针药并用治疗肝胃郁热型反流性食管炎临床症状及胃镜观察研究
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摘要
目的：通过对RE患者的针药治疗观察,对采用的针药结合治疗RE的临床疗效、穴位的选择予以客观评价,为临床治疗提供新思路、新方法,观察病人停药后的复发情况,以利于探索RE的长期疗效。
方法：采用随机、开放对照试验,以调查问卷、症状量表、胃镜检查等方法相结合的形式,客观评价针药同用治疗RE的临床疗效,临床选择符合纳入标准的RE患者60例,随机分为两组,针药结合组予中药水煎剂配合相应的针刺治疗,对照组单纯给予中药水煎剂治疗,治疗后分别再次进行症状积分问卷调查,部分病例进行胃镜复查,评价两组疗效。
结果：临床研究显示：针药结合组治疗RE的总有效率为96.7%,胃镜疗效总有效率为90.0%；中药组总有效率为86.7%,胃镜疗效总有效率为73.3%,两组疗效对比,均有显著性差异(P<0.05)。针药组能够明显缓解患者的食物反流、反酸、烧心、胸骨后疼痛不适等典型的症状,并且两组的复发率比较也存在显著性差异(P<0.05)。
结论：
1.针药结合组治疗RE临床疗效优于单纯的中药治疗,体现在患者自我感觉的症状缓解上、客观的胃镜检查结果上和抑制RE的复发上。
2.其机制可能是针刺和药物在改善LES功能、促进胃排空、调节胃酸分泌和排泄方面有协同作用。
Objective:To evaluate objectively the clinical effect and the selection of acupoints for the patients with reflux esophagitis (RE) who received the treatment of acupuncture combined with medicine; to observe the rucurrence and provide new methods and explore the long-term effect of RE.
Method:adopting the random and open trial through the questionnaire、rating scale of symptoms and gastroscope, we select 60 cases meeting the inclusive criteria and divide them into two groups randomly. We apply the acupuncture to the treatment group besides the herbal decoction while herbal decoction only for the control group. After the treatment phase, we do the questionnaire of symptoms again and the gastroscope again for portion of the cases.
Results:The clinical research shows that the total effective rate of treatment group is 96.7% and 90.0% for gastroscope effect. Correspondingly, in the control group, the value is 86.7% and 73.3%. there is significant difference (p<0.05)in both groups, but the treatment group is better on the improvement of some symptoms as acid regurgitatio、heart burn、retrosternal pain as well as the reduction of recurrence.
Conclusion:
1.In light of the improvement of symptoms and gastroscope result and the reduction of recurrence, treatment group is a better selection than the control group which has only the oral decoction for the treatment.
2.The probable mechanism lies in the acupucture has a coordinating effect when combined with herbal medicine on improving the LES function, promoting stomach evacuation, regulating the acid secretion and excretion.
方法：采用随机、开放对照试验,以调查问卷、症状量表、胃镜检查等方法相结合的形式,客观评价针药同用治疗RE的临床疗效,临床选择符合纳入标准的RE患者60例,随机分为两组,针药结合组予中药水煎剂配合相应的针刺治疗,对照组单纯给予中药水煎剂治疗,治疗后分别再次进行症状积分问卷调查,部分病例进行胃镜复查,评价两组疗效。
结果：临床研究显示：针药结合组治疗RE的总有效率为96.7%,胃镜疗效总有效率为90.0%；中药组总有效率为86.7%,胃镜疗效总有效率为73.3%,两组疗效对比,均有显著性差异(P<0.05)。针药组能够明显缓解患者的食物反流、反酸、烧心、胸骨后疼痛不适等典型的症状,并且两组的复发率比较也存在显著性差异(P<0.05)。
结论：
1.针药结合组治疗RE临床疗效优于单纯的中药治疗,体现在患者自我感觉的症状缓解上、客观的胃镜检查结果上和抑制RE的复发上。
2.其机制可能是针刺和药物在改善LES功能、促进胃排空、调节胃酸分泌和排泄方面有协同作用。
Objective:To evaluate objectively the clinical effect and the selection of acupoints for the patients with reflux esophagitis (RE) who received the treatment of acupuncture combined with medicine; to observe the rucurrence and provide new methods and explore the long-term effect of RE.
Method:adopting the random and open trial through the questionnaire、rating scale of symptoms and gastroscope, we select 60 cases meeting the inclusive criteria and divide them into two groups randomly. We apply the acupuncture to the treatment group besides the herbal decoction while herbal decoction only for the control group. After the treatment phase, we do the questionnaire of symptoms again and the gastroscope again for portion of the cases.
Results:The clinical research shows that the total effective rate of treatment group is 96.7% and 90.0% for gastroscope effect. Correspondingly, in the control group, the value is 86.7% and 73.3%. there is significant difference (p<0.05)in both groups, but the treatment group is better on the improvement of some symptoms as acid regurgitatio、heart burn、retrosternal pain as well as the reduction of recurrence.
Conclusion:
1.In light of the improvement of symptoms and gastroscope result and the reduction of recurrence, treatment group is a better selection than the control group which has only the oral decoction for the treatment.
2.The probable mechanism lies in the acupucture has a coordinating effect when combined with herbal medicine on improving the LES function, promoting stomach evacuation, regulating the acid secretion and excretion.
引文
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