Objective: To observe the clinical therapeutic effect of Tiaoshen Jianpi acupuncture therapy (acupuncture for regulating the mind and strengthening the spleen) on the gut microbiota and the content of fecal short-chain fatty acids (SCFAs) in patients with diarrhea type irritable bowel syndrome (IBS-D).
Methods: A total of 20 patients with IBS-D and 20 healthy subjects were included. The patients with IBS-D were treated with Tiaoshen Jianpi acupuncture therapy at Baihui (GV 20), Yintang (GV 29), Tianshu (ST 25), Shangjuxu (ST 37), Zusanli (ST 36), Sanyinjiao (SP 6) and Taichong (LR 3). The treatment was given once every two days, 3 times weekly, consecutively for 6 weeks. No intervention was provided for the healthy subjects. Before and after treatment, the IBS symptom severity score (IBS-SSS) was observed in the patients. The fecal samples were collected before and after treatment separately in the patients and in the healthy subjects. Using 16S rRNA sequencing technique, the structure and diversity of gut microbiota were analyzed. Using high-performance liquid chromatography, the content of SCFAs was detected.
Results: After treatment, the abdominal pain severity score, the abdominal pain days score, the satisfaction in bowel movement score, the life interference score and the total IBS-SSS score were all lower than those before treatment in the patients with IBS-D (P<0.05). Compared with the healthy subjects, Firmicutes was increased (P<0.05), Bacteroidetes and Proteobacteria were decreased (P<0.05), and Shannon index was reduced (P<0.05) and Simpson index was increased in patients with IBS-D before treatment (P<0.05). Compared before treatment, Firmicutes was decreased (P<0.05), Bacteroidetes and Proteobacteria were increased (P<0.05), and Shannon index was increased (P<0.05) and Simpson index was reduced in the patients with IBS-D after treatment (P<0.05). Besides, the content of SCFAs was reduced after treatment (P<0.05).
Conclusion: Tiaoshen Jianpi acupuncture therapy relieves abdominal pain and diarrhea, which may be related to regulating the structure and diversity of gut microbiota and reducing the content of fecal SCFAs in the patients with IBS-D.
目的：观察“调神健脾”针法治疗腹泻型肠易激综合征（IBS-D）的临床疗效及对患者肠道菌群及粪便短链脂肪酸含量的影响。方法：纳入20例IBS-D患者和20例健康受试者。IBS-D患者予“调神健脾”针法治疗，穴取百会、印堂、天枢、上巨虚、足三里、三阴交、太冲，隔日1次，每周3次，治疗6周；健康受试者不予任何干预。观察患者治疗前后肠易激综合征症状严重程度（IBS-SSS）积分的变化。收集患者治疗前后及健康受试者的粪便标本，采用16S rRNA测序技术分析肠道菌群的结构丰度和多样性；高效液相色谱法检测粪便短链脂肪酸的含量。结果：治疗后，IBS-D患者腹痛程度、腹痛天数、排便满意度、生活干扰度积分以及IBS-SSS总积分均较治疗前降低（P<0.05）。与健康受试者比较，治疗前IBS-D患者厚壁菌门增多（P<0.05），拟杆菌门、变形菌门减少（P<0.05）；肠道菌群多样性Shannon指数降低、Simpson指数升高（P<0.05）。与治疗前比较，治疗后IBS-D患者厚壁菌门减少（P<0.05），拟杆菌门、变形菌门增多（P<0.05）；肠道菌群多样性Shannon指数升高、Simpson指数降低（P<0.05）；粪便短链脂肪酸含量降低（P<0.05）。结论：“调神健脾”针法可改善IBS-D患者腹痛、腹泻症状，可能与改变肠道菌群结构与多样性、降低粪便中短链脂肪酸含量有关。.
Keywords: acupuncture; gut microbiota; irritable bowel syndrome, diarrhea type; short-chain fatty acids.