胃脘十二针治疗肝郁脾虚型胃脘痛的临床研究
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摘要
目的
本研究采用随机对照的方法比较胃脘十二针与常规取穴治疗肝郁脾虚型胃脘痛的临床疗效差别,并从理论和临床研究两个方面探讨胃脘十二针治疗肝郁脾虚型胃脘痛的机制。
方法
将入选的60例合格受试者随机分为治疗组30例,治疗组30例。治疗组：采用胃脘十二针(上脘、中脘、下脘、双足三里、气海、双天枢、双内关、双太冲)治疗。对照组：参照2002年中国中医药出版社《针灸学》教材胃脘痛症取穴(双足三里、双内关、中脘、双太冲、双期门、双脾俞、气海)治疗。两组穴位每日上午进行针刺,1次,周一至周五,周六、日休息。每次针刺时,直刺进针,参照2009年第1版《刺法灸法学》采用中度刺激提插捻转手法得气后,接66805—-1型电针仪,选用连续波,50Hz,强度以患者能耐受为度。每次留针20min,10次为一个疗程,1个疗程结束后观察疗效。两组均在首次治疗前、治疗3天、一周及一个疗程(2周)结束时记录各观察指标所得数据,并进行评分以观察其疗效。
结果
治疗组有效率为86.67%,对照组有效率为63.33%,两组有效率比较差异明显(P<0.05),治疗组优于对照组。对两组病人治疗前后进行临床症候及发作频度评分,两组自身治疗前后对比均有统计学意义(P 结论
胃脘十二针治疗肝郁脾虚型胃脘痛,具有一定的临床实效性和推广性。
Objective
This study compares the effect differences between Epigastric Twelve Needles in the treatment and conventional acupuncture treatment of Gastralgia caused by Hepatic Stasis, and through theoretical and clinical researches on two aspects to discuss the main Twelve Needles in the treatment of Gastralgia caused by Hepatic Stasis.
Methods
The60selected cases of eligible subjects are randomly divided into the treatment group of30cases and the control group of30cases. The treatment group:treatment by Epigastric Twelve Needles (Shangwan, Zhongwan, Xiawan, the double Zusanli, Qihai, the double Tianshu, the double Neiguan, the double Sanyinjiao). Control group:treatment refered to the textbook—《Acupuncture and Moxibustion》 published by the China Press of traditional Chinese medicine in2002(the double Zusanli, the double Neiguan, Zhongwan, the double Taichong, the double Pishu, the double Qimen, Qihai).All the subjects are treated by acupuncture in the every morning. Plug the needles into the skin vertically, and then get gas by referring to the textbook—《Acupuncture and Moxibustion》 published in2002with moderate stimulation lifting and thrusting twirling. Connect with the electroacupuncture instrument by the type of G6805-1and use continuous wave50-100Hz with the strength degree toleranced to patients. We can do it every day for once from Monday to Friday. On Saturday and Sunday we have a break. Every treatment retains needles in20minutes and10times are a course to observe the curative effect. The two groups are recorded each outcome measure data before the treatment or the treatment in the first3days a week and a course of the treatment (2weeks) in order to to observe the effect of scoring. Follow the patients who are on the treatment after a course of15days to understand the efficacy persistence.
Results
The effective rate of treatment group is86.67%and the effective rate of control group is63.33%.Two groups have obviously differences (P<0.05). The treatment group is superior to the control group. On two groups of patients before and after treatment, clinical symptoms and seizure frequency score, two groups of their own compared before and after treatment are statistically significant (P<0.01). After the treatment between two groups (P<0.01), effect of the treatment group is superior to control group. Seizure frequency overall analysis, the effects of treatment group are better than the control group.
Conelusion
Epigastric Twelve Needles for treatment of Gastralgia caused by Hepatic Stasis, with some clinical effectiveness, and worthy of popularization.
本研究采用随机对照的方法比较胃脘十二针与常规取穴治疗肝郁脾虚型胃脘痛的临床疗效差别,并从理论和临床研究两个方面探讨胃脘十二针治疗肝郁脾虚型胃脘痛的机制。
方法
将入选的60例合格受试者随机分为治疗组30例,治疗组30例。治疗组：采用胃脘十二针(上脘、中脘、下脘、双足三里、气海、双天枢、双内关、双太冲)治疗。对照组：参照2002年中国中医药出版社《针灸学》教材胃脘痛症取穴(双足三里、双内关、中脘、双太冲、双期门、双脾俞、气海)治疗。两组穴位每日上午进行针刺,1次,周一至周五,周六、日休息。每次针刺时,直刺进针,参照2009年第1版《刺法灸法学》采用中度刺激提插捻转手法得气后,接66805—-1型电针仪,选用连续波,50Hz,强度以患者能耐受为度。每次留针20min,10次为一个疗程,1个疗程结束后观察疗效。两组均在首次治疗前、治疗3天、一周及一个疗程(2周)结束时记录各观察指标所得数据,并进行评分以观察其疗效。
结果
治疗组有效率为86.67%,对照组有效率为63.33%,两组有效率比较差异明显(P<0.05),治疗组优于对照组。对两组病人治疗前后进行临床症候及发作频度评分,两组自身治疗前后对比均有统计学意义(P
胃脘十二针治疗肝郁脾虚型胃脘痛,具有一定的临床实效性和推广性。
Objective
This study compares the effect differences between Epigastric Twelve Needles in the treatment and conventional acupuncture treatment of Gastralgia caused by Hepatic Stasis, and through theoretical and clinical researches on two aspects to discuss the main Twelve Needles in the treatment of Gastralgia caused by Hepatic Stasis.
