头针强刺激治疗顽固性呃逆疗效观察
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摘要
目的观察头针强刺激联合口服呃逆汤治疗顽固性呃逆的临床疗效。方法将100例顽固性呃逆患者采用随机数字表法分为治疗组和对照组,每组50例。两组患者在口服呃逆汤基础上,治疗组采用头针胃区和胸腔区,进行强刺激;对照组采用电针治疗。观察对比两组患者的起效时间以及症状频率评分。结果 1个疗程结束后,治疗组痊愈率为42%,愈显率为66%,总有效率为78%;对照组痊愈率为24%,愈显率为40%,总有效率为68%,两组痊愈率与愈显率比较差异均有统计学意义(P<0.05),两组总有效率比较差异无统计学意义(P>0.05)。2个疗程结束后,治疗组痊愈率为68%,愈显率为78%,总有效率为88%;对照组痊愈率为40%,愈显率为60%,总有效率为74%,两组痊愈率比较差异有统计学意义(P<0.05),两组愈显率和总有效率比较差异无统计学意义(P>0.05)。1个疗程后和2个疗程后,治疗组呃逆症状频率评分与对照组比较差异有统计学意义(P<0.05),治疗组起效时间为2～5 h,对照组起效时间5～8 h。结论头针强刺激治疗顽固性呃逆总有效率与电针治疗无明显差异,但痊愈率明显优于电针治疗,起效快,可以减少呃逆次数,缓解呃逆伴随症状。
Objective To investigate the efficacy of scalp acupuncture with strong stimulation plus oral hiccup decoction in treating intractable hiccup. Method One hundred patients with intractable hiccup were allocated, using a random number table, to treatment and control groups, 50 cases each. In addition to oral hiccup decoction in the two groups, the treatment group received scalp acupuncture with strong stimulation at the stomach and chest areas and the control group, electroacupuncture, for two courses of treatment. The times to produce the effect and the symptom frequency scores were compared between the two groups. Result After one course of treatment, the cure rate, the cure and marked efficacy rate and the total efficacy rate were 42%, 66% and 78%,respectively, in the treatment group and 24%, 40% and 68%, respectively, in the control group. There were statistically significant difference in the cure rate and the cure and marked efficacy rate(P<0.05) but no in the total efficacy rate(P>0.05) between the two groups. After two courses of treatment, the cure rate, the cure and marked efficacy rate and the total efficacy rate were 68%, 78% and 88%, respectively, in the treatment group and 40%, 60% and 74%, respectively,in the control group. There were statistically significant difference in the cure rate(P<0.05) but no in the cure and marked efficacy rate and the total efficacy rate(P>0.05) between the two groups. After one and two courses of treatment, there was a statistically significant difference in the hiccup frequency score between the treatment and control groups(P<0.05). The time to produce the effect was 2-5 hrs in the treatment group and 5-8 hrs in the control group. Conclusion The total efficacy rate of scalp acupuncture with strong stimulation for intractable hiccup is not significantly different from that of electroacupuncture, but the cure rate of the former was significantly higher than that of the latter. Scalp acupuncture with strong stimulation can produce a quick effect, reduce the frequency of hiccups and relieve symptoms accompanying hiccup.
Objective To investigate the efficacy of scalp acupuncture with strong stimulation plus oral hiccup decoction in treating intractable hiccup. Method One hundred patients with intractable hiccup were allocated, using a random number table, to treatment and control groups, 50 cases each. In addition to oral hiccup decoction in the two groups, the treatment group received scalp acupuncture with strong stimulation at the stomach and chest areas and the control group, electroacupuncture, for two courses of treatment. The times to produce the effect and the symptom frequency scores were compared between the two groups. Result After one course of treatment, the cure rate, the cure and marked efficacy rate and the total efficacy rate were 42%, 66% and 78%,respectively, in the treatment group and 24%, 40% and 68%, respectively, in the control group. There were statistically significant difference in the cure rate and the cure and marked efficacy rate(P<0.05) but no in the total efficacy rate(P>0.05) between the two groups. After two courses of treatment, the cure rate, the cure and marked efficacy rate and the total efficacy rate were 68%, 78% and 88%, respectively, in the treatment group and 40%, 60% and 74%, respectively,in the control group. There were statistically significant difference in the cure rate(P<0.05) but no in the cure and marked efficacy rate and the total efficacy rate(P>0.05) between the two groups. After one and two courses of treatment, there was a statistically significant difference in the hiccup frequency score between the treatment and control groups(P<0.05). The time to produce the effect was 2-5 hrs in the treatment group and 5-8 hrs in the control group. Conclusion The total efficacy rate of scalp acupuncture with strong stimulation for intractable hiccup is not significantly different from that of electroacupuncture, but the cure rate of the former was significantly higher than that of the latter. Scalp acupuncture with strong stimulation can produce a quick effect, reduce the frequency of hiccups and relieve symptoms accompanying hiccup.
