| Background:IBS is one of most common disease in digestive and related department. Irritable bowel syndrome, IBS, is one of common functional intestinal disorder. It mainly includes abdominal pain, distension and other discomfort, abnormal stool consistency, no pathogenic characters, etc. Except that, its character also includes various causes, being ill both physically and mentally and no related organic disease pathomechanism. So far, most types of irritable bowel syndrome is IBS-D,74% among epidemiology research. IBS-D is research hotspot, and the next is IBS-C, IBS-A, and IBS-U. the theories of IBS mechanism is still arguing, but academia disagree this disease just in colon. Academia thinks the digestive system (intestine, stomach, esophagus, etc.) and digestive gland that can secrets join together functionally to create a closed chain caused the pathomechanism and dysfunction.The personal character, mental condition, diet custom, infection and inheritance will affect pathogenes and predisposing factor. The lesion is from nerve system dysfunctions to gastrointestinal local neuroendocrine network abnormal adjustment. Just for the undefined pathomechanism, the therapeutic target of western medicine is unclear and lake of specific medicine. Now symptomatic treatment is clinical main used in IBS, combining psychological counseling and anti-anxiety treatment. The cure effect still needs to improve.Though IBS never appear in Chinese medicine, but the statements of similar syndrome, diarrhea, have great clinical value. Much clinical paper reported it is convenient and low-cost to use acupuncture and manipulation as main measure in preventing IBS, which succeeded gained cure effect. But the literature research is short of high quality, caused by unclear description of random method, imprecise concealment mechanism, small sample size, and skimble-scamble accepting criteria and diagnosis standard. Hence, the defect of literature research that cannot prove acupuncture and manipulation are clinical effective treatment, influence this treatment popularization.Objective:The study aims to enhance the curative effect of Irritable bowel syndrome with the abdominal rubbing exercise, and explore whether the combination of abdominal rubbing exercise and acupuncture is much much better than the simple acupuncture in reducing negative emotions, improving the symptoms of diarrhea, improve the quality of life. On the other sides, abdominal rubbing exercise is effectively, useful, and no limit to yard and consumptive material. we can finish the abdominal rubbing exercise by myself. so, the abdominal rubbing exercise is worth popularizing.Method:Most cases in the research are from outpatients who visited the acupuncture clinic in public security department’s hospital of Guangdong Province and the acupuncture clinic first affiliated hospital of Guangzhou University of TCM and the student in Guangzhou university of Chinese medicine and southern medical university. In accordance with the standard the research set to select cases,60 cases were equally randomized into treatment group (combination of abdominal rubbing exercise and acupuncture) and control group (simple acupuncture), with 30 cases each. In the first two weeks, the patient received five-day treatment every week and the rest interval is 2 days. The frequency of acupuncture is once a day and the abdominal rubbing exercise twice a day. Then in the third and the forth week the patient received treatment once every other day and 3days in total every week, with continue next week treatment after two-day resting. The total course of the treatment consists of 16 acupuncture and 9 week. The baseline period is one week, the treatment period is 4 week, follow up for four week after finishing the treatment. Cases from two groups were randomly visited in three different periods (these were period after the first treatment, period in the fourth and eighth week), during which curative effect index was evaluated. The curative effect of the treatment and control group are observed.Result:1. Through comparison of the treatment group and the control group in sex, age, course of disease, anxiety, depression, there’s no significant difference between the two groups, and the same equilibrium are observed in two group, with P>0.05.2. according to the score of the treatment group and the control group in abdominal pain, abdominal distension, bowel changes of defecation and frequently defecation, we can draw a conclusion that among the 30 cases of Irritable bowel syndrome in treatment group, there are 5 clinical convalesces example,16 shows results examples and 8 effective examples, which means that it is only 1 invalid examples. Therefore, the total curative effect rate is 96.67%, while the control group is 86.67%. The control is including 3 clinical convalesces examples,10 shows results examples,13 effective examples and 4 invalid examples. The rank sum test are used to examine the curative effect of the treatment group and the control group, with (P<0.05). this report that the treatment’s effectiveness is much more better than the control group.3. as to the SAS score, there’s no significant difference among pre-treatment, after-treatment and one-month-after-treatment in the abdomen-rubbing group (with P>0.05), which indicates that the abdomen-rubbing is ineffective and could not ease the patient’s anxiety.4. As to the SDS score, there’s no significant difference among pre-treatment, after-treatment and one-month-after-treatment in the acupuncture group (with P>0.05), which indicates that the acupuncture is ineffective and could not ease the patient’s depression.5. The patients in the control group did not have any adverse reaction during treatment. However,2 patients in the abdomen-rubbing group occurred symptoms like peri-umbilicus skin flush, bowel sounds active and hiccup, but the patient did not complain discomfort and these reaction disappeared after half to two hours after the abdomen-rubbing and there’s no other special symptom. With preliminary inference, we consider the peri-umbilicus skin flush, bowel sounds active and hiccup of the two patients as a possible result of the abdomen-rubbing’s stimulation of peri-umbilicus acupoints which could regulate qi activity, relieve stagnation and promote circulation of qi and blood.Conclusion:The result of the clinical research indicates that the combination of abdomen-rubbing and acupuncture could effectively relieve the IBS patient’s symptoms, especially to improve the stool property and frequency of defecation, and relieve the abdominal pain or discomfort, etc, which apparently improve the patient’s life quality. Besides, the overall efficacy of the abdomen-rubbing group is significantly better than the acupuncture group. But the effect on the patient’s psychology is not clear for there’s no significant improvement about the patient’s anxiety and depression in this research. This may due to the fact that the acupoints chosen in this research do not have specific effect on regulating the mood and the rubbing part confined to the abdomen but not on the mind-tranquilizing portion like the head and the neck, and the liver and gallbladder free-coursing portion like the region of the hypochondria. In a words, the combination of the abdomen-rubbing and acupuncture to treat the IBS is worthy of promotion and application, and the more specific and comprehensive effect and the improvement of the therapy method need further study in the future. |
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