Shanghai Journal of Acupuncture and Moxibustion
温针灸八髎穴治疗老年阳虚型慢性功能性便秘的疗效观察
李博,黎昱辰(河南省郑州市中心医院,郑州 450007)
观察温针灸八髎穴(上髎、次髎、中髎和下髎穴)治疗老年阳虚型慢性功能性便秘的临床疗效,并与常规针刺进行疗效比较。 将 60 例 60 岁以上阳虚型慢性功能性便秘患者随机分为试验组与对照组,每组 30例。对照组采取普通针刺八髎穴治疗,试验组采取温针灸八髎穴治疗。比较两组临床疗效,观察两组治疗前后 Bristol 大便性状量表评分、慢性便秘严重度评分量表评分、中医证候积分和生活质量自评量表评分的变化。 两组治疗后 Bristol 大便性状量表评分、慢性便秘严重度评分量表评分、中医证候积分和生活质量自评量表评分均明显低于治疗前( P＜ 0.05),且试验组治疗后上述评分均低于对照组( P＜ 0.05)。试验组总有效率高于对照组( P＜ 0.05)。 温针灸八髎穴治疗老年阳虚型慢性功能性便秘的临床疗效优于普通针刺治疗,可改善便秘症状,提高生活质量。
针灸疗法;温针疗法;穴,八髎;便秘;阳虚;老年人
R246.1 A
Doi:10.13460/j.issn.1005-0957.2024.08.0860
Therapeutic observation of warming needle therapy applied to Baliao points for senile functional constipation of Yang deficiency pattern LI Bo, LI Yuchen. Henan Zhengzhou Central Hospital, Zhengzhou 450007, China [Abstract] Objective To observe the clinical efficacy of applying warming needle therapy to Baliao points [consist of Shangliao (BL31), Ciliao (BL32), Zhongliao (BL33), and Xialiao (BL34)] to treat chronic functional constipation in the aged of Yang deficiency pattern and compare it with conventional acupuncture. Method Sixty patients aged over 60 years old with chronic functional constipation of Yang deficiency pattern were randomized into a trial group and a control group, with 30 cases in each group. The control group received ordinary acupuncture at Baliao points, and the trial group received warming needle therapy at Baliao points. The clinical efficacy was compared between the two groups. Before and after the treatment, the Bristol stool form scale score, chronic constipation severity scale score, symptom score of traditional Chinese medicine (TCM), and self-rating quality of life scale score were observed. Result After the treatment, the Bristol stool form scale score, chronic constipation severity scale score, TCM symptom score, and self-rating quality of life scale score dropped notably compared to those before treatment in both groups ( P＜ 0.05) and were lower in the trial group than in the control group ( P＜ 0.05). The total effective rate was higher in the trial group than in the control group ( P＜ 0.05). Conclusion Warming needle therapy at Baliao points can produce more significant clinical efficacy than ordinary acupuncture, improve constipation symptoms, and enhance the quality of life in treating senile chronic functional constipation of Yang deficiency pattern.
[Key words] Acupuncture-moxibustion; Needle warming therapy; Point, Baliao; Constipation; Yang deficiency; Aged
【摘要】结果目的【关键词】【中图分类号】结论方法【文献标志码】
功能性便秘指大便秘结排出困难,排便周期长于正常周期;或即使周期没有延长但粪质干硬;或排便周期正常但有排出不畅;需经临床检查排除肠器质性病[1]变及肠易激综合征的一种功能性肠病 。国外研究显
示功能性便秘常见于老年人群,发生率高达 24%,女性群体较为常见。中国普通人群功能性便秘患病率为6%[ 2]。中医学属“便秘”范畴,长时间便秘会诱发患者出现肛周疾病以及泻剂结肠等症状,严重便秘患者还
李博(1987—),女,主治医师,Email:312225985@qq.com
[3]会出现睡眠障碍及心理疾病 。功能性便秘症状以阳虚型较为多见,患者体内阳气衰减,会使新陈代谢功能减缓,代谢废物增多,进一步加重病情。八髎穴位于人体下焦,统一身气血,用温针灸能将艾灸和针刺相结合,共同刺激穴位,提高疗效 。本研究旨在观察温针灸八髎穴治疗老年阳虚型慢性功能性便秘的临床疗效。后,用 0.30 mm × 40 mm 不锈钢毫针快速直刺,刺入 1寸左右,得气后,取直径及高度均为2 cm 的艾条,将其放置在针柄上,点燃一端,当艾条燃尽后留针30 min。温针灸治疗过程中要避免温度过高而造成皮肤烫伤。
两组隔日治疗1次,每周治疗3次,共治疗1个月。
组别
试验组对照组
例数30 30痊愈12 5
显效9 9
有效6 10无效3 6
总有效率(%)
1) 90.0
80.0
1)
注:与对照组比较 P＜ 0.05。
3.4.2 两组治疗前后 Bristol 大便性状量表评分、慢性便秘严重度评分量表评分、中医证候积分和生活质量自评量表评分比较
治疗前,两组 Bristol 大便性状量表评分、慢性便秘严重度评分量表评分、中医证候积分和生活质量自评量表评分比较,差异无统计学意义( P＞ 0.05),有可比性。两组治疗后 Bristol 大便性状量表评分、慢性便秘严重度评分量表评分、中医证候积分和生活质量自评量表评分均明显低于治疗前( P＜ 0.05),且试验组治疗后上述评分均低于对照组( P＜ 0.05)。详见表 2。
两组治疗前后Bristol大便性状量表评分、慢性便秘严重度评分量表评分、中医证候积分和生活质量自评量表评分比较
温针灸疗法能够通过穴位刺激机体激活调节系统改善机体功能,在燃烧艾条时将药物直接渗透到深层组织,
[20]有效调节结肠运动,改善便秘症状 。足太阳膀胱经从头走足,从循行部位而言,膀胱经循行于背腰及臀部,入循于腹部,与便秘病位密切相关。在针刺八髎穴基础上温针灸不仅能加大穴位刺激量,延长治疗时间,更可上温肾助阳,向下调理魄门开阖,优于普通针刺治疗。
综上,温针灸八髎穴治疗老年阳虚型慢性功能性便秘的临床疗效优于普通针刺治疗,可改善便秘症状,提高生活质量。[1] [2] [3] [4] [5] [6] [7] [8] [9]
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收稿日期 2023-11-20