Factorial study of moxibustion in treatment of diarrhea-predominant irritable bowel syndrome.
Factorial study of moxibustion in treatment of diarrhea-predominant irritable bowel syndrome.
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DOI：
10.3748/wjg.v20.i37.13563
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发表时间：
2014-10
影响因子：
4.3
通讯作者：
Jimeng Zhao;Luyi Wu;Hui-rong Liu;Hong-yi Hu;Jia-Ying Wang;R. Huang;Yin Shi;Shan-ping Tao;
中科院分区：
文献类型：
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作者：
Jimeng Zhao;Luyi Wu;Hui-rong Liu;Hong-yi Hu;Jia-Ying Wang;R. Huang;Yin Shi;Shan-ping Tao;
目的探讨隔附子饼灸治疗腹泻型肠易激综合征的适宜治疗方案。方法采用析因设计法考察艾灸频度和锥体数两个因素。两个测试频率为每周三到六次艾灸，两个测试剂量为每次治疗一个或两个锥体。共166例D-IBS患者被随机分为四组，每组包括检查频率和剂量的每一种组合。取双侧天俞穴(ST25)、七海穴(RN6)进行隔乌饼灸。每例患者接受两个疗程的治疗，每个疗程均为2wk。于治疗前、治疗1个疗程后、治疗2个疗程后分别测定伯明翰肠易激综合征(IBS)症状问卷、IBS生活质量量表、抑郁自评量表(SDS)、焦虑自评量表(SAS)、汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)评分。结果：隔附子饼灸治疗1、2疗程后，4组患者的症状、生活质量、抑郁自评量表、焦虑自评量表、汉密尔顿抑郁量表、汉密尔顿抑郁量表评分均显著低于治疗前(P均<0.001)。隔附子饼灸4组患者第二疗程后症状、生活质量、抑郁自评量表、焦虑自评量表、汉密尔顿抑郁量表、汉密尔顿抑郁量表评分均显著低于第一疗程后(P均<0.001)。第2疗程后组间比较，第1组(1个锥体，3次/周)和第3组(2个锥体，3个疗程/周)的症状积分明显低于第2组(1个锥体，6个疗程/周)(5.55±5.05vs10.45±6.61vs10.45±6.61，P<；0.001；5.65±4.00vs10.45±6.61，P<；0.001)。隔附子饼灸两个被测因素的两个水平，第一个疗程后，两个受试艾灸频率的HAMA评分变化差异有统计学意义(P=0.011)，其中“6次/周”组的变化幅度大于“3次/周”组，且艾灸次数与球果数之间存在交互作用(P=0.028)。治疗2个疗程后，2个艾灸频次的症状积分变化差异有统计学意义(P=0.002)，3个疗程/周组的变化幅度大于6个疗程/周组。结论：附子隔饼灸治疗D-IBS 3个疗程/周、1个疗程/疗程的治疗效果优于其他受试方案。
AIM To identify an appropriate therapeutic regimen for using aconite cake-separated moxibustion to treat diarrhea-predominant irritable bowel syndrome (D-IBS). METHODS A factorial design was employed to examine the two factors of moxibustion frequency and number of cones. The two tested frequencies were three or six moxibustion sessions per week, and the two tested doses were one or two cones per treatment. A total of 166 D-IBS patients were randomly divided into four treatment groups, which included each combination of the examined frequencies and doses. The bilateral Tianshu acupoints (ST25) and the Qihai acupoint (RN6) were selected for aconite cake-separated moxibustion. Each patient received two courses of treatment, and each course had a duration of 2 wk. For each group, the scores on the Birmingham irritable bowel syndrome (IBS) symptom questionnaire, the IBS Quality of Life scale, the Self-Rating Depression Scale (SDS), the Self-Rating Anxiety Scale (SAS), the Hamilton Depression (HAMD) scale, and the Hamilton Anxiety (HAMA) scale were determined before treatment, after the first course of treatment, and after the second course of treatment. RESULTS The symptom, quality of life, SDS, SAS, HAMD, and HAMA scores of the patients in all 4 aconite cake-separated moxibustion groups were significantly lower after the first and second courses of treatment than before treatment (P < 0.001 for all). The symptom, quality of life, SDS, SAS, HAMD, and HAMA scores of the patients in all four aconite cake-separated moxibustion groups were significantly lower after the second course of treatment than after the first course of treatment (P < 0.001 for all). Between-group comparisons after the second course of treatment revealed that the symptom scores for group 1 (1 cone, 3 treatments/wk) and group 3 (2 cones, 3 treatments/wk) were significantly lower than that for group 2 (1 cone, 6 treatments/wk) (5.55 ± 5.05 vs 10.45 ± 6.61, P < 0.001; 5.65 ± 4.00 vs 10.45 ± 6.61, P < 0.001). Regarding the two levels of the two examined factors for aconite cake-separated moxibustion, after the first course of treatment, the changes in HAMA scores were significantly different for the two tested moxibustion frequencies (P = 0.011), with greater changes for the "6 treatments/wk" groups than for the "3 treatments/wk" groups; in addition, there were interaction effects between the number of cones and moxibustion frequency (P = 0.028). After the second course of treatment, changes in symptom scores for the 2 tested moxibustion frequencies were significantly different (P = 0.002), with greater changes for the "3 treatments/wk" groups than for the "6 treatments/wk" groups. CONCLUSION An aconite cake-separated moxibustion treatment regimen of 3 treatments/wk and 1 cone/treatment appears to produce better therapeutic effects for D-IBS compared with the other tested regimens.