引文
[1]何成.顽固性呃逆的治疗进展[J].中国综合临床,2003,19(1):11-12.
[2]周怡.近十余年针灸治疗呃逆之概况[J].吉林中医药,2002,22(3):57-58.
[3]郑方.慢性呃逆的诊断与治疗[J].实用疼痛学杂志,2007,3(1):47-53.
[4]唐国彬.呃逆病因病机及治疗方法研究进展[J].中医学报,2012,27(7):878-879.
[5]左毅.顽固性呃逆的治疗研究进展[J].现代中西医结合杂志,2008,17(16):2591-2592.
[6]雷征霖.顽固性呃逆的临床诊治进展[J].医师进修杂志,2001,24(5):6-7.
[7]上海市卫生局.上海市中医病证诊疗常规[S].上海:上海中医药大学出版社,1998:17-18.
[8]闫晓瑞.醒脑开窍针刺法治疗脑卒中后顽固性呃逆临床观察[J].光明中医,2012,27(1):97-98.
[9]杨国荣,赵援非.针药并用治疗中风后顽固性呃逆临床观察[J].辽宁中医杂志,2007,34(3):327.
[10]麻秋雷,赵烨,李鹏,等.背俞穴针刺配合艾灸治疗顽固性呃逆1例[J].四川中医,2013,31(9):125-126.
[11]闻斐斐,李振华.呃逆病因病机探析[J].环球中医药,2013,6(7):529-531.
[12]陈锦伦.呃逆病因病机及治法刍议[J].光明中医,2012,27(6):1078-1079.
[13]姜道新,任安文.顽固性呃逆的发病机制及药物治疗进展[J].临床荟萃,1998,13(9):400-401.
[14]韦立新,张建福.顽固性呃逆的中医药治疗进展[J].广西中医药,2010,33(2):1-2.
[15]王莉珍,秦杨鹏,姜蕾,等.近10年呃逆针灸治疗概况[J].中医药临床杂志,2011,(9):840-841.
[16]胡吉庆,王红菊.中西医结合治疗脑血管病顽固性呃逆46例[J].实用心脑肺血管病杂志,2009,17(10):896-897.
[17]邓江慧,胡元汉,陈嘉莹.氯丙嗪联合山莨菪碱治疗呃逆85例临床分析[J].临床合理用药杂志,2011,4(21):5.
[18]鲁发强.山莨菪碱联合氯丙嗪治疗顽固性呃逆的疗效观察[J].临床合理用药,2014,7(3):59.
[19]杨丽霞.胃复安联合氯丙嗪穴位注射对脑卒中患者呃逆的治疗效果观察[J].中国实用医药,2014,9(9):155-156.
[20]唐世容.胃复安足三里穴位注射临床应用体会[J].现代医药卫生,2013,29(23):3654-3655.
[21]陈红英.巴氯芬治疗脑卒中后顽固性呢逆的疗效观察[J].中国伤残医学,2013,21(6):252-253.
[22]吴翠平,钟彩英,刘海燕,等.氯丙嗪滴鼻治疗中枢系统病变致顽固性呃逆效果观察[J].中国误诊学杂志,2010,10(21):5071.
[23]Ripamonti C,Fusco F.Respiratory problems in advanced cancer[J].Supportive Care in Cancer,2002,10(3):204-216.
[24]刘晶晶,王玉才,张小建,等.柴胡桂枝汤加减治疗肝胃不和型中风后顽固性呃逆23例临床观察[J].河北中医,2015,37(6):879-880.
[25]刘彦晶.刘铁军教授运用三焦辨证治疗呃逆验案举隅[J].中国民间疗法,2015,23(1):12-13.
[26]李建珍.对呃逆的辨证施治[J].辽宁中医药大学学报,2008,10(12):115-116.
[27]王志杰,刘朝晖,汤永全,等.针刺奇穴为主治疗中枢性顽固性呃逆疗效观察[J].上海针灸杂志,2016,35(11):1290-1292.
[28]李呈新.电针为主治疗术后顽固性呃逆疗效观察[J].上海针灸杂志,2015,34(8):737-738.
