基于“脾主肌肉”理论浮针治疗老年虚秘型功能性便秘的效果分析 [中文引用][英文引用]

目的  探讨基于“脾主肌肉”理论的浮针疗法治疗老年虚秘型功能性便秘的临床疗效。方法  选取 2024 年 3 月至 10 月在本院门诊治疗的 80 例老年虚秘型功能性便秘患者，按随机数字表法分为试验组与对照组，每组 40 例。对照组采用假针干预，试验组采用浮针疗法。比较两组患者临床疗效，并于治疗前后评估便秘评估量表（constipation assessment scale，CAS）、便秘患者生活质量自评问卷（patient assessment of constipation quality of life questionnaire，PAC-QOL）评分，监测肠鸣音指标及血清胃动素（motilin，MTL）、P 物质（substance P，SP）水平。结果  共 77 例患者完成研究（试验组 39 例，对照组 38 例）。治疗后，试验组患者治疗总有效率为 82.05%，高于对照组 34.21%（P<0.001），试验组患者 CAS 评分及 PAC-QOL 评分改善幅度均优于对照组（均 P<0.001），肠鸣音频率增加值高于对照组（P<0.01），但肠鸣音振幅改变值组间比较，差异无统计学意义（P>0.05），试验组患者血清 MTL 及 SP 增加程度高于对照组（均 P<0.001）。结论  基于“脾主肌肉”理论的浮针疗法可有效改善老年虚秘型功能性便秘患者的临床症状与生活质量。其作用机制可能与调节 MTL、SP 等胃肠激素水平以及直接改善肠道蠕动功能有关。

Objective To explore the efficacy of floating-needle therapy based on the“theory of spleen governs muscles”of traditional Chinese medicine in treatment of deficiency type functional constipation in elderly. Methods A total of 80 elderly outpatients with functional constipation were randomly divided into an trial group（n=40）and a control group（n=40）with a random number table. Patients in the control group received sham needling，while those in the trial group received floating-needle therapy. The clinical effective rate，scores of constipation assessment scale（CAS），patient assessment of constipation quality of life（PAC-QOL），bowel function and serum motilin（MTL）and substance P（SP）levels were observed and compared between the two groups. Results A total of 77 patients （39 in the trial group and 38 in the control group）completed the study. The trial group showed a significantly higher total effective rate compared with the control group（82.05% vs 34.21%，P<0.001）. CAS and PAC-QOL scores of the trial group improved were significantly higher than those of the control group（both P<0.01）. Bowel sound frequency improved in the trial group was significantly increased （P<0.01），while bowel sound amplitude showed no significant difference（P>0.05）. Serum MTL and SP levels in the trial group improved were significantly higher than those in the control group（both P<0.001）. Conclusion Floating needle therapy based on the theory of “spleen governs muscles”in traditional Chinese medicine can effectively improve clinical symptoms and enhance quality of life in elderly patients with deficiency type functional constipation，because the therapy may regulate gastrointestinal hormones，such as MTL and SP， and directly improve intestinal function.