Methods
The60selected cases of eligible subjects are randomly divided into the treatment group of30cases and the control group of30cases. The treatment group:treatment by Epigastric Twelve Needles (Shangwan, Zhongwan, Xiawan, the double Zusanli, Qihai, the double Tianshu, the double Neiguan, the double Sanyinjiao). Control group:treatment refered to the textbook—《Acupuncture and Moxibustion》 published by the China Press of traditional Chinese medicine in2002(the double Zusanli, the double Neiguan, Zhongwan, the double Taichong, the double Pishu, the double Qimen, Qihai).All the subjects are treated by acupuncture in the every morning. Plug the needles into the skin vertically, and then get gas by referring to the textbook—《Acupuncture and Moxibustion》 published in2002with moderate stimulation lifting and thrusting twirling. Connect with the electroacupuncture instrument by the type of G6805-1and use continuous wave50-100Hz with the strength degree toleranced to patients. We can do it every day for once from Monday to Friday. On Saturday and Sunday we have a break. Every treatment retains needles in20minutes and10times are a course to observe the curative effect. The two groups are recorded each outcome measure data before the treatment or the treatment in the first3days a week and a course of the treatment (2weeks) in order to to observe the effect of scoring. Follow the patients who are on the treatment after a course of15days to understand the efficacy persistence.
Results
The effective rate of treatment group is86.67%and the effective rate of control group is63.33%.Two groups have obviously differences (P<0.05). The treatment group is superior to the control group. On two groups of patients before and after treatment, clinical symptoms and seizure frequency score, two groups of their own compared before and after treatment are statistically significant (P<0.01). After the treatment between two groups (P<0.01), effect of the treatment group is superior to control group. Seizure frequency overall analysis, the effects of treatment group are better than the control group.
Conelusion
Epigastric Twelve Needles for treatment of Gastralgia caused by Hepatic Stasis, with some clinical effectiveness, and worthy of popularization.
引文
[1]中华医学会消化病分会胃肠动力组.中国消化不良的诊治指南.胃肠病学,2008,13(2)：114.
[2]凌奇荷.功能性消化不良的研究进展.临床内科杂志,2000,17(2)：69.
[3]SARNELLI G, GAENEPEEL P, GEYPENS B, et al. Symptoms associated with impaired gasteic emptying of solids and liquids in functional dyspepsia. Am J Gastroenterol, 2003,98:783-788.
[4]高立山.针灸心扉[M].学苑出版社,2003：222.
[5]余秋焕,杨春晓.自拟养胃汤治疗慢性胃炎73例.陕西中医药,2008,29(1)：27.
[6]王天龙,余滟钧.胃脘痛肝胃气滞证病因病机之我见.中国中西医结合消化杂志,2000,8(3)： 52.
[7]王玉芳.关思友主任医师辨治胃脘痛经验.陕西中医,2007,28(1)：89-90.
[8]洪文旭.董建华治疗胃肠病经验述要.中医杂志,2002,43(4)：255-256.
[9]谢爱华.周亨德主任治肝法祛胃脘痛经验.甘肃中医,2010,23(1)：12-13.
[10]过伟峰.周仲瑛教授从肝胃失和论治慢性胃脘痛的经验.南京中医药大学学报,2007,23(5)：325-327.
[11]张效科.慢性胃脘痛从肝论治的立论依据及意义.四川中医,2006,24(9)：30-31.
[12]孙秋凌.王远芳从肝论治胃脘痛经验.湖北中医杂志,2008,30(1)：30.
[13]罗辉等.王玉英教授治疗胃脘痛经验.北京中医药大学学报,2010,10(3)：713-715.
[14]谢爱华.周亨德主任治肝法祛胃脘痛经验.甘肃中医,2010,23(1)：12-13.
[15]贝立民.辨治慢性胃脘痛的经验介绍.云南中医中药杂志,2010,31(5)：86.
[16]叶庆莲.肝胃相关与胃脘痛证治探析.上海中医药杂志,2001,4(30-32)。
[17]刘庆军.“老十针”应用举隅.河北中医,2005,27(11)：850-851.
