耳穴贴压结合体针治疗慢性胆囊炎的临床疗效观察
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摘要
目的:本研究以慢性胆囊炎患者治疗前后症状、体征评定积分的改变为主观指标,以治疗前后B超检查所示胆囊壁厚度、毛糙和透光的改变情况为客观指标,对比观察耳穴贴压结合体针治疗组和口服胆清片对照组对慢性胆囊炎患者疗效的差异,以期对耳穴贴压结合体针治疗慢性胆囊炎的临床疗效进行评价。方法:将纳入研究的病例66例,按照随机数字表法分为治疗组(耳穴贴压结合体针组)33例和对照组(口服胆清片组)33例。治疗前给所有患者进行症状、体征总评分,行胆囊B超检查,了解胆囊壁厚度及毛糙和透光情况,然后给予治疗组耳穴贴压结合体针治疗,对照组给予口服胆清片治疗。两组疗程均为三个月,至疗程结束后,对症状、体征进行再次总评分,复查胆囊B超,观察胆囊壁厚度及毛糙和透光变化情况,最后用SPSS16.0统计软件包将所得结果进行统计学处理。结果:耳穴贴压结合体针治疗组治疗前后症状、体征评定总有效率为93.33%,口服胆清片对照组总有效率为83.33%,两组比较P<0.05,治疗组优于对照组;在改善胆囊壁厚度方面,两组比较P<0.05,治疗组优于对照组;在B超改善的总体有效率方面,治疗组和对照组总体疗效差异性无统计学意义,P>0.05。结论:两组均能改善慢性胆囊炎患者的临床症状、体征和减轻胆囊壁厚的程度。耳穴贴压结合体针比口服胆清片能更好的消除慢性胆囊炎患者的临床症状,对减轻胆囊壁炎症程度有明显的作用。
Objective: To observe the clinical efficacy of applying auricular pressure combined with body acupuncture in treating chronic cholecystitis.
Method: The 66 cases included in the study were randomly divided into treatment group with 33cases of auricular pressure combined with body acupuncture and 33 cases took Danqing Pian as control group. All patients’signs and symptoms were scored before the treatment, and type-B ultrasonic was operated at gallbladder as an examination to evaluate the thickness, coarse, and light transmittance of gallbladder wall. Then gave treatment group auricular pressure in combination with body acupuncture, and gave Danqing Pian to the control group, the course of treatment were three months for both groups, after the treatment, signs and symptoms were scored for a second time,the thickness, coarse, and light transmittance of gallbladder wall were re-checked, the results were processed with SPSS16.0 statistical software packages.
Result: The total effective rate of auricular pressure combined with body acupuncture group is 93.33%, while the total effective rate of the control group is 83.33%, with P <0.05, the treatment group is superior to the control group. In improving the thickness of gallbladder wall, the treatment group is superior to the control group, with P <0.05; in improving the general condition of type-B ultrasonic,the treatment group and the control group had no significant differences, with P﹥0.05.
Conclusion: Both groups can obviously improve the clinical symptoms and signs, and reduce the thickness of gallblader wall. The Auricular pressure combined with body acupuncture can better eliminate the clinical symptoms of chronic cholecystitis, and has obvious effects to alleviate the inflammation of gallbladder wall.
Objective: To observe the clinical efficacy of applying auricular pressure combined with body acupuncture in treating chronic cholecystitis.
Method: The 66 cases included in the study were randomly divided into treatment group with 33cases of auricular pressure combined with body acupuncture and 33 cases took Danqing Pian as control group. All patients’signs and symptoms were scored before the treatment, and type-B ultrasonic was operated at gallbladder as an examination to evaluate the thickness, coarse, and light transmittance of gallbladder wall. Then gave treatment group auricular pressure in combination with body acupuncture, and gave Danqing Pian to the control group, the course of treatment were three months for both groups, after the treatment, signs and symptoms were scored for a second time,the thickness, coarse, and light transmittance of gallbladder wall were re-checked, the results were processed with SPSS16.0 statistical software packages.
Result: The total effective rate of auricular pressure combined with body acupuncture group is 93.33%, while the total effective rate of the control group is 83.33%, with P <0.05, the treatment group is superior to the control group. In improving the thickness of gallbladder wall, the treatment group is superior to the control group, with P <0.05; in improving the general condition of type-B ultrasonic,the treatment group and the control group had no significant differences, with P﹥0.05.
