| Background:Irritable bowel syndrome belongs to a type of functional bowel disease,which is a type of global frequently-occurring disease.Its incidence in my country is about 10%,and the population is mainly young and middle-aged adults.The typical manifestation is high recurrence of abdominal pain,combined with changes in stool characteristics or bowel habits.However,the main related mechanisms of this disease may be visceral hypersensitivity,gastrointestinal motility imbalance,etc.,mainly due to gastrointestinal functional changes,without obvious gastrointestinal Organic disease of the tract.The disease is classified into categories such as "diarrhea","constipation",and "abdominal pain".Spleen and kidney yang deficiency is one of the common syndromes of IBS,and clinically,the number of patients with spleen and kidney yang deficiency IBS-D is increasing year by year.It is often lingering and difficult to heal.This topic is based on TCM syndrome differentiation and treatment.Traditional Chinese medicine decoction combined with acupuncture point application method with TCM characteristics to treat IBS-D,which inherits the TCM thinking mode of syndrome differentiation and treatment,and innovatively utilizes the treatment methods of traditional medicine.Purposes:The purpose of this research is to observe the clinical efficacy,safety and safety of acupoint application therapy combined with Chinese medicine decoction for strengthening the spleen and warming the kidney in the treatment of diarrhea predominant irritable bowel syndrome(IBS-D).The recent recurrence rate,and at the same time the etiology and pathogenesis of this disease and the advantages of combining acupuncture and medicine for its treatment will be discussed.Methods:A total of 120 patients with diarrhea-type irritable bowel syndrome with spleen-kidney yang deficiency were included in the study.Randomized controlled trails(RCT)were used to randomly divide them into control group,acupoint sticking group,traditional Chinese medicine decoction group,and acupoint sticking combined with traditional Chinese medicine.Decoction group,30 cases in each group.There were no significant differences in age,duration of disease,IBS-SSS total score before treatment,and TCM syndrome score among the four groups,and they were comparable.The control group was given pinaverium bromide tablets orally,1 tablet each time,3 times a day,for a total of 4 weeks;the acupoint sticking group was given acupoint sticking therapy,which was administered to Dachangshu(shuang),Zusanli(shuang),Shenshu(Double),Qihai and Pishu(Double)paste traditional Chinese medicine powder,2 times a week,4 hours each time,a total of 4 weeks of treatment;Chinese medicine decoction group was given oral Chinese medicine decoction Jianpi Wenshen prescription Treatment,1 dose orally every day,divided into 1 time in the morning and 1 time in the evening,0.2L/time,for a total of 4 weeks of treatment.Acupoint sticking combined with traditional Chinese medicine decoction group(combined treatment group)was given acupoint sticking,and oral traditional Chinese medicine decoction Jianpi Wenshen formula.week.The total treatment period of the 4 groups was 4 weeks.During the treatment,the 4 groups were not arranged to be intervened by other drugs.After treatment,the total score of IBS symptom severity scale(IBS-SSS),total score of TCM syndrome,total effective rate and recurrence rate were used to evaluate the clinical efficacy of each group.Result:A total of 120 patients with IBS-D were enrolled,30 in the control group,aged(9.93 ±6.65)years,and the course of disease was(20.68±9.11)months;30 cases in the acupoint application group,aged(37.32±6.26)years,and the course of disease was(20.68±9.11)months(20.30±6.42)months,the course of disease was(20.30±6.42)months;30 patients in the traditional Chinese medicine decoction group were(39.04±6.80)years old;30 patients in the combined treatment group were(37.09±5.03)years old,and the course of disease was(18.53 ± 7.07)(P>0.05).The gender distribution of the control group,the acupoint application group,the traditional Chinese medicine decoction group,and the combined treatment group were as follows:males were 14 cases,15 cases,15 cases,and 16 cases;women were 16 cases,15 cases,15 cases,and 14 cases.The total scores of IBS-SSS before treatment in the four groups:the average total IBS-SSS score of the control group was(214.14±26.84)points;the average IBS-SSS total score of the acupoint application group was(219.17 ±29.0)points;the average IBS of the traditional Chinese medicine decoction group was(219.17±29.0)points-The total SSS score was(215.23±29.05)points;the average IBS-SSS total score in the combined treatment group was(216.13 ±26.35)points(P>0.05).There was no significant difference in the scores of IBS-SSS before treatment,the main symptoms of TCM before treatment,the scores of secondary symptoms of TCM,and the total score of TCM symptoms before treatment(P>0.05).