Neuroendocrinological effects of acupuncture treatment in patients with irritable bowel syndrome
Neuroendocrinological effects of acupuncture treatment in patients with irritable bowel syndrome
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DOI：
10.1016/j.ctim.2006.12.002
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发表时间：
2007-12-01
影响因子：
3.6
通讯作者：
Friederich, H. C.
中科院分区：
文献类型：
--
作者：
Schneider, A.;Weiland, C.;Friederich, H. C.
目的：在针灸（AC）治疗期间，肠易激综合征（IBS）患者的生活质量（QoL）改善似乎是由于安慰剂效应。目的是探讨针灸是否对神经内分泌和自主神经系统（ANS）有一些特定的影响。设计/设置：IBS患者被随机分配接受针灸（AC）或假针灸（SAC），使用所谓的“Streitberger针”。生活质量采用功能生活质量疾病生活质量问卷（FDDQL）和SF-36进行测量。通过在10次AC治疗前后在倾斜台上测量唾液皮质醇和心血管反应来评估对ANS的影响。9例AC组和12例SAC组的倾斜表和唾液早晨皮质醇的完整数据集。结果：两组患者的生活质量均有提高（p = 0.001），组间差异无统计学意义。各组唾液皮质醇均下降（F=10.55; p=0.006）。然而，AC组的下降更为明显（F=4.07; p=0.033）（方差分析重复测量模型）。直立应激时，AC组心率反应下降，而SAC组心率反应增加（F=9.234; p=0.005），表明AC组副交感神经张力增加。AC组疼痛的改善与副交感神经张力的增加呈正相关（F= 10.1; p = 0.006），但SAC组无此关系。结论：针刺对AC组和SAC组患者生活质量的特异性生理效应与非特异性生理效应形成对比。因此，不同的机制似乎涉及安慰剂和真正的针灸驱动的改善。针刺对ANS的具体作用机制尚不清楚，值得进一步研究。(C) 2007 Elsevier Ltd.版权所有。
Objectives: Quality of life (QoL) improvement in patients with irritable bowel syndrome (IBS) during acupuncture (AC) treatment seems to be due to a placebo effect. The aim was to explore if acupuncture has some specific influence on the neuroendocrinic and autonomic nervous system (ANS).Design/setting: Patients with IBS were randomly assigned to receive either acupuncture (AC) or sham acupuncture (SAC) using the so-called "Streitberger needle". QoL was measured with the functional quality of life diseases quality of life questionnaire (FDDQL) and SF-36. The effect on ANS was evaluated by measuring salivary cortisol and by cardiovascular responses on a tilt table before and after 10 AC treatments. Complete data sets of tilt table and salivary morning cortisol were available for 9 patients in the AC and 12 in SAC group.Results: QoL increased in both groups (p = 0.001) with no group differences. Salivary cortisol decreased in all groups (F=10.55; p=0.006). However, the decrease was more pronounced in the AC group (F=4.07; p=0.033) (ANOVA repeated measures model). Heart rate response decreased during orthostatic stress in the AC group while it increased in the SAC group (F=9.234; p=0.005), indicating an increased parasympathetic tone in the AC group. Improvement of pain was positively associated with increased parasympathetic tone in the AC group (F= 10.1; p = 0.006), but not in the SAC group.Conclusions: The acupuncture specific physiological effects are in contrast to the unspecific improvement of QoL in both AC and SAC groups. Thus, different mechanisms seem to be involved in placebo and real-acupuncture driven improvements. The specific mechanism of action of acupuncture on the ANS remains unclear and deserves further evaluation. (C) 2007 Elsevier Ltd. All rights reserved.