| Objective:This study was conducted in a randomized controlled clinical trial,to evaluate the clinical efficacy of acupoint thread embedding on patients with Qi deficiency type constipation after stroke.The changes of SP and VIP content in blood-serum were observed to explore the possible mechanism of this therapy for the treatment of this disease,thus providing a certain theoretical basis for acupoint thread embedding for the treatment of Qi deficiency type constipation after stroke.Methods:Sixty Qi deficiency type constipation after stroke patients from the First Affiliated Hospital of Heilongjiang University of Traditional Chinese Medicine were randomly divided into two groups:treatment group(n=30)and control group(n=30).On the basis of stroke unit,all patients were treated with bilateral Dachangshu,bilateral Tiansfhu,bilateral Shangjuxu,bilateral Zhigou,bilateral Zusanli,bilateral Pishu,Qihai.The treatment group was treated with thread embedding at acupoint,once every 10 days,once for a course of treatment,with a total of 2 courses of treatment.The control group was treated with ordinary acupuncture once a day,6 days a week and 1 week as a course of treatment,with a total of 3 courses of treatment.The constipation symptom score,bristol stool trait score and Patient Assessment of Constipation Quality of Life scale(PAC-QOL)score of the two patients were recorded before and after treatment.The changes of serum SP and VIP in each group were detected by ELISA,and the data were statistically analyzed to obtain the results.Result:1.Before treatment,there were no statistical differences in gender,age,course of disease,stroke type,constipation symptom score,stool trait score,PAC-QOL score,and serum SP and VIP levels in the two groups(P>0.05).2.Constipation symptom scores:After treatment,the individual scores and total scores of constipation symptoms in both groups were improved(all P<0.01);Compared between the two groups,there was no difference between the two groups in terms of defecation time,difficulty in defecation,and defecation sense,and efficacy Equivalent(P>0.05),but the treatment group was significantly better than the control group in improving the first defecation time,defecation interval time,defecation traits and comorb idities(P<0.05).3.Bristol stool trait score:After treatment,the stool trait scores of both groups were higher than before treatment,and the stool traits of the patients were significantly improved(all P<0.01);Compared between the groups,the treatment group was significantly better than the control group(P<0.05).4.PAC-QOL score:After treatment,the PAC-QOL scores of the two groups of patients were lower than before treatment,and the quality of life of patients was significantly improved(all P<0.01);Compared between the groups,the treatment group was significantly better than the control group(P<0.01).5.Content of blood-serum SP and VIP:After treatment,the serum SP content of the two groups of patients was higher than before treatment(all P<0.01),and the treatment group was significantly higher than the control group(P<0.01);After treatment,the serum VIP content of the two groups of patients was significantly lower than before treatment(all P<0.01),and the treatment group was lower than that of control group(P<0.01),indicating that acupoint thread embedding can obviously increase the serum SP content and reduce the serum VIP content in patients.6.The efficacy of TCM syndromes:After 20 days of treatment,the total effective rate of the treatment group was 90.0%,and that of the control group was 73.3%,with statistically significant difference(Z=-2.02,P=0.043<0.05).7.Follow-up results:1 month after the end of treatment,4 patients in the treatment group relapsed,with a relapse rate of 13.3%;There were 12recurrent patients in the control group,with a relapse rate of 40.0%.Both treatments were effective,and the effective rate of the treatment group was higher than that of the control group,and the recurrence rate was lower than that of the control group(?~2=5.455,P=0.020<0.05).This indicates that the patients in the treatment group had better prognosis of qi-deficiency constipation than the control group after short-term thread embedding at acupiont.Conclusion:1.Thread embedding therapy at acupoint and ordinary acupuncture are both effective for the treatment of constipation of Qi deficiency type after stroke.Moreover,thread embedding at acupoint is superior to ordinary acupuncture in improving the first defecation time,defecation interval time,defecation traits and concurrent symptoms.2.Thread embedding therapy at acupoint is better than ordinary acupuncture in improving the quality of life of patients with Qi deficiency constipation after stroke.3.Thread embedding at acupoint can increase SP content and decrease VIP content in blood-serum of patients with Qi deficiency constipation after stroke,and then adjust the dynamic balance between them.4.Thread embedding therapy at acupoint can improve Qi deficiency constipation symptoms after stroke by increasing blood-serum SP content and decreasing VIP content,with regulating brain-intestine axis. |
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