(1)Therapeutic efficacy analysis:The scores of the symptoms of the four groups of patients before and after treatment are as follows:①In terms of abdominal pain:the control group has(4.55±1.38)points before treatment and(1.97 ± 1.20)points after treatment(P<0.001);acupoint application Before treatment(4.57± 1.54)points,after treatment(1.41± 1.08)points(P<0.001);Chinese medicine decoction group before treatment(4.35±1.19)points,after treatment(1.08±1.32)points(P<0.001);The combined treatment group had(4.29±1.22)points before treatment and(0.95 ± 0.91)points after treatment(P<0.001).②In terms of abdominal distension:the control group was(44.48±1.25)points before treatment,(1.94±0.91)points after treatment(P<0.001);the acupoint application group was(4.64±1.08)points before treatment,and(1.08 ± 0.99)points after treatment(P<0.001);in the Chinese medicine decoction group before treatment(4.54±1.40)points,after treatment(1.07±1.21)points(P<0.001);combined treatment group before treatment(4.46±1.40)points,after treatment(1.03 ± 0.86)points(P<0.001).③For loose stools:the control group had(4.11±1.05)points before treatment and(1.55±1.54)points after treatment(P<0.001);the acupoint application group had(4.51±1.18)points before treatment and(1.08±0.96)after treatment)Points(P<0.001);TCM decoction group before treatment(4.73 ± 1.06)points.after treatment(1.02± 1.00)points(P<0.001);combined treatment group before treatment(4.28±1.]9)points after treatment(0.98±0.52)points(P<0.001).④For cold limbs:control group(3.79±1.32)points before treatment,(1.98 ±1.22)points after treatment(P<0.001);acupoint application group before treatment(3.89±1.09)points,after treatment(1.46±1.06)points(P<0.001);TCM decoction group before treatment(3.96± 1.33)points,after treatment(1.38±0.96)points(P<0.001);combined treatment group before treatment(3.90±1.21)points,after treatment(1.39± 0.87)points(P<0.001).⑤The soreness of waist and knees:the control group before treatment(2.08±0.64)points,after treatment(0.78±0.55)points(P<0.001);the acupoint application group before treatment(1.98±0.69)points,after treatment(0.58±0.45))Points(P<0.001);TCM decoction group before treatment(1.93±0.75)points,after treatment(0.65 ±0.58)points(P<0.001);combined treatment group before treatment(2.14±0.65)points,after treatment(0.22±0.41)points(P<0.001).⑥Intestinal swelling:the control group before treatment(2.02 ±0.56)points,after treatment(0.89±0.42)points(P<0.001);the acupoint application group before treatment(1.90±0.62)points,after treatment(0.68±0.40)Points(P<0.001);the traditional Chinese medicine decoction group before treatment(2.02±0.50)points,after treatment(0.70±0.41)points(P<0.001);the combined treatment group before treatment(1.96±0.57)points,after treatment(0.49 ± 0.52)points(P<0.001).⑦Regarding diet:the control group had(1.91±0.44)points before treatment and(0.95±0.33)points after treatment(P<0.001);the acupoint application group had(1.94±0.65)points before treatment and after treatment(0.31±0.41))Points(P<0.001);TCM decoction group before treatment(1.82±0.57)points,after treatment(0.42±0.37)points(P<0.001);combined treatment group before treatment(1.95±0.71)points,after treatment(0.13±0.36)points(P<0.001).⑧ Fatigue:Before treatment(1.90±0.69)points in the control group,(0.79 ± 0.68)points after treatment(P<0.001);acupoint application group before treatment(1.81 ±0.73)points,after treatment(0.58±0.41)Points(P<0.001);the traditional Chinese medicine decoction group before treatment(1.82±0.80)points,after treatment(0.38±0.45)points(P<0.001);the combined treatment group before treatment(1.84±0.60)points,after treatment(0.33±0.43)points(P<0.001).(2)The total IBS-SSS scores of the four groups of cases before and after treatment are as follows:the control group(214.14±26.84)points before treatment,(96.86±14.67)points after treatment(P<0.001);the acupoint application group before treatment(219.17±29.0)points after treatment(78.43±15.29)points(P<0.001);TCM decoction group before treatment(215.23±29.05)points,after treatment(82.63±8.52)points(P<0.001);combined treatment group before treatment(216.13 ±26.35)points,after treatment(71.36±15.02)points(P<0.001);in terms of the comparison of IBS-SSS points before and after treatment in the four groups,the results show that in terms of improving the degree of abdominal pain,the order of efficacy of each group is:combined Treatment group>acupoint application group>Chinese medicine decoction group>control group;in terms of reducing the frequency of abdominal pain,the order of efficacy of each group is:combined treatment group>acupoint application group>Chinese medicine decoction group>control group;in terms of improving the degree of abdominal distension The order of the curative effect of each group is:combined treatment group>acupoint application group>Chinese medicine decoction group>control group;in terms of improving defecation satisfaction,the order of efficacy of each group is:combination treatment group>acupoint application group>Chinese medicine decoction group>Control group;in terms of improving life interference,the order of efficacy of each group is:combined treatment group>acupoint application group>Chinese medicine decoction group>control group.