[29]许樱樱,蔡亚红,叶富英.隔盐灸治疗化疗所致呃逆疗效观察[J].上海针灸杂志,2014,33(8):728-729.
[30]郭灵祥,闫晓瑞,师林会.中医综合疗法治疗呃逆临床疗效观察[J].光明中医,2015,30(11):2383-2384.
[31]汤国娟.针药穴注三联治疗呃逆的临床体会[J].针灸临床杂志,2006,22(7):46-47.
[32]赵志强.针药推综合治疗呃逆40例[J].亚太传统医药,2010,6(12):39-40.
[33]唐胜修,王小莲,刘辛,等.针灸治疗呃逆现状研究[J].辽宁中医药大学学报,2010,(9):70-72.
[34]王美丽.近10年针灸治疗呃逆的进展[J].世界最新医学信息文摘(电子版),2018,18(11):34-36.
[35]江涛,王馨悦.呃逆的针灸治疗概况[J].云南中医学院学报,2009,32(5):67-70.
[36]吴耀持.头针胸腔区治疗呃逆51例[J].上海针灸杂志,1996,15(S1):81-82.
[37]祝波,焦杨.头针为主治疗中风后顽固性呃逆临床体会[J].中国中医急症,2010,19(1):125-126.
[38]李在琉,金泽重,李基俊,等.丁香、高良姜、草豆蔻对胃液分泌的影响[J].中医杂志,1980,(2):68-72.
[39]王玮,吴志松,曹芳,等.周平安治疗肺癌化疗后呃逆一则[J].中医杂志,2016,(4):359-360.
[40]孙卫国.丁香柿蒂汤治疗腹部手术后并发顽固性呃逆疗效观察[J].中医学报,2010,(5):941-942.
[41]翟林柱,曹洋,赵媛媛,等.温胆汤合丁香柿蒂汤预防含顺铂方案化疗所致恶心呕吐临床研究[J].广州中医药大学学报,2014,(3):343-347.
[42]赵丹,许绍兰,李蔚,等.健脾和胃颗粒质量标准的研究[J].东南国防医药,2015,17(6):598-601.
[43]侯家玉,姜泽伟.党参对应激型胃溃疡大鼠胃电,胃运动和胃排空的影响[J].中西医结合杂志,1989,(1):31-32.
[44]姜威,李晶峰,高久堂,等.石决明的化学成分及药理作用[J].吉林中医药,2015,(3):272-274.
[45]文荣学.天麻钩藤饮临床应用举隅[J].实用中医药杂志,2010,(1):41.
[2]周怡.近十余年针灸治疗呃逆之概况[J].吉林中医药,2002,22(3):57-58.
[3]郑方.慢性呃逆的诊断与治疗[J].实用疼痛学杂志,2007,3(1):47-53.
[4]唐国彬.呃逆病因病机及治疗方法研究进展[J].中医学报,2012,27(7):878-879.
[5]左毅.顽固性呃逆的治疗研究进展[J].现代中西医结合杂志,2008,17(16):2591-2592.
[6]雷征霖.顽固性呃逆的临床诊治进展[J].医师进修杂志,2001,24(5):6-7.
[7]上海市卫生局.上海市中医病证诊疗常规[S].上海:上海中医药大学出版社,1998:17-18.
[8]闫晓瑞.醒脑开窍针刺法治疗脑卒中后顽固性呃逆临床观察[J].光明中医,2012,27(1):97-98.
[9]杨国荣,赵援非.针药并用治疗中风后顽固性呃逆临床观察[J].辽宁中医杂志,2007,34(3):327.
[10]麻秋雷,赵烨,李鹏,等.背俞穴针刺配合艾灸治疗顽固性呃逆1例[J].四川中医,2013,31(9):125-126.
[11]闻斐斐,李振华.呃逆病因病机探析[J].环球中医药,2013,6(7):529-531.
[12]陈锦伦.呃逆病因病机及治法刍议[J].光明中医,2012,27(6):1078-1079.
[13]姜道新,任安文.顽固性呃逆的发病机制及药物治疗进展[J].临床荟萃,1998,13(9):400-401.
[14]韦立新,张建福.顽固性呃逆的中医药治疗进展[J].广西中医药,2010,33(2):1-2.
[15]王莉珍,秦杨鹏,姜蕾,等.近10年呃逆针灸治疗概况[J].中医药临床杂志,2011,(9):840-841.
[16]胡吉庆,王红菊.中西医结合治疗脑血管病顽固性呃逆46例[J].实用心脑肺血管病杂志,2009,17(10):896-897.
