jì)學(xué)意義(p0.05)。3.試驗(yàn)組患者血清CRF、ACTH、CORT含量針刺后較針刺前降低,差別具有統(tǒng)計(jì)學(xué)意義(P0.05);而對(duì)照組患者血清CRF、ACTH、CORT含量用藥六周后較用藥前比較,差異無(wú)統(tǒng)計(jì)學(xué)意義(均P0.05)。4.兩組患者腸內(nèi)容物SIgA含量干預(yù)后較干預(yù)前升高,組內(nèi)差異均具有統(tǒng)計(jì)學(xué)意義(均P0.05)。兩組組間比較無(wú)明顯差異(P0.05)。結(jié)論:調(diào)神健脾針刺法能夠明顯緩解D-IBS患者臨床癥狀,改善患者精神狀態(tài),作用機(jī)制可能是通過調(diào)節(jié)HPA軸,下調(diào)血清CRF、ACTH、CORT,促進(jìn)SIgA分泌,改善患者腸道功能及精神狀態(tài)而發(fā)揮臨床療效。
[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.
【學(xué)位授予單位】：南京中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R246.1

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