(3)Comparison of the total scores of TCM syndromes before and after treatment in the four groups of cases,the control group was(24.84±2.40)points before treatment,(10.86±2.58)points after treatment(P<0.001);the compress group was(25.23 ± 3.03)points before treatment,After treatment(7.17±2.16)points(P<0.001);TCM decoction group before treatment(25.16±1.98)points,after treatment(6.69±2.28)points(P<0.001);combined treatment group before treatment(24.82 ± 2.98)points,after treatment(5.54±2.18)points(P<0.001);in terms of improving TCM syndromes,the order of efficacy of each group is:combined treatment group>traditional Chinese medicine decoction group>acupoint application group>control group.(4)In terms of the total effective rate index,the Chinese medicine decoction group combined treatment group has the largest number of cured cases and the highest proportion.In the control group,acupoint application group,traditional Chinese medicine decoction group,and combined treatment group,the rates were 83.3%,93.3%,90.0%,and 96.7%,respectively.(5)Analysis of follow-up results:The treatment course was completed and the drug was stopped for 4 weeks to arrange follow-up.In the control group,a total of 25 patients were followed up,and 8 relapsed,with a recurrence rate of 32%;in the acupoint application group,a total of 20 patients were followed up,There were 3 relapses,with a recurrence rate of 15%;in the traditional Chinese medicine decoction group,a total of 26 patients received follow-up,with 3 relapses,with a recurrence rate of 11.5%;in the combined treatment group,a total of 28 patients received follow-up,with 1 Relapse,reaching 3.6%recurrence rate.The recurrence rate of the combined treatment group was significantly lower than that of the control group,acupoint application group,and traditional Chinese medicine decoction group,indicating that acupoint application combined with the method of strengthening the spleen and warming the kidney has significantly better control of the recurrence rate of IBS-D spleen-kidney-yang deficiency syndrome.Ammonium bromide tablets,simple acupoint application therapy or simple oral medicine for strengthening the spleen and warming the kidney;and simple acupoint application therapy or pure oral therapy for strengthening the spleen and warming the kidney has better control of the recurrence rate of IBS-D spleen-kidney-yang deficiency syndrome.Vitamin Bromide Tablets.Analysis of safety monitoring results:During the entire treatment period,none of the patients in the four groups had allergic reactions and side effects caused by the drugs used in the study.In the control group,the number of patients with moderate headaches,drowsiness,and mild intraoral numbness was 2 cases.The three major routines,colonoscopy,liver function,electrocardiogram,and renal function of the four groups of patients were all normal.Conclusion:①Comparing the therapeutic effects of acupoint application combined with the method of strengthening the spleen and warming the kidney on IB S-D with yang deficiency of the spleen and kidney,it is more effective than using western medicine alone,acupoint application alone or a single oral Chinese medicine for strengthening the spleen and warming the kidney Advantage.②In terms of short-term recurrence rate and synergy after treatment,the control group,acupoint application group,traditional Chinese medicine decoction group,and combination therapy all have certain curative effects,while the acupoint application group,traditional Chinese medicine decoction group,and combined treatment group have curative effects.It is better than the control group,and the incidence of adverse reactions is lower than that of the control group.③Acupoint application combined with the method of strengthening the spleen and warming the kidney is safe for the treatment of spleen and kidney yang deficiency type IBS-D.The above research results show that the acupoint application combined with the spleen warming and kidney method can improve the degree of abdominal pain,frequency of abdominal pain,degree of bloating,satisfaction with defecation and life interference in IBS-SSS,and its curative effect is better than that of Western medicine treatment,pure acupoint application,and simple oral administration.Jianpi Wenshen Recipe is better and safer,and it is worthy of further promotion to clinical and other medical applications. |
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