[17]邓江慧,胡元汉,陈嘉莹.氯丙嗪联合山莨菪碱治疗呃逆85例临床分析[J].临床合理用药杂志,2011,4(21):5.
[18]鲁发强.山莨菪碱联合氯丙嗪治疗顽固性呃逆的疗效观察[J].临床合理用药,2014,7(3):59.
[19]杨丽霞.胃复安联合氯丙嗪穴位注射对脑卒中患者呃逆的治疗效果观察[J].中国实用医药,2014,9(9):155-156.
[20]唐世容.胃复安足三里穴位注射临床应用体会[J].现代医药卫生,2013,29(23):3654-3655.
[21]陈红英.巴氯芬治疗脑卒中后顽固性呢逆的疗效观察[J].中国伤残医学,2013,21(6):252-253.
[22]吴翠平,钟彩英,刘海燕,等.氯丙嗪滴鼻治疗中枢系统病变致顽固性呃逆效果观察[J].中国误诊学杂志,2010,10(21):5071.
[23]Ripamonti C,Fusco F.Respiratory problems in advanced cancer[J].Supportive Care in Cancer,2002,10(3):204-216.
[24]刘晶晶,王玉才,张小建,等.柴胡桂枝汤加减治疗肝胃不和型中风后顽固性呃逆23例临床观察[J].河北中医,2015,37(6):879-880.
[25]刘彦晶.刘铁军教授运用三焦辨证治疗呃逆验案举隅[J].中国民间疗法,2015,23(1):12-13.
[26]李建珍.对呃逆的辨证施治[J].辽宁中医药大学学报,2008,10(12):115-116.
[27]王志杰,刘朝晖,汤永全,等.针刺奇穴为主治疗中枢性顽固性呃逆疗效观察[J].上海针灸杂志,2016,35(11):1290-1292.
[28]李呈新.电针为主治疗术后顽固性呃逆疗效观察[J].上海针灸杂志,2015,34(8):737-738.
[29]许樱樱,蔡亚红,叶富英.隔盐灸治疗化疗所致呃逆疗效观察[J].上海针灸杂志,2014,33(8):728-729.
[30]郭灵祥,闫晓瑞,师林会.中医综合疗法治疗呃逆临床疗效观察[J].光明中医,2015,30(11):2383-2384.
[31]汤国娟.针药穴注三联治疗呃逆的临床体会[J].针灸临床杂志,2006,22(7):46-47.
[32]赵志强.针药推综合治疗呃逆40例[J].亚太传统医药,2010,6(12):39-40.
[33]唐胜修,王小莲,刘辛,等.针灸治疗呃逆现状研究[J].辽宁中医药大学学报,2010,(9):70-72.
[34]王美丽.近10年针灸治疗呃逆的进展[J].世界最新医学信息文摘(电子版),2018,18(11):34-36.
[35]江涛,王馨悦.呃逆的针灸治疗概况[J].云南中医学院学报,2009,32(5):67-70.
[36]吴耀持.头针胸腔区治疗呃逆51例[J].上海针灸杂志,1996,15(S1):81-82.
[37]祝波,焦杨.头针为主治疗中风后顽固性呃逆临床体会[J].中国中医急症,2010,19(1):125-126.
[38]李在琉,金泽重,李基俊,等.丁香、高良姜、草豆蔻对胃液分泌的影响[J].中医杂志,1980,(2):68-72.
[39]王玮,吴志松,曹芳,等.周平安治疗肺癌化疗后呃逆一则[J].中医杂志,2016,(4):359-360.
[40]孙卫国.丁香柿蒂汤治疗腹部手术后并发顽固性呃逆疗效观察[J].中医学报,2010,(5):941-942.
[41]翟林柱,曹洋,赵媛媛,等.温胆汤合丁香柿蒂汤预防含顺铂方案化疗所致恶心呕吐临床研究[J].广州中医药大学学报,2014,(3):343-347.
[42]赵丹,许绍兰,李蔚,等.健脾和胃颗粒质量标准的研究[J].东南国防医药,2015,17(6):598-601.
[43]侯家玉,姜泽伟.党参对应激型胃溃疡大鼠胃电,胃运动和胃排空的影响[J].中西医结合杂志,1989,(1):31-32.
[44]姜威,李晶峰,高久堂,等.石决明的化学成分及药理作用[J].吉林中医药,2015,(3):272-274.
[45]文荣学.天麻钩藤饮临床应用举隅[J].实用中医药杂志,2010,(1):41.