Observation On Electroacupuncture In The Treatment Of Irritable Bowel Syndrome With Predominant Constipation

Objective The research aimed to observe the clinical efficacy of Electroacupuncture(EA)for Irritable Bowel Syndrome with Predominant Constipation(IBS-C)including its impact on clinical symptoms,quality of life(IBS-QOL)and the level of CGRP and VIP of patients with IBS-C.Besides,an attempt was made to explore the underlying mechanism of EA in the treatment of IBS-C,serving as a theoretical underpinning for the clinical promotion of EA treatment for IBS-C.Methods After a baseline screening,sixty-three patients who suffered from IBS-C were selected and divided randomly into two groupsEA group(n=31)and Medication(MED)group(n=32)and received corresponding interventions for four weeks.EA at 0.5-1.0mA and 2Hz frequency continuous wave were applied to Tianshu(ST25,bilateral),Zusanli(ST36,bilateral)and Shangjuxu(ST37,bilateral).All the needle retention time were kept for 30 minutes once per day and the treatment was kept five consecutive days with an interval of two days as a course.Meanwhile,the intervention of Medication group was to oral administration of lactulose oral Liquid(15ml once per day),and the course was on a par with EA group.The two groups were made a therapeutic comparison after successive four courses.Clinical symptoms score and IBS Quality of Life(IBS-QOL)score were observed before and after treatment and at follow-up.The level of CGRP and VIP in both groups before and after treatment were detected by enzyme-linked immunosorbent assay.Results 1.Comparative analysis of general information: Thirty cases in each group completed the study finally.There were no differences in gender,age and disease course between two groups(P> 0.05).2.Comparative analysis of Clinical symptoms score: Before treatment,the clinical symptoms score of two groups was not statistically significant(P> 0.05).The total symptoms score of EA group were significantly decreased after treatment and at follow-up(P <0.01),which were better than that in MED group(P <0.01 after treatment,P <0.05 at follow-up).As to single symptom score analysis,EA was found to be more effective in ameliorating the symptom of abdominal pain and abdominal distension than that in the MED group both after treatment and at follow-up(P <0.01).3.Comparative analysis of IBS-QOL score: There was no difference in IBS-QOL score before treatment between two groups(P >0.05).Both EA and medication can radically improve the total IBS-QOL score after treatment and at follow-up(P <0.01).The scores of IBS-QOL in EA group and MED group were significantly improved after treatment and follow-up(P <0.01).Comparing IBS-QOL score between two groups after treatment as well as at follow-up,the difference was statistically significant(P <0.01).Besides,as to each dimension of IBS-QOL,EA was superior to those in the MED in improving Dysphoria,Interference with activity,Body image,Food avoidance and Relationship both after the treatment and at follow-up(P <0.05).4.Comparative analysis of comprehensive curative effect: The clinical efficacy in EA was better as compared to MED(P <0.05).5.Comparative analysis of CGRP and VIP: Comparing levels of CGRP and VIP before treatment in two groups,the difference was not statistically significant(P >0.05).After treatment,the levels of CGRP in both groups were significantly lower than those before treatment(P <0.01)and there was no significant difference between the two groups(P >0.05).Likewise,the levels of VIP in both groups were lower than those before treatment(P <0.05)and there was no significant difference between the two groups after treatment(P >0.05).Conclusions 1.EA could significantly improving symptoms and QOL of patients with IBS-C and showing longterm efficacy in a sense.2.EA could reduce the level of CGRP and VIP in patients with IBS-C,i.e.the treatment could regulate abnormally secreted brain-gut peptide benignly,which might be one of the mechanisms of alleviating visceral hypersensitivity and promoting gastrointestinal motility.3.The study confirms that EA has definite advantages in the treatment of IBS-C,which is suitable for clinical application.