Based On Observation Of Acupuncture Treating Severe Functional Constipation Effectiveness Meridian State

Objectives:1. To evaluate the effectiveness of electro-acupuncture treatment for severe functional constipation by clinical randomized double-blind placebo-controlled study.2. To observe the relevance of meridians’state changes, severe functional constipation treatment efficacy and syndrome patterns.Methods:1. Study on the efficacy of Electro-acupunctureIn accordance with the Rome III diagnostic criteria and cases exclusion criteria,we included70patients with severe functional constipation recruited from acupuncture clinic of Beijing University of Traditional Chinese Medicine Hospital affiliated to Beijing university of TCM, then divided the70patients into electro-acupuncture group35cases and Sham electro-acupuncture group35cases using the central random system. The electro-acupuncture group selected Tianshu, Fujie and Shangjuxu acupoints.For Tianshu and Fujie,we use2-3inch needles piercing to the parietal peritoneum far, then connected the electrodes of electro-acupuncture device to the needle handles of the above points horizontally and bilaterally(density wave, frequency15Hz, the current intensity0.1-10mA, untill abdominal muscle vibrates slightly,retain needles30minutes),with no inserting and twisting.For Shangjuxu, we use1.5inch Filiform needles inserting linch vertically, then slightly and uniformly lifted and twisted3times untill the sense of soreness and swollen was brought out. When retaining the needle, the needles were manipulated every10minutes.The Sham electro-acupuncture group selected non-acupoints named as Tianshu pang、Fujie Pang and Shangjuxu Pang,which located besides the bilateral Tianshu, Fujie and Shangjuxu and are the midpoiints of two adjacent meridians.All the three acupoints were adopted0.3-0.5inches vertically insertion, with no inserting and twisting, then connected the electrodes of spacial-made electro-acupuncture device to the needle handles of the above points of Tianshu Pang and Fujie Pang horizontally and bilaterally.The Special electric wires of the spacial-made electro-acupuncture device are cut off while they look the same as the normal ones, when the device was turned on, it indicated a successful connection, while there is no electricity through the wire actually. The parameters of the spacial--made electro-acupuncture device were set same as the electro-acupuncture group,except the current intensity was set at0.5mA. At the same time,Patients were told that there was a slight current was putting in, which may hardly feel by the body.The two groups were all treated for8weeks. The first2weeks,5times a week, the back six weeks, three times a week.2. Study on the relevance of meridians’state changes, Electro-acupuncture efficacy and syndrome patternsWe created meridians examination scale by ourself. In the baseline period,we examinated and recorded the primary abnormal points of14meridians(including the12meridians and Du meridian,Ren meridian).We examinated and recorded the14meridians abnormal points again at each time point (treatment2nd week,4th week,6th week and8th week) to observe the increase or decrease of the abnormal points compared with the primary abnormal points.We created syndromes scoring scale by ourself,inquried and recored the syndrome distribution and score of the70volunteers at each time point (baseline period, treatment2nd week,4th week,6th week and8th week) carefully to observe the changes.Results:1. Study on the efficacy of Electro-acupunctureThe study included severe functional constipation subjects73cases,70cases had completed the full course,1sample of the electro-acupuncture group and2samples of Sham electro-acupuncture group withdrawed from the study. Compared the age, gender, disease duration aspects and the number of complete spontaneous bowel movement (CSBM)and of spontaneous bowel movement (SBM), the score of defecation traits and of defecation difficulty of the tow groups,the p values were all greater than0.05.So the difference of the two groups in the baseline period was no statistically significance.The two groups were comparable.In treatment period,1) On increasing CSBM,EA group had a statistical significannce comparied with baseline after treating2weeks,while Sham EA group after treating6weeks(P <0.05).The difference between EA group and Sham EA group was statistically significant every evaluating points(P<0.05).So EA group and Sham EA group both have effects on increasing the CSBM,while the EA group has a better and faster effect.2) On increasing SBM,both EA group and Sham EA group had a statistical significannce comparied with baseline after treating2weeks(P<0.05).The difference