【目的】 观察浮针疗法联合常规西药治疗腹泻型肠易激综合征（IBS-D）肝郁气滞证的临床疗效。【方法】 选取 2021 年 1 月至2024年8月邢台市中心医院病房及门诊收治的100例明确诊断为IBS-D肝郁气滞证的患者作为研究对象，并按随机数 字表将患者随机分为观察组和对照组，每组各50例。对照组给予健康宣教联合常规西药治疗，观察组在对照组治疗的基础 上，给予浮针疗法治疗。连续治疗4周。治疗1个月后，评价2组临床疗效。观察2组患者治疗前后肠易激综合征严重程度 量表（IBS-SSS）、中医证候积分、肠易激综合征生活质量量表（IBS-QOL）评分的变化情况。比较 2组患者治疗前后炎性因子 [白细胞介素8（IL-8）、高敏C反应蛋白（hs-CRP）、干扰素γ（IFN-γ）]及胃肠激素[胃动素（MTL）、血管活性肠肽（VIP）、5-羟 色胺（5-HT）]水平的变化情况，以及肠道菌群的情况。并评价2组的安全性及不良反应的发生情况。【结果】（1）研究过程中， 对照组剔除患者1例，观察组剔除患者2例。最终对照组49例、观察组48例纳入疗效统计。（2）治疗后，2组患者的IBS-SSS 评分、中医证候评分、IBS-QOL评分明显改善（P＜0.05），且观察组在改善 IBS-SSS评分、中医证候评分、IBS-QOL评分方 面明显优于对照组，差异有统计学意义（P＜0.05）。（3）治疗后，2组患者的IL-8、hs-CRP、IFN-γ明显改善（P＜0.05），且观 察组在改善 IL-8、hs-CRP、IFN-γ方面明显优于对照组，差异有统计学意义（P＜0.05）。（4）治疗后，2组患者的 MTL、VIP、 5-HT水平明显改善（P＜0.05），且观察组在改善MTL、VIP、5-HT水平方面明显优于对照组，差异有统计学意义（P＜0.05）。 （5）治疗后，2 组患者的肠道菌群明显改善（P＜0.05），且观察组在改善肠道菌群方面明显优于对照组，差异有统计学意义 （P＜0.05）。（6）观察组总有效率为 95.83%（46/48），对照组为 81.63%（40/49），观察组疗效优于对照组，差异有统计学意义 （P＜0.05）。（7）观察组不良反应发生率为4.17%（2/48），对照组无明显不良反应情况发生。观察组与对照组的不良反应发生率 比较，差异无统计学意义（P＞0.05）。【结论】 浮针疗法联合常规西药治疗IBS-D肝郁气滞证，能够明显减轻患者病情的严重 程度，缓解患者的临床症状，降低炎症因子水平，调节胃肠激素，纠正肠道菌群失调，提高生活质量，疗效显著，且安全 性好。

Objective To evaluate the clinical efficacy of Fu’s Subcutaneous Needling （FSN） combined with conventional western medicine in treating diarrhea-predominant irritable bowel syndrome （IBS-D） with liver depression and qi stagnation syndrome. Methods A total of 100 patients diagnosed with IBS-D （liver depression and qi stagnation type） were enrolled from the wards and Outpatient Departments of Xingtai Central Hospital between January 2021 and August 2024. They were randomly divided into an observation group and a control group （n=50 each） using a random number table. The control group received health education combined with conventional western medicine， while the observation group received additional Fu’s Subcutaneous Needling therapy based on the control group’s treatment. The treatment duration was 4 weeks for both groups. After one month of treatment， clinical efficacy was evaluated. Changes in the Irritable Bowel Syndrome-Severity Scoring System （IBS-SSS）， traditional Chinese medicine （TCM） syndrome scores， and Irritable Bowel SyndromeQuality of Life （IBS-QOL） scores were observed before and after treatment. Levels of inflammatory factors [interleukin-8（IL-8），high-sensitivity C-reactive protein （hs-CRP），interferon-γ（IFN-γ）]，gastrointestinal hormones [motilin （MTL）， vasoactive intestinal peptide （VIP）， 5-hydroxytryptamine （5-HT）]， and gut microbiota composition were compared between the two groups before and after treatment. Safety and adverse reactions were also assessed. Results （1） During the study，one patient was excluded from the control group and two from the observation group. Finally， 49 patients in the control group and 48 in the observation group were included in the efficacy analysis.（2） After treatment，both groups showed significant improvements in IBS-SSS scores，TCM syndrome scores，and IBS-QOL scores （P＜0.05）. The observation group demonstrated significantly greater improvements in these scores compared to the control group，with statistically significant difference （P＜ 0.05）.（3） After treatment，both groups showed significant improvements in IL-8，hs-CRP，and IFN-γ levels （P＜0.05），with the observation group exhibiting significantly greater improvements than the control group，with statistically significant difference （P＜0.05）.（4） After treatment，both groups showed significant improvements in MTL， VIP， and 5-HT levels （P＜0.05）， and the observation group demonstrated significantly greater improvements than the control group， with statistically significant difference （P＜0.05）.（5） After treatment， both groups showed significant improvements in gut microbiota （P＜0.05），with the observation group showing significantly greater improvement than the control group， with statistically significant difference （P＜0.05）. （6）The total effective rate was 95.83% （46/48） in the observation group and 81.63% （40/49） in the control group，with the observation group showing significantly superior efficacy，with statistically significant difference （P＜0.05）. （7） The incidence of adverse reactions was 4.17% （2/48） in the observation group， while no significant adverse reactions occurred in the control group. The difference in the incidence of adverse reactions between the two groups was not statistically significant （P＞0.05）. Conclusion Fu’s Subcutaneous Needling combined with conventional western medicine significantly reduces disease severity，alleviates clinical symptoms，decreases inflammatory factor levels，regulates gastrointestinal hormones，corrects gut microbiota dysbiosis，and improves quality of life in patients with IBS-D （liver depression and qi stagnation type），demonstrating notable efficacy and a favorable safety profile.

R246.9

邢台市科技计划自筹经费项目（编号：2024ZC197）]