[18]樊亚红.浮针为主治疗胃脘痛的临床观察.上海针灸杂志,2007,26(11)：18-19.
[19]葛恒壁.浮针疗法治疗阑尾炎3例.上海针灸杂志,2002,21(4)：47.
[20]许文涛.鼻针治疗胃脘痛150例.中医研究,2001,14(6)：53-54.
[21]金建东.推拿手法配合推擦双胁治疗肝气犯胃型胃脘痛58例观察.中医中药中西医结合,2010,9：2627.
[22]王文文,沈玉明,王红根,等.穴位埋线治疗运动障碍型功能性消化不良80例.针灸临床杂志,2001,17(8)：47.
[23]宋建宁.穴位注射治疗胃脘痛51例.中国针灸,2003,23(4)：199.
[24]中华医学会消化病学分会胃肠动力学组.中国消化不良的诊治指南(2007,大连).中华消化杂志,2007,27：832.
[25]MOAYYEDI P, DELANEY B C, VAKIL N, et al. The efficacy of proton pump inhibitors in nonulcer dyspepsia:a systematic review an deconomic analysis. Gastroenterology,2004,127:1329-1337.
[26]莫剑忠.功能性消化不良与罗马.胃肠病学,2006,12：726-728.
[27]YEOH K G, KANG J Y, TAY H H, et al. Effect of cisapride on fundtional dyspepsia in patients withand without histological gastritis:a double blind placebo controlled trial. J Gastroenterol Hepatol,1997,12:13-18.
[28]MOAYYEDI P, SOOS, DEEKS J, et al. Eradication of helicobacter pylori for non ulcer dyspepsia.Coehrane Database Syst Rev,2005,19:CD002096.
[29]LEVY RL, OLDEN KW, NAL IBOFF BD, et al. Psychosocial aspects of the functional gastro intestinal disorders. Gastroenterology,2006,130:1447.
[30]赖世隆.中西医结合临床科研方法学[M].北京：科学出版社,2003.8：64-69.
[31]方积乾,孙振球.卫生统计学[M].北京：人民卫生出版社,2003.8：4-221.
[32]刘立功,顾杰.急病针灸典籍通览[M].上海：上海科学技术出版社,2000.
[33]Iwa M, Sakita M, Effect of Acupuncture and Moxibus-tion on Intestinal Motility in Mice, Am J chin Med,1994,22 (2):119.
[34]曹飞,等.温针治疗胃肠神经官能症的临床观察.上海针灸杂志,1995,14(6)：247.
[35]陈横昌.脾胃气虚与胃动力障碍的关系.南京中医药大学学报,1996,12(2)：62.
[36]马成福,等.针刺治疗胃轻瘫综合症38例.中国针灸,1996,16(4)：25.
[37]邓晶晶,袁青.针刺对腹部术后大鼠胃肠动力及炎症反应的影响.广州中医药大学学报,2010,27(5)：462.[38]冯骅,向谊.针灸治疗便秘取穴规律探究.针灸临床杂志,2003,19(10)：3.
[39]Li Y, Tougas G, Chiverton S G, et al. The Effect of Acupunture on Gas2 trointestinal Function and Disor-ders,Am Jof Gastroenterol.1992,87 (10):1312.
[40]Sato A, Satoy.Suzuki A, et al, Neural Mechanisms of the Reflex in Hibi2 tion and Excitation of Gastric Motility Elicited by Acupuncture-like Stimulation in Anesthetized Rats. Neurosci Res,1953,18 (1):53.
[41]张安莉,陈日新,康明非,等.针刺调整旋转法实验性家兔5-羟色胺、胃泌素的研究.中国针灸,1997,17(5)：299.
[42]杨甲三.针灸腧穴学[M].上海：上海科学技术出版社,1989.509.
[2]凌奇荷.功能性消化不良的研究进展.临床内科杂志,2000,17(2)：69.
[3]SARNELLI G, GAENEPEEL P, GEYPENS B, et al. Symptoms associated with impaired gasteic emptying of solids and liquids in functional dyspepsia. Am J Gastroenterol, 2003,98:783-788.
[4]高立山.针灸心扉[M].学苑出版社,2003：222.
[5]余秋焕,杨春晓.自拟养胃汤治疗慢性胃炎73例.陕西中医药,2008,29(1)：27.
[6]王天龙,余滟钧.胃脘痛肝胃气滞证病因病机之我见.中国中西医结合消化杂志,2000,8(3)： 52.
[7]王玉芳.关思友主任医师辨治胃脘痛经验.陕西中医,2007,28(1)：89-90.
[8]洪文旭.董建华治疗胃肠病经验述要.中医杂志,2002,43(4)：255-256.
