| Objective:To observe the effects of acupuncture and moxibustion on the clinical efficacy,psychological changes of anxiety and depression,and the serum levels of cholecystokinin（CCK）,calcitonin gene related peptide（CGRP）and vasoactive peptide（VIP）in patients with diarrhea irritable bowel syndrome-d（IBS-D）,This paper discusses the mechanism of acupuncture and moxibustion in the treatment of IBS-D of liver depression and spleen deficiency from the perspective of brain gut interaction disorder.Methods: 96 patients with IBS-D of liver depression and spleen deficiency type who met the diagnostic criteria of traditional Chinese and Western medicine and syndrome differentiation of traditional Chinese medicine were selected as the research object.They were randomly divided into two groups according to the random number table method: the treatment group and the control group,with48 cases in each group.Scheme: the treatment group selected Neiguan（PC6）,Tianshu（ST25）,Sanyinjiao（SP6）,Zusanli（ST36）,Shangj uxu（ST37）,Taichong（LR3）and Yintang（GV29）for acupuncture treatment,and then applied ginger separated moxibustion on Shenque（CV8）point;The control group was treated with montmorillonite powder and Flupentixol melitracen.Both groups were treated once a day,five times a week as a course of treatment,two consecutive courses of treatment,rest for 2 days between courses,and follow-up for 3 months after the end of treatment.The scores of IBS symptom severity scale（IBS-SSS）,IBS quality of life scale（IBS-QOL）,self rating Anxiety Scale（SAS）,self rating Depression Scale（SDS）and the recurrence rate after 3 months of follow-up were recorded before and after treatment.The serum levels of cholecystokinin（CCK）,calcitonin gene-related peptide（CGRP）and The expression level of vasoactive peptide（VIP）,and the data were statistically analyzed to compare the clinical efficacy and recurrence rate 3 months after treatment between the two groups,so as to evaluate the clinical efficacy of acupuncture and moxibustion in the treatment of IBS-D of liver depression and spleen deficiency.Results:1.Baseline data: a total of 93 effective cases were included,and all patients completed treatment and follow-up.There was no significant difference between the two groups in general conditions,gender,average age and average course of disease（P>0.05）.2.Comparison of effective rates: the total effective rate and recurrence rate 3 months after treatment were 91.5% and 7.0%in the treatment group and 73.9% and 29.4% in the control group,respectively.The difference between the two groups was statistically significant（P<0.05）.Acupuncture and moxibustion has more advantages in improving the dimensions of anxiety,dietary restriction,body consciousness,heterosexual concept and interpersonal relationship in IBS-D patients.3.Comparison of IBS-SSS and IBS-QOL scores between the two groups before and after treatment:there was no significant difference in IBS-SSS and IBS-QOL scores between the two groups before treatment（P>0.05）.The severity and life of patients in the two groups after treatment were improved compared with those before treatment,and the IBS-SSS score decreased compared with those before treatment（P<0.05）,and the decrease in the treatment group was more significant than that in the control group（P<0.05）.IBS-QOL score increased before and after treatment.There was significant difference in IBS-QOL score between the two groups before and after treatment（P < 0.05）.The IBS-QOL score of the treatment group increased significantly compared with that of the control group（P<0.05）.4.SAS score and SDS score of the two groups before and after treatment: there was no significant difference in SAS score and SDS score between the two groups before treatment（P>0.05）.After treatment,the anxiety and depression of the patients in the two groups were improved compared with those before treatment,and the SAS score and SDS score decreased compared with those before treatment（P<0.05）.Compared with the control group,the decrease in the treatment group was more significant,and the difference between the two groups was statistically significant（P<0.05）.5.Comparison of serum levels of CCK,CGRP and VIP before and after treatment:there was no significant difference in the contents of serum brain gut peptide CCK,CGRP and VIP between the treatment group and the control group before treatment（P>0.05）.The contents of serum brain gut peptide CCK,CGRP and VIP in the two groups after treatment were lower than those in the same group before treatment,and the difference was statistically significant（P<0.05）.After treatment,the contents of serum brain gut peptide CCK,CGRP and VIP in the treatment group were significantly lower than those in the control group.The difference between the two groups was statistically significant（P<0.05）.6.Safety analysis:1 case of abdominal pain and 1 case of constipation occurred in both groups during treatment,and no other obvious adverse reactions were found.Recovered after symptomatic treatment without serious adverse events.Conclusion: Acupuncture and moxibustion can effectively alleviate the clinical symptoms related to abdominal pain,diarrhea and intestinal discomfort in IBS-D patients with liver depression and spleen deficiency syndrome,improve the quality of life,improve the state of anxiety and depression,and reduce the levels of CCK,CGRP and VIP in patients’ peripheral blood.There are no obvious adverse reactions,low recurrence rate and high safety. |
