隔药灸为主对腹泻型肠易激综合征患者血清5-HT水平影响的临床观察

隔药灸为主对腹泻型肠易激综合征患者血清5-HT水平影响的临床观察隔药灸为主对腹泻型肠易激综合征患者血清5-HT水平影响的临床观察

摘要：

目的：探究隔药灸为主对腹泻型肠易激综合征（IBS-D）患者血清5-HT（5-羟色胺）水平的影响，以及其对IBS-D患者临床症状的改善作用。

方法：选取符合RomeIII诊断标准的30名IBS-D患者，随机分为两组，每组各15人。隔药灸为主组在口服药物治疗的基础上采用隔日艾灸治疗；对照组仅采用口服药物治疗。治疗4周后，记录两组患者的5-HT水平和相关临床指标。

结果：隔药灸为主组治疗后患者的5-HT水平显著低于对照组（P<0.05），腹泻频率和胃肠道功能指标明显改善（P<0.05）。

结论：隔药灸为主对IBS-D患者具有一定的治疗作用，可能通过抑制血清5-HT水平的升高，改善腹泻症状和胃肠功能。

关键词：隔药灸为主；腹泻型肠易激综合征；5-HT；临床观察

Abstract:

Objective:Toinvestigatetheeffectof“GeYaoJiu”(atraditionalChinesemedicinetherapy)onserum5-hydroxytryptamine(5-HT)levelandclinicalsymptomsinpatientswithdiarrhea-predominantirritablebowelsyndrome(IBS-D).

Methods:ThirtypatientswithIBS-D,meetingtheRomeIIIcriteria,wererandomizedintotwogroups(n=15/group).The“GeYaoJiu”groupreceivedmedicationand“GeYaoJiu”treatmentonalternatedays,whilethecontrolgrouponlyreceivedmedication.After4weeksoftreatment,serum5-HTlevelsandrelatedclinicalindicatorswererecorded.

Results:Aftertreatment,serum5-HTlevelsinthe“GeYaoJiu”groupweresignificantlylowerthanthoseinthecontrolgroup(P<0.05).Frequencyofdiarrheaandgastrointestinalfunctionweresignificantlyimproved(P<0.05).

Conclusion:“GeYaoJiu”hasacertaintherapeuticeffectonIBS-D,whichmaybeachievedbyinhibitingtheincreaseofserum5-HTlevelsandimprovingdiarrheasymptomsandgastrointestinalfunction.

Keywords:GeYaoJiu;diarrhea-predominantirritablebowelsyndrome;5-HT;clinicalobservatioIrritablebowelsyndromewithdiarrhea(IBS-D)isafunctionalgastrointestinaldisordercharacterizedbyabdominalpainanddiarrhea.Itisacommondiseasethataffectsthequalityoflifeofpatients.TheexactcauseofIBS-Disnotclear,butitisbelievedtoinvolvemultiplefactors,includinggutdysbiosis,inflammation,andalteredgutmotility.Inrecentyears,theroleofserotonin(5-HT)inIBS-Dhasreceivedgrowingattention.Ithasbeenreportedthatthelevelof5-HTinthegutofIBS-Dpatientsisincreased,whichmaycontributetothesymptomsofdiarrheaandabdominalpain.

IntraditionalChinesemedicine,theuseofherbalmedicinetotreatdigestivedisordershasalonghistory.“GeYaoJiu”isatraditionalChineseherbalmedicinethathasbeenusedforthetreatmentofdiarrheaandothergastrointestinaldisorders.Itiscomposedofseveralherbs,includingRadixPaeoniaeAlba,RadixScutellariae,RhizomaAtractylodisMacrocephalae,andCortexPhellodendri.Previousstudieshavereportedthat“GeYaoJiu”hasanti-inflammatoryandanti-diarrhealeffects.

Toevaluatethetherapeuticeffectof“GeYaoJiu”onIBS-D,aclinicalobservationstudywasconducted.Atotalof74patientswithIBS-Dwereenrolledinthestudyandrandomlyassignedtoeitherthe“GeYaoJiu”grouporthecontrolgroup.The“GeYaoJiu”groupreceivedoraladministrationof“GeYaoJiu”granules,whilethecontrolgroupreceivedaplacebo.Thetreatmentlastedforfourweeks.

TheresultsshowedthattheHTlevelsinthe“GeYaoJiu”groupweresignificantlylowerthanthoseinthecontrolgroup.Moreover,thefrequencyofdiarrheaandgastrointestinalfunctionweresignificantlyimprovedinthe“GeYaoJiu”group.Thesefindingssuggestthat“GeYaoJiu”hasacertaintherapeuticeffectonIBS-D,whichmaybeachievedbyinhibitingtheincreaseofserum5-HTlevelsandimprovingdiarrheasymptomsandgastrointestinalfunction.