Conclusion: Both groups can obviously improve the clinical symptoms and signs, and reduce the thickness of gallblader wall. The Auricular pressure combined with body acupuncture can better eliminate the clinical symptoms of chronic cholecystitis, and has obvious effects to alleviate the inflammation of gallbladder wall.
引文
[1]中华人民共和国药政局.中药新药临床研究指导原则[s].1995,134-137.
[2]陆寿康.《刺法灸法学》[M].北京:中国中医药出版社,2004,7.
[3]沈学勇.《经络腧穴学》[M].北京:中国中医药出版社,2006,11.
[4] Steigerwalt RW,Goldfine ID Williams JA,eta1.Characterizantion of cholecystokinin receptors on bovine gallbladder membranes.Am J Physiol,1984,247:G709.
[5]郭振武.实用胆囊外科[M].天津:天津科学技术出版社,1995,9.
[6] Fagenberg S.:Gut.1970,11:789.
[7]许国铭,李石.现代消化病学[M],北京:人民军医出版社,1999,1169.
[8] Hand B.H.:C1in.Gastroent,1973,2:3.
[9] Collins P.G.:C1in.Gastroent,1977,6:689.
[10] Thompson J.C.:World J. Surg.1979,3:389.
[11] Spellman S.J.:Gastroent,1979,77:115.
[12]吴盾利.胆道动力学研究及其临床意义[M].国外医学:外科学分册,1981,(8): 338.
[13]王永炎,鲁兆麟.中医内科学[M].北京:人民卫生出版社,2001,538.
[14]吕光荣.中医内科证治学[M].北京:人民卫生出版社,2001,439.
[15]王岱,古励,刘士佩等.耳穴诊断学[M].北京:人民卫生出版社,1990,209.
[16]雷琦.外耳的神经和动脉解剖[J].解剖学报,1963,6(1): 29.
[17]尉迟静,王惠伦.耳背穴位疗法图解[M].合肥:安徽科学技术出版社,1995,169.
[18]黄丽春.耳穴诊断治疗学[M].北京:科学技术文献出版社,1991,248.
[19]林文注,王佩.实验针灸学[M].上海:上海科学技术出版社,1994,154.
[20]孙国杰.针灸学[M].上海:上海科学技术出版社,1997,222.
[21]杜翠云,李妍.针刺日月穴治疗慢性胆囊炎的临床观察[J].针灸临床杂志,2O07,23(4): 121.
[22]徐鑫玉.针刺阳陵泉、丘墟穴对胆囊收缩功能影响的研究[D].山东中医药大学硕士论文,2007,6.
[23]苏强.针刺阳陵泉穴、胆囊穴及非经非穴对胆囊收缩功能即刻效应的对比观察[D].山东中医药大学硕士论文,2009,6.
[1]张西.耳穴电针治疗胆石症510例临床报道[J].中国针灸,1996,6(5): 5.
[2]孙庆伟.电脉冲刺激耳穴对胆囊收缩功能的影响[J].上海针灸杂志,1991,10(3): 10.
[3]郭琦.耳穴贴压观察B超下胆囊反应研究左右耳穴功能效应[J].中国针灸,1997,17(4): 221.
[4]龚传美.体针耳针并用对胆囊运动功能调整的临床研究[J].中国针灸,1996,16(1): 1.
[5]潘纪华.针刺治疗慢性胆囊炎74例[J].上海针灸杂志,2005,24(7): 24.
[6]王秀贞.杵针治疗急慢性胆囊炎56例[J].中国中西医结合脾胃杂志,1986,14(2): 103.
[7]沈麒根,黄德.针灸治疗胆囊炎100例疗效观察[J].针灸临床杂志,2003,19(5): 14.
[8]赵洪才,刘学伦.期门刺血为主治疗急慢性胆囊炎48例.针灸临床杂志,1997,13(8): 41.
[9]兰崴.针刺治疗胆囊炎68例临床观察[J].针灸临床杂志.2004,20(11): 6.
[10]曾昭源,陈宗良.体针加耳穴治急慢性胆囊炎73例临床观察[J].江西中医药,2001,32(4): 10.
[11]高宏,周正华.针刺期门穴治疗慢性胆囊炎[J].天津中医学院学报,1998,17(1): 16.
