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刘淑萍,王田,李晓菲,刘更,支建梅.芒针深刺联合穴位贴敷治疗卒中后排便障碍的效果及对肠道SCFAs的影响[J].湖南中医药大学学报英文版,2023,43(2):343-348.[Click to copy
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| 芒针深刺联合穴位贴敷治疗卒中后排便障碍的效果及对肠道SCFAs的影响 |
| 刘淑萍,王田,李晓菲,刘更,支建梅 |
| (秦皇岛市中医医院脑病二科, 河北 秦皇岛 066000) |
| 摘要: |
| 目的 探讨芒针深刺联合穴位贴敷治疗卒中后排便障碍的临床效果，观察对肠道短链脂肪酸（short chain fatty acids，SCFAs）含量的影响。方法 选择秦皇岛市中医医院2020年8月至2022年2月收治的卒中后排便障碍患者，随机分为研究组和对照组，对照组（43例）接受脑卒中的常规治疗和神阙穴穴位贴敷，研究组（43例）在对照组的基础上接受芒针深刺治疗，疗程均为4周。比较两组治疗前后临床症状评分（包括排便困难、排便时间、排便频率和腹胀评分）、Bristol粪便性状量表（bristol stool form scale， BSFS）评分、慢性便秘严重度评分量表（chronic constipation severity rating scale, CCS）评分、直肠肛管容量感觉阈值[包括直肠扩张时初始感觉阈值（first sensation volume, FSV）、初始排便阈值（defecating sensation volume, DSV）和最大耐受阈值（maximum tolerable volume, MTV）]、粪便SCFAs含量，并比较两组治疗总有效率。结果 治疗后，两组临床症状评分（包括排便困难、排便时间、排便频率、腹胀评分）、CCS评分、FSV、DSV、MTV均降低（P<0.01），BSFS评分、粪便中丁酸和SCFAs含量均升高（P<0.01）；研究组临床症状评分、CCS评分、FSV、DSV、MTV均低于对照组（P<0.01），BSFS评分、粪便中丁酸和SCFAs含量均高于对照组（P<0.01）；研究组治疗总有效率高于对照组（P<0.01）。结论 芒针深刺联合穴位贴敷可有效缓解临床症状，增加肠道SCFAs含量，改善粪便性状，降低排便障碍程度，治疗卒中后排便障碍效果显著。 |
| 关键词: 芒针深刺 穴位贴敷 卒中后排便障碍 短链脂肪酸 临床症状评分 Bristol粪便性状量表 慢性便秘严重度量表 直肠肛管容量感觉阈 |
| DOI：10.3969/j.issn.1674-070X.2023.02.027 |
| Received:September 29, 2022 |
| 基金项目:秦皇岛市科学技术研究与发展计划项目（202005A043）。 |
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| Effects of deep needling with elongated needle combined with acupoint application on defecation disorder after stroke and its influence on intestinal SCFAs |
| LIU Shuping,WANG Tian,LI Xiaofei,LIU Geng,ZHI Jianmei |
| (The Second Department of Encephalopathy, Qinhuangdao Hospital of Chinese Medicine, Qinhuangdao, Hebei 066000, China) |
| Abstract: |
| Objective To investigate the clinical effects of deep needling with elongated needle combined with acupoint application on defecation disorder after stroke, and observe the influence on the content of short chain fatty acids (SCFAs). Methods The patients with defecation disorder after stroke admitted to Qinhuangdao Hospital of Chinese Medicine from August 2020 to February 2022 were randomly divided into study group and control group. The control group (43 cases) received routine treatment of stroke and acupoint application of Shenque (RN8), and study group (43 cases) received deep needling with elongated needle additionally, with the treatment of 4 weeks. The scores of clinical symptoms (including difficult defecation, defecation time, defecation frequency and abdominal distension), Bristol stool form scale (BSFS) score, chronic constipation severity rating scale (CCS) score, the sensory threshold of anorectal canal volume [including the first sensation volume (FSV), defecating sensation volume (DSV) and maximum tolerant volume (MTV) during rectal dilatation], the content of SCFAs in feces, and the total effective rate of two groups were compared. Results After treatment, the scores of clinical symptoms (including difficult defecation, defecation time, defecation frequency, abdominal distension), CCS score, FSV, DSV, MTV of two groups decreased (P<0.01), while the BSFS score, the content of butyric acid and SCFAs in feces increased (P<0.01); the clinical symptom scores, CCS score, FSV, DSV and MTV in study group were lower than those in control group (P<0.01), BSFS score, butyric acid and SCFAs in feces were higher than those in control group (P<0.01); the total effective rate of the study group was higher than that of control group (P<0.01). Conclusion Deep needling with elongated needle combined with acupoint application can effectively relieve clinical symptoms, increase the content of intestinal SCFAs, improve stool properties, and lower the degree of defecation disorder, and it has a significant effect on defecation disorder after stroke. |
| Key words: deep needling with elongated needle acupoint application defecation disorder after stroke short chain fatty acids clinical symptom scores Bristol stool form scale chronic constipation severity rating scale the sensory threshold of anorectal canal volume |
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