| Objective:Through the Tiaoshen of acupuncture treatment of diarrhea type irritable bowel syndrome,observe the Tiaoshen of acupuncture treatment in the two aspects of intestinal symptoms and mood symptoms improve the situation.And comparing with the specific point acupuncture group,we will discuss which kind of treatment is more superior effect,so that it can guide the clinical doctors according to the clinical manifestations of patients to treat and achieve the best curative effect and provide ideas for further scientific research design.Method:A total of 61 subjects that met the criteria were included.According to the table of random numbers,all subjects were divided into the spirit conditioning group and the specific acupoint group,with 31 subjects in the Tiaoshen group and 30 subjects in the specific acupoint group.Zhongwan,Tianshu,Guanyuan,Zusanli and Shangjuxu were selected for the specific point group,and different points were selected according to the dialectical classification of troditional Chinese medicine,such as the syndrome of liver stagnation and spleen deficiency plus Taichong,the syndrome of dampness resistance of spleen deficiency plus Sanyinjiao,the syndrome of dampness and heat of spleen and stomach plus Neiting,Baihui,Yintang,Shenting and Benshen were added to the specific point group in Tiaoshen group.After hand disinfection and skin disinfection,Baihui flat acupuncture 0.5-0.8 inch,Benshen upward flat acupuncture 1 inch,Shenting upward flat acupuncture 1 inch,Yintang downward oblique acupuncture 0.3-0.5 inche,Tianshu,Guanyuan,Zusanli and Shangjuxu straight acupuncture 1-1.5 inches,Zhongwan straight acupuncture 0.5-1 inch.Patients with local numbness and acid swelling as a degree,the needle for 30 mins.All patients received treatment for 6 weeks,3 times a week for 1-3 weeks and 2 times a week for 4-6 weeks,and followed up for 8 weeks.Subjects were required to fill in a defecation diary card every day throughout the trial to record their daily symptoms such as defecation and abdominal pain.The visual analog scale(VAS scale)was used to evaluate the score of the most severe abdominal pain in the past 24 hours and calculate the weekly average.Daily fecal traits and frequency were recorded,and the number of days with loose stools indicated the number of days with at least one fecal trait of type 6 or 7.PHQ9 scale,HAMA scale and IBS-SSS scale were scored for all patients.And effective response rate as the primary outcome indicators,namely average 6 weeks the most severe abdominal pain from baseline to improve by 30%,and the percentage of patients in loose days fell 50% baseline.The weekly effective response rate of the treatment period,the baseline period,week2,week4,week6,week10,week14 of PHQ9 scale,HAMA scale and IBS-SSS scale score as a secondary outcome indicators,and collect relevant data.Result:1.A total of 61 subjects were intaked in this experiment.During the experiment,2subjects in the Tiaoshen group and 2 subjects in the specific acupoint group fell off.A total of57 subjects completed the experiment.2.General data analysis: there are no statistical significance of differences(P > 0.05)in the two groups of gender,age,BMI,course of diseases,whether for college students,IBS-SSS score,PHQ9 score,HAMA scores and syndrome differentiation of traditional Chinese medicine.3.The main outcome indicators: the Tiaoshen group total effective response rate was65.50%,the specific point group total effective response rate was 53.6%,total effective response rates of the Tiaoshen group is better than that of specific acupoint group,there was no statistically significant difference(P > 0.05);The effective response rate was 62.10% in the Tiaoshen group on the days of sparse defecation,and 60.70% in the specific point group on the days of sparse defecation.The overall effective response rate in the Tiaoshen group was better than that in the specific point group,and the difference was not statistically significant(P>0.05).The effective response rate of abdominal pain score in the spirit adjustment group was 75.90%,and the effective response rate of abdominal pain score in the specific point group was 50.00%.The overall effective response rate of abdominal pain score in the Tiaoshen group was better than that in the specific point group,and the difference was statistically significant(P<0.05).4.Secondary outcome indicators: At week 1,3,4,5 and 6 of the treatment period,the total effective response rates of the Tiaoshen group were higher than the total effective response rates of the specific acupoint group,at the second week,the effective response rate of the Tiaoshen group was lower than that of the specific acupoint group,with no statistical significance(P>0.05);The PHQ9 scale was used to evaluate the depressive symptoms of the subjects.At the 6th week of treatment,the PHQ9 scores of the two groups were lower than baseline(P<0.001)significantly,and there wasn’t statistical significance in the PHQ9 scores between the Tiaoshen group and the specific acupoint group at the 6th week of treatment(P>0.05).At the 10 th week of follow-up period,PHQ9 score in the Tiaoshen group was lower than that in the specific acupoint group,and the difference was statistically significant(P<0.05).At the 14 th week of follow-up period,PHQ9 score in the Tiaoshen group was lower than PHQ9 score in the specific acupoint group,and the difference was significant statistically(P<0.05).The results showed that both acupuncture methods could reduce PHQ9 score and relieve depressive symptoms of the subjects,but there was no significant difference between the two groups in the 6th week of treatment,and the treatment effect of the Tiaoshen adjustment group was more obvious than that of the specific point group in the 10 th and 14 th week of follow-up period.HAMA scale was used to evaluate the anxiety symptoms of the subjects,and in the two groups,HAMA scores at week 6 of treatment were both lower than baseline(P<0.001)significantly,but there were no significant differences in HAMA scores between the 2 groups at week 6 of treatment,week 10 of follow-up period and week 14 of follow-up period(P>0.05).The results showed that both acupuncture methods could reduce HAMA scores and relieve anxiety symptoms of the subjects,but there was no significant difference in the treatment effect between the two groups in the treatment period and the follow-up period,suggesting that the long-term anxiety symptoms of the patients could not be fully improved due to the short treatment course,and professional doctors’ intervention and self-intervention regulation were needed in the later stage.The IBS-SSS scale was used to evaluate the improvement of the severity of symptoms in the two groups.The IBS-SSS score of the two groups was significantly lower than that of baseline at the 6th week of treatment(P<0.001),and there was no statistically significant difference between the IBS-SSS scale score of the Tiaoshen group and the specific point group at the 6th week of treatment and the10 th week of follow-up period(P>0.05).The IBS-SSS score of subjects in the Tiaoshen group at the 14 th week of follow-up period was lower than the score in the specific point group,and the imparities was significant statistically(P<0.05),demonstating both acupuncture methods could reduce the IBS-SSS score of subjects and improve the overall quality of life of patients,but the treatment effect of Tiaoshen group at the 14 th week of follow-up period was more obvious.Conclusion:1.The treatment of diarrhea type irritable bowel syndrome by Tiaoshen acupuncture and specific point acupuncture both has good overall efficacy;2.Comparing with specific point acupuncture,the treatment of diarrhea type irritable bowel syndrome has a better effect on reducing the abdominal pain score of subjects.3.The Tiaoshen of acupuncture is a specific point acupuncture treatment of diarrhea type irritable bowel syndrome severity to improve the symptoms of depression and subjects in curative effect is better;4.The Tiaoshen of acupuncture is based on a specific point acupuncture optimized treatment,for patients with intestinal symptoms and depressive symptoms have better curative effect,and optimum effect in depressive symptoms suggest the Tiaoshen of acupuncture can be used as a group of patients with depressive symptoms evident in the treatment,so it is worth further large sample clinical research and clinical application. |
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