[12]张永臣.针刺治疗胆囊炎41例疗效观察[J].中国针灸,1998,18(12): 731.
[13]孙振华,李生荣,陈梅等.针刺治疗胆囊炎68例体会[J].武警医学,2003,13(3): 151.
[14]王奎军.针灸治疗慢性胆囊炎72例小结[J].甘肃中医,1998,11(3): 38.
[15]石尚忠.耳体针治疗慢性胆囊炎疗效观察[J].中国针灸,1998,18(11): 651.
[16]张林昌,陈英红.B超直视下观察针刺耳穴贴压治疗胆囊炎疗效[J].中国针灸,2003,23(8): 455.
[17]陈雁南,韩霞,邹海珠等.针刺对急性胆囊炎患者胆囊收缩功能的影响[J].上海针灸杂志,2000,19(4): 12.
[18]黄东源.健脾利胆汤配合针灸治疗慢性胆囊炎42例[J].中医药临床杂志,2005,5(17): 52.
[19]胡涛,田明.针药并用治疗慢性胆囊炎52例[J].上海针灸杂志,2005,24(3): 14.
[20]秦芝秀,吕建辉.胆囊炎的超声诊断与针药结合疗效分析[J].实用医技杂志,1995,4(2): 43.
[21]王新奇.针刺配合中药治疗慢性胆囊炎急性发作期36例[J].新疆中医药,2000,18(1): 26.
[22]李景义,魏秀兰,李桂芬.针药并用治疗慢性胆囊炎140例[J].上海针灸杂志,2003,22(4): 30.
[23]张友祥,刘平.针药结合对家兔胆囊炎模型影响的实验研究[J].甘肃中医,2000,19(6): 48.
[24]安志民.中药贴敷法治疗慢性胆囊炎60例[J].中国中西医结合外科杂志,1999,2(5): 34.
[25]秦文栋,刘文君.胆囊穴654—2小剂量注射对慢性胆囊炎所致胁痛的影[J].针灸临床杂志,2002,22(8): 35.
[26]马宁,戚宏.温通膏穴位外敷治疗慢性胆囊炎116例临床观察[J].中国中医药科技,1997,4(6): 89.
[27]王宗江,李福臻.耳穴配合艾灸治疗慢性胆囊炎80例[J].中国针灸,2000,20(8): 500.
[28]孟昭奇.穴位埋线治疗慢性胆囊炎90例[J].中医外治杂志,2001,l0(2): 23.
[2]陆寿康.《刺法灸法学》[M].北京:中国中医药出版社,2004,7.
[3]沈学勇.《经络腧穴学》[M].北京:中国中医药出版社,2006,11.
[4] Steigerwalt RW,Goldfine ID Williams JA,eta1.Characterizantion of cholecystokinin receptors on bovine gallbladder membranes.Am J Physiol,1984,247:G709.
[5]郭振武.实用胆囊外科[M].天津:天津科学技术出版社,1995,9.
[6] Fagenberg S.:Gut.1970,11:789.
[7]许国铭,李石.现代消化病学[M],北京:人民军医出版社,1999,1169.
[8] Hand B.H.:C1in.Gastroent,1973,2:3.
[9] Collins P.G.:C1in.Gastroent,1977,6:689.
[10] Thompson J.C.:World J. Surg.1979,3:389.
[11] Spellman S.J.:Gastroent,1979,77:115.
[12]吴盾利.胆道动力学研究及其临床意义[M].国外医学:外科学分册,1981,(8): 338.
[13]王永炎,鲁兆麟.中医内科学[M].北京:人民卫生出版社,2001,538.
[14]吕光荣.中医内科证治学[M].北京:人民卫生出版社,2001,439.
[15]王岱,古励,刘士佩等.耳穴诊断学[M].北京:人民卫生出版社,1990,209.
[16]雷琦.外耳的神经和动脉解剖[J].解剖学报,1963,6(1): 29.
[17]尉迟静,王惠伦.耳背穴位疗法图解[M].合肥:安徽科学技术出版社,1995,169.
[18]黄丽春.耳穴诊断治疗学[M].北京:科学技术文献出版社,1991,248.
[19]林文注,王佩.实验针灸学[M].上海:上海科学技术出版社,1994,154.
[20]孙国杰.针灸学[M].上海:上海科学技术出版社,1997,222.
[21]杜翠云,李妍.针刺日月穴治疗慢性胆囊炎的临床观察[J].针灸临床杂志,2O07,23(4): 121.