[9]谢爱华.周亨德主任治肝法祛胃脘痛经验.甘肃中医,2010,23(1)：12-13.
[10]过伟峰.周仲瑛教授从肝胃失和论治慢性胃脘痛的经验.南京中医药大学学报,2007,23(5)：325-327.
[11]张效科.慢性胃脘痛从肝论治的立论依据及意义.四川中医,2006,24(9)：30-31.
[12]孙秋凌.王远芳从肝论治胃脘痛经验.湖北中医杂志,2008,30(1)：30.
[13]罗辉等.王玉英教授治疗胃脘痛经验.北京中医药大学学报,2010,10(3)：713-715.
[14]谢爱华.周亨德主任治肝法祛胃脘痛经验.甘肃中医,2010,23(1)：12-13.
[15]贝立民.辨治慢性胃脘痛的经验介绍.云南中医中药杂志,2010,31(5)：86.
[16]叶庆莲.肝胃相关与胃脘痛证治探析.上海中医药杂志,2001,4(30-32)。
[17]刘庆军.“老十针”应用举隅.河北中医,2005,27(11)：850-851.
[18]樊亚红.浮针为主治疗胃脘痛的临床观察.上海针灸杂志,2007,26(11)：18-19.
[19]葛恒壁.浮针疗法治疗阑尾炎3例.上海针灸杂志,2002,21(4)：47.
[20]许文涛.鼻针治疗胃脘痛150例.中医研究,2001,14(6)：53-54.
[21]金建东.推拿手法配合推擦双胁治疗肝气犯胃型胃脘痛58例观察.中医中药中西医结合,2010,9：2627.
[22]王文文,沈玉明,王红根,等.穴位埋线治疗运动障碍型功能性消化不良80例.针灸临床杂志,2001,17(8)：47.
[23]宋建宁.穴位注射治疗胃脘痛51例.中国针灸,2003,23(4)：199.
[24]中华医学会消化病学分会胃肠动力学组.中国消化不良的诊治指南(2007,大连).中华消化杂志,2007,27：832.
[25]MOAYYEDI P, DELANEY B C, VAKIL N, et al. The efficacy of proton pump inhibitors in nonulcer dyspepsia:a systematic review an deconomic analysis. Gastroenterology,2004,127:1329-1337.
[26]莫剑忠.功能性消化不良与罗马.胃肠病学,2006,12：726-728.
[27]YEOH K G, KANG J Y, TAY H H, et al. Effect of cisapride on fundtional dyspepsia in patients withand without histological gastritis:a double blind placebo controlled trial. J Gastroenterol Hepatol,1997,12:13-18.
[28]MOAYYEDI P, SOOS, DEEKS J, et al. Eradication of helicobacter pylori for non ulcer dyspepsia.Coehrane Database Syst Rev,2005,19:CD002096.
[29]LEVY RL, OLDEN KW, NAL IBOFF BD, et al. Psychosocial aspects of the functional gastro intestinal disorders. Gastroenterology,2006,130:1447.
[30]赖世隆.中西医结合临床科研方法学[M].北京：科学出版社,2003.8：64-69.
[31]方积乾,孙振球.卫生统计学[M].北京：人民卫生出版社,2003.8：4-221.
[32]刘立功,顾杰.急病针灸典籍通览[M].上海：上海科学技术出版社,2000.
[33]Iwa M, Sakita M, Effect of Acupuncture and Moxibus-tion on Intestinal Motility in Mice, Am J chin Med,1994,22 (2):119.
[34]曹飞,等.温针治疗胃肠神经官能症的临床观察.上海针灸杂志,1995,14(6)：247.
[35]陈横昌.脾胃气虚与胃动力障碍的关系.南京中医药大学学报,1996,12(2)：62.
[36]马成福,等.针刺治疗胃轻瘫综合症38例.中国针灸,1996,16(4)：25.
[37]邓晶晶,袁青.针刺对腹部术后大鼠胃肠动力及炎症反应的影响.广州中医药大学学报,2010,27(5)：462.[38]冯骅,向谊.针灸治疗便秘取穴规律探究.针灸临床杂志,2003,19(10)：3.
[39]Li Y, Tougas G, Chiverton S G, et al. The Effect of Acupunture on Gas2 trointestinal Function and Disor-ders,Am Jof Gastroenterol.1992,87 (10):1312.
[40]Sato A, Satoy.Suzuki A, et al, Neural Mechanisms of the Reflex in Hibi2 tion and Excitation of Gastric Motility Elicited by Acupuncture-like Stimulation in Anesthetized Rats. Neurosci Res,1953,18 (1):53.
[41]张安莉,陈日新,康明非,等.针刺调整旋转法实验性家兔5-羟色胺、胃泌素的研究.中国针灸,1997,17(5)：299.
[42]杨甲三.针灸腧穴学[M].上海：上海科学技术出版社,1989.509.