between EA group and Sham EA group was statistically significant every evaluating points eexcept point one(P<0.05).So EA group and Sham EA group both had effects on increasing the SBM,while the EA group has a better effect than Sham EA group except point one.3) On improving bowel traits,EA group had a statistical significannce comparied with baseline after treating2weeks,while Sham EA group after treating8weeks(P<0.05).The difference between EA group and Sham EA group was statistically significant every evaluating points(P<0.05).So EA group and Sham EA group both has effects on improving bowel traits,while the EA group has a better and faster effect.4) On improving constipation severity,EA group had a statistical significannce comparied with baseline after treating4weeks,while Sham EA group no statistical significannce (P>0.05).The difference between EA group and Sham EA group was statistically significant every evaluating points(P<0.05).So EA group has effects on improving constipation severity,while the EA group has a better and faster effect。In follow-up period, the differences between and within EA group and Sham EA group were statistically significant in terms of increasing the frequency of CSBM(P<0.05), indicating that both two groups had an long term effect.The difference of CSBM increased mean between the EA group and Sham EA group were statistically significant(P<0.05),so we can say the EA group had an better long term effect.2. Study on the relevance of meridians’state changes, Electro-acupuncture efficacy and syndromes’changes1)In the baseline period, the Large Intestine Channnel of Hand-Yangming, the Stomach Channel of Foot-Yangming, the Spleen Channel of Foot-Taiyin, the Liver Channel of Foot-Jueyin and Du Channel had more abnormal points than other meridians in both EA group and Sham EA group,indicating the5channel have a most close relationship with occurrence of SFC.2) Th ecomparison of total abnormal channels’change means of two groups were significantly different between and within two groups(P<0.05),indicating the two kinds of interventions has a overall adjustment effect on the14meridians.3) Th ecomparison of abnormal changes of the Stomach Channel of Foot-Yangming, the Spleen Channel of Foot-Taiyin, the Liver Channel of Foot-Jueyin and Du Channel of two groups were between and within two groups(P<0.05),while of Lung channnel of Hand-Taiyin of EA group had significant difference,indicating the two kinds of interventions has a adjustment effect on the5meridians,excepting Sham EA group on the Lung channnel of Hand-Taiyin,and EA group has a better effect than SEA group.4) The Stomach Channel of Foot-Yangming, the Spleen Channel of Foot-Taiyin, the Liver Channel of Foot-Jueyin and Du Channel distributed mostly in the five syndrome patterns of FC in the aboue8%.The Kidney Channel of Foot-Shaoyin distributed mostly in lung and spleen deficiency pattern,while Gallbladder Channel of Foot-Shaoyang in liver and kidney Yin deficiency pattern in aboue9%.5) Through statistical analysis of the relevance betwwen the syndrom patterns of FC and abnormal distribution of14meridians,we discovered:No channel had revelance with the stomach heat accumulation syndrome pattern (P>0.05); No channel had revelance with the hepatosplenic disorder syndrome pattern (P>0.05);only the abnormal distributions of Kidney Meridian of Foot-Shaoyin had revelance with the lung and spleen deficiency syndrome pattern(P<0.05); No channel had revelance with the asdthenic splenonephro-yang syndrome pattern (P>0.05);only the abnormal distributions of Heart Meridian of Hand-Shaoyin had revelance with Yin deficiency of liver and kidney syndrome pattern (P<0.05)Conclusions:1) EA group had efficancy in increasing the number of CSBM,SBM,improving the faeces properties and in easing defecate difficulty degree,while hace a long term effect in increasing CSBM and had a better efficancy than Sham EA group,which can exclude the placebo effect basically. 2) The station of channels are closely related to the occurrence and development of disease.So as the main method to find the abnormal channels,meridian examination method will has an important significance for diagnosis, analysis and effect evaluation for acupuncture. There is no equivalent relation between distribution of abnormal channels and syndrome patterns completely,not in a included or a complex relationship. So acupuncture can’t depend too much on viscera or experience to guide meridians and acupoints’selection, but should explore the establishment of new acunpuncure pattern,which is based on the channels examination method,combined with the differentiation of syndromes of meridian and the mutual influence of viscera function.