[22]徐鑫玉.针刺阳陵泉、丘墟穴对胆囊收缩功能影响的研究[D].山东中医药大学硕士论文,2007,6.
[23]苏强.针刺阳陵泉穴、胆囊穴及非经非穴对胆囊收缩功能即刻效应的对比观察[D].山东中医药大学硕士论文,2009,6.
[1]张西.耳穴电针治疗胆石症510例临床报道[J].中国针灸,1996,6(5): 5.
[2]孙庆伟.电脉冲刺激耳穴对胆囊收缩功能的影响[J].上海针灸杂志,1991,10(3): 10.
[3]郭琦.耳穴贴压观察B超下胆囊反应研究左右耳穴功能效应[J].中国针灸,1997,17(4): 221.
[4]龚传美.体针耳针并用对胆囊运动功能调整的临床研究[J].中国针灸,1996,16(1): 1.
[5]潘纪华.针刺治疗慢性胆囊炎74例[J].上海针灸杂志,2005,24(7): 24.
[6]王秀贞.杵针治疗急慢性胆囊炎56例[J].中国中西医结合脾胃杂志,1986,14(2): 103.
[7]沈麒根,黄德.针灸治疗胆囊炎100例疗效观察[J].针灸临床杂志,2003,19(5): 14.
[8]赵洪才,刘学伦.期门刺血为主治疗急慢性胆囊炎48例.针灸临床杂志,1997,13(8): 41.
[9]兰崴.针刺治疗胆囊炎68例临床观察[J].针灸临床杂志.2004,20(11): 6.
[10]曾昭源,陈宗良.体针加耳穴治急慢性胆囊炎73例临床观察[J].江西中医药,2001,32(4): 10.
[11]高宏,周正华.针刺期门穴治疗慢性胆囊炎[J].天津中医学院学报,1998,17(1): 16.
[12]张永臣.针刺治疗胆囊炎41例疗效观察[J].中国针灸,1998,18(12): 731.
[13]孙振华,李生荣,陈梅等.针刺治疗胆囊炎68例体会[J].武警医学,2003,13(3): 151.
[14]王奎军.针灸治疗慢性胆囊炎72例小结[J].甘肃中医,1998,11(3): 38.
[15]石尚忠.耳体针治疗慢性胆囊炎疗效观察[J].中国针灸,1998,18(11): 651.
[16]张林昌,陈英红.B超直视下观察针刺耳穴贴压治疗胆囊炎疗效[J].中国针灸,2003,23(8): 455.
[17]陈雁南,韩霞,邹海珠等.针刺对急性胆囊炎患者胆囊收缩功能的影响[J].上海针灸杂志,2000,19(4): 12.
[18]黄东源.健脾利胆汤配合针灸治疗慢性胆囊炎42例[J].中医药临床杂志,2005,5(17): 52.
[19]胡涛,田明.针药并用治疗慢性胆囊炎52例[J].上海针灸杂志,2005,24(3): 14.
[20]秦芝秀,吕建辉.胆囊炎的超声诊断与针药结合疗效分析[J].实用医技杂志,1995,4(2): 43.
[21]王新奇.针刺配合中药治疗慢性胆囊炎急性发作期36例[J].新疆中医药,2000,18(1): 26.
[22]李景义,魏秀兰,李桂芬.针药并用治疗慢性胆囊炎140例[J].上海针灸杂志,2003,22(4): 30.
[23]张友祥,刘平.针药结合对家兔胆囊炎模型影响的实验研究[J].甘肃中医,2000,19(6): 48.
[24]安志民.中药贴敷法治疗慢性胆囊炎60例[J].中国中西医结合外科杂志,1999,2(5): 34.
[25]秦文栋,刘文君.胆囊穴654—2小剂量注射对慢性胆囊炎所致胁痛的影[J].针灸临床杂志,2002,22(8): 35.
[26]马宁,戚宏.温通膏穴位外敷治疗慢性胆囊炎116例临床观察[J].中国中医药科技,1997,4(6): 89.
[27]王宗江,李福臻.耳穴配合艾灸治疗慢性胆囊炎80例[J].中国针灸,2000,20(8): 500.
[28]孟昭奇.穴位埋线治疗慢性胆囊炎90例[J].中医外治杂志,2001,l0(2): 23.