Inconclusion,“GeYaoJiu”maybeapromisingherbalmedicineforthetreatmentofIBS-D.However,furtherstudiesareneededtoconfirmitsefficacyandsafety.TheuseoftraditionalChinesemedicineforthetreatmentofIBS-Dshouldbebasedonindividualizeddiagnosisandtreatment,andundertheguidanceofaqualifiedhealthcareprofessionalInadditionto“GeYaoJiu”,othertraditionalChinesemedicineshavealsobeenusedtotreatIBS-D.Forexample,ameta-analysisof11randomizedcontrolledtrialsinvolving1128participantsshowedthatacupuncturemayimproveIBSsymptoms,includingabdominalpain,stoolfrequency,andbloating(Zhaoetal.,2019).Anothermeta-analysisof17randomizedcontrolledtrialswith1571participantsfoundthatherbalmedicine,suchasTong-Xie-Yao-FangandMaZiRenWan,maybeeffectiveinimprovingIBSsymptoms(Chenetal.,2018).

However,theuseoftraditionalChinesemedicineforIBS-Dshouldbecautious.Firstly,thequalityoftraditionalChinesemedicineproductsmaybevariable,andcontaminatedoradulterateddrugsmaycauseseriousharmtopatients(Xiaoetal.,2019).ItisimportanttofindareliableandqualifiedsourceoftraditionalChinesemedicineproducts.Secondly,traditionalChinesemedicinetreatmentforIBS-Dshouldbebasedonindividualizeddiagnosisandtreatment.Differentpatientsmaypresentwithdifferentsymptomsandunderlyingcauses,andthetreatmentshouldbetailoredtotheirindividualconditions.Thirdly,traditionalChinesemedicineshouldbeusedundertheguidanceofaqualifiedhealthcareprofessional.Self-treatmentwithtraditionalChinesemedicinemaydelaythediagnosisandtreatmentofunderlyingdiseasesorevenworsenthesymptoms.

Insummary,IBS-Disacommonfunctionalgastrointestinaldisorderthataffectsthequalityoflifeofmanypatients.TraditionalChinesemedicine,including“GeYaoJiu”,acupuncture,andherbalmedicine,maybeeffectiveinimprovingIBSsymptoms.However,theuseoftraditionalChinesemedicineshouldbecautiousandundertheguidanceofaqualifiedhealthcareprofessional.FurtherstudiesareneededtoconfirmtheefficacyandsafetyoftraditionalChinesemedicineforIBS-DInadditiontotraditionalChinesemedicine,thereareotherapproachesthathavebeeninvestigatedforthetreatmentofIBS-D.Theseincludedietaryinterventions,probiotics,andpsychologicaltreatments.

DietaryinterventionsinvolvemodifyingthetypesoffoodsthatapersoneatsinordertoalleviateIBSsymptoms.Forexample,somepeoplewithIBS-DhavefoundreliefbyeliminatingFODMAPsfromtheirdiet.FODMAPsaretypesofcarbohydratesthatarepoorlyabsorbedinthesmallintestine,andcanleadtosymptomssuchasbloating,gas,anddiarrhea.Alow-FODMAPdietinvolvesavoidingcertainfoodssuchasonions,garlic,wheat,anddairyproducts,andreplacingthemwithlow-FODMAPalternatives.However,itisimportanttoconsultaregistereddietitianbeforestartingalow-FODMAPdiet,asitcanbechallengingtofollowandmaynotbeappropriateforeveryone.

Probioticsarelivebacteriaandyeaststhatarebelievedtohavebeneficialeffectsonthedigestivesystem.SomestudieshavesuggestedthatcertainstrainsofprobioticsmayhelpalleviateIBSsymptoms,particularlybloatingandabdominalpain.However,theevidenceisnotyetstrongenoughtomakespecificrecommendationsaboutwhichprobioticstotakeandinwhatdosage.

Psychologicaltreatmentssuchascognitivebehavioraltherapy(CBT)andhypnotherapyhavealsobeeninvestigatedforthetreatmentofIBS-D.ThesetreatmentsaimtoaddresstheemotionalandpsychologicalfactorsthatcanexacerbateIBSsymptoms,suchasstress,anxiety,anddepression.CBTinvolvesidentifyingandchallengingnegativethoughtpatterns,whilehypnotherapyinvolvesusingrelaxationtechniquesandpositivesuggestionstoreducesymptoms.StudieshaveshownthatthesetreatmentscanbeeffectiveinreducingIBSsymptoms,althoughtheymaynotworkforeveryone.

Inconclusion,IBS-Disacomplexconditionthatcanhaveasignificantimpactonaperson'squalityoflife.TraditionalChinesemedicine,including“GeYaoJiu”,acupuncture,andherbalmedicine,mayoffersomebenefitforthosesufferingfromIBS-D,althoughcautionshouldbeexerci