针刺足阳明胃经特定穴与非特定穴治疗功能性消化不良疗效比较  

Comparative study on therapeutic effect between acupuncture at special acupoints and non-specific acupoints in Foot Yangming Meridian for functional dyspepsia

作　　者：王德军[1] 常小荣[1] 严洁[1] 王小娟[2] 王婷[1] 刘珏[1] 刁利红 谢辉[4] 

机构地区：[1]湖南中医药大学针灸推拿学院国家中医药管理局经穴脏腑相关重点研究室湖南省教育厅针灸生物信息分析重点实验室,长沙410007 [2]湖南中医药大学第一附属医院 [3]深圳市南山区蛇口人民医院 [4]郴州市第一人民医院

出　　处：《中国针灸》2012年第8期703-708,共6页Chinese Acupuncture & Moxibustion

基　　金：国家重点基础研究发展计划(973计划)资助项目:2006CB504501;国家自然科学基金资助项目:81173326

摘　　要：目的:比较针刺足阳明胃经特定穴、非特定穴以及非经非穴点治疗功能性消化不良(FD)不同评价时点的临床疗效差异,探讨经穴效应差异性。方法:将116例患者随机分为足阳明胃经特定穴组(A组)36例、足阳明胃经非特定穴组(B组)39例和非经非穴组(C组)41例。A组针刺冲阳、丰隆、足三里、梁丘,B组针刺条口、阴市、伏兔、犊鼻,并均沿穴位所在经络近心端约2mm位置设置辅助针刺点进行浅刺。C组针刺4个非经非穴点:①肘内侧,肘尖与腋窝连线中点;②肱骨内上髁与尺骨腕部之间中点;③臂内前缘三角肌和二头肌交接处;④足三里水平旁开1～2cm,胫骨外侧缘处,并沿非经非穴点所在肢体纵轴线体表投影在非经非穴点近心端约2mm位置设置辅助针刺点进行浅刺。各组针刺点及其旁开的辅助针刺点均接韩氏穴位神经刺激仪,均治疗4个疗程。治疗后、治疗后1个月、3个月随访观察各组功能消化不良症状积分(FDI)、健康相关生活质量评分(SF-36)情况,并评定临床疗效。结果:治疗后A组餐后饱胀、早饱感、上腹痛、上腹烧灼感症状的总有效率分别为84.8%(28/33)、67.7%(21/31)、76.9%(20/26)、56.3%(9/16),B组分别为45.9%(17/37)、38.7%(12/31)、42.9%(12/28)、38.5%(5/13),C组分别为15.8%(6/38)、18.4%(7/38)、46.1%(12/26)、16.7%(4/24),A组在餐后饱胀、早饱感、上腹痛3个症状方面总有效率均优于B组(均P<0.05);A组在餐后饱胀、早饱感、上腹痛、上腹烧灼感4个方面总有效率均优于C组(均P<0.05);B组在餐后饱胀症状方面总有效率亦优于C组(P<0.05)。各组FDI评分、SF-36评分在治疗后、1个月随访、3个月随访时点较治疗前均明显改善(均P<0.05);A组在以上各时点FDI评分、SF-36评分较其他两组改善更明显(均P<0.05);B组在治疗后2项评分也较C组改善明显(均P<0.05)。结论:针刺足阳明胃经特定穴、足阳明胃经非特定穴与针刺非经非穴治疗FD均有Objective To compare the clinical efficacy differences among acupuncture at special acupoints,non-specific acupoints and non acupoints in Foot Yangming Meridian for functional dyspepsia（FD） at different time points.Methods One hundred and sixteen FD patients were randomly divided into a special acupoints in Foot Yangming Meridian group（group A,n=36）,a non-specific acupoints in Foot Yangming Meridian group（group B,n=39）and a non acupoints group（group C,n=41）.Group A was treated with acupuncture at Chongyang（ST 42）,Fen-glong（ST 40）,Zusanli（ST 36）and Liangqiu（ST 34）,and group B was treated with acupuncture at Tiaokou（ST 38）,Yinshi（ST 33）,Futu（ST 32）and Dubi（ST 35）,and the assisted acupoints were setting up at 2mm apart from selected acupoints in meridian of proximal part.Group C was treated with 4non acupoints：①medial elbow,middle point on the line between olecranon and armpit;②middle point on the line between condylus medialis humeri and wrist of elbow-bone;③the junction of deltoid and biceps inside the arm;④1-2cm horizontally away from Zusanli（ST 36）,lateral border of shin bone,and the assisted acupoints were setting up at 2mm away from selected non acupoints along limb longitud inalaxis of proximal part.All acupoints and assisted acupoints were connected to the HANS nerve stimulator and they were alltreated for 4courses.The FD Symptom Index（FDI） and MOS 36-Item Short-Form Health Survey（SF-36）after treatment,1month and 3months after treatment were observed and the clinical efficacy was assessed.Results After treatment,the total effective rate of abdominal fullness after meal,early satiation,upper abdominal pain and upper abdominal burning sensation were 84.8%（28/33）,67.7%（21/31）,76.9%（20/26）and 56.3%（9/16）,respectively,in group A,and 45.9%（17/37）,38.7%（12/31）,42.9%（12/28） and 38.5%（5/13）,respectively,in group B,and 15.8%（6/38）,18.4%（7/38）,46.1%（12/26）and 16.7%（4/24）,respectively,in group C.The tota

关 键 词：功能性消化不良 针刺疗法 胃经 穴位 特定 穴位特异性 

分 类 号：R246.1[医药卫生—针灸推拿学]