针刺对功能性消化不良患者内脏敏感性的影响  

Effect of Electroacupuncture Stimulation on Visceral Sensitivity in Patients with Functional Dyspepsia

作　　者：姚筱梅[1] 姚树坤[1] 张瑞星[1] 常丽丽[1] 

机构地区：[1]河北医科大学第四医院消化内科,石家庄050011

出　　处：《针刺研究》2006年第4期228-231,共4页Acupuncture Research

摘　　要：目的:观察针刺对功能性消化不良患者机械性胃扩张内脏感觉的影响,并探讨针灸对内脏敏感性的调节机理。方法:将30名功能性消化不良患者随机分为针刺组和对照组。通过内脏电子刺激器Barostat进行等容扩张,当达到最大耐受容积时,针刺组进行针刺双侧足三里、内关和天枢穴,并保留15 min,对照组不进行针刺保留15 min。观察最大耐受容积、压力及上腹胀、上腹痛、恶心等症状积分值的变化;评价自主神经功能的心率变异频域指标。结果:针刺组针刺后的症状积分值显著下降,最大耐受容积、压力显著升高,心率变异的频域指标也有显著变化,和针刺前比较均有显著性差异(P<0.05);而对照组达到最大耐受时的症状积分值、最大耐受压力和容积、心率变异的频域指标均无明显变化(P>0.05)。结论:针刺能够显著降低功能性消化不良患者等容机械性胃扩张的内脏敏感性,其内在机理可能与调节自主神经功能有关。Objective： To investigate the effect of acupuncture on visceral sensitivity in patients with functional dyspepsia （FD） who were undergoing mechanical gastric distention. Methods： Thirty volunteer FD patients were randomly divided into control group （n = 11） and acupuncture group （n = 19） according to the designed rancom table. For patients of acupuncture group, Zusanli （ST 36） and Neiguan （PC 6） were punctured and stimulated with an electric pulse generator by setting the parameters being 10 mA in strength, 500 μs in the duration of pulses, 40 Hz in frequency, 12 cpm of pulse trains, and 15 min in the duration of stimulation. Tianshu （ST 25） was punctured with the needle retained. Isovolurnetric gastric distention was performed in all the subjects through a balloon which was swallowed before hand and filled with 300 mL of air and then connected to SVS/Barostat （Synectice Visceral Stimulator）. Heart rate variability （HRV） was recorded and analyzed by using HS9616 Dynamic Electrocardiography Recorder. The maximal tolerable volume and pressure of the stomach were recorded, the epigastric pain, fullness and nausea were scored simultaneously. The automatic nervous function was assessed by the power spectral analysis of HRV. Results： Self-comparison showed that in acupuncture group, the scores of gastralgia, fullness and nausea, and low frequency/high frequency （LF/HF） and ultimate LF of HRV decreased remarkably （P〈0.05）, and the maximal tolerable volume and pressure, LF and HF of HRV increased significantly after acupuncture stimulation （P〈 0.05,0.01 ）, suggesting that acupuncture stimulation could lower gastric distension induced increase of the visceral sensitivity （noxious reactions）, lower the activity of the sympathetic nerve and potentiate vagal tension in FD patients. No significant changes were found in control group （P〉0.05）. Conclusion： Acupuncture can reduce the increased visceral sensitivity in FD patients, which may be realized by favorabl

关 键 词：功能性消化不良 机械性胃扩张 针刺 内脏敏感性 心率变异 

分 类 号：R573.9[医药卫生—消化系统]