针灸对食管运动障碍NERD患者临床症状及食管动力的影响研究  

The effect of acupuncture on reflux symptom and esophageal motility in cases of non-erosive reflus disease with dysmotility

作　　者：刘谦[1] 夏兴洲[1] 许晓芳[1] 齐义军[2] 

机构地区：[1]郑州大学第五附属医院消化内科,河南郑州450052 [2]河南大学淮河医院肿瘤内科,河南开封475000

出　　处：《重庆医学》2013年第17期1929-1931,共3页Chongqing medicine

基　　金：国家自然科学基金资助项目(81072039)

摘　　要：目的研究针灸疗法对伴有食管运动障碍的非糜烂性反流病(NERD)患者症状及食管动力的影响。方法按标准选取具有典型胃食管反流症状及食管运动障碍的NERD患者32例,评估其胃食管反流症状,行高分辨率测压(HRM),分析不同物理性质食团吞咽模式下(510次5mL液体、10次胶体吞咽、10次2cm×2cm×2cm固体吞咽)的食管动力特点。给予针灸治疗4周,对比治疗前、后胃食管反流症状及各种吞咽模式下食管动力的变化。结果针灸治疗后患者胃食管反流单项症状及总症状积分较治疗前减少[(31.5±11.4)vs(8.3±2.6),P=0.000];治疗后患者下食管括约肌(LES)压力的异常率下降(65.6%vs34.4%,P=0.004),LES压力低下患者的压力值升高[(4.3±3.1)mm Hg vs(8.9±4.3)mm Hg,P=0.004];不同吞咽模式下食管近、中、远段压力及远段食管收缩积分较治疗前增加(P<0.05);患者不同吞咽模式下的吞咽成功率提高,食管体部运动功能障碍数降低(P<0.05)。结论针灸疗法能有效改善NERD患者的胃食管反流症状,部分改善食管运动障碍,对不同吞咽模式的食管动力影响有所不同。Objective To investigate the effects of acupuncture on reflux symptoms in non-erosive reflux disease（NERD）patients with esophageal motor abnormalities.Methods 32NERD patients with esophageal motor abnormalities who had typical gastroesophageal reflux symptoms were enrolled in this trial.Subjects received acupuncture therapy for 4weeks.Symptoms,including heartburn,regalrgitation,chest pain and dysphagia,were recorded to evaluate the effect of acupuncture therapy.The esophageal motility was demonstrated by high resolution esophageal manometry（HRM,Mansean 360TM,Given Imaging）before and after acupuncture therapy.Each patient was given 10liquid swallows（5mL physiological saline each）,10paste swallow,followed by 10solid swallows（steamedbread.2cm×2cm×2cm 3cach）.All scored symptoms and esophageal funotion was determined in pre-treatment of acupuncture therapy as baseline.Results（1）Compared with baseline,the significant decrease in the total score of gastroesophageal reflus symptoms[（31.5±11.4）vs（8.3±2.6）,P=0.000]was noted with 4-weeks acupuncture.The score of every recorded symptom was lower than baseline（all P〈0.05）.（2）The patients with low lower esophageal sphincter pressure were increased with acupuncture treatment[（4.3±3.1）mm Hg vs（8.9±4.3）mm Hg,P=0.004],while there were no statistical significance of the uper esophageal sphincter pressure.（3）The esophagus body peristalsis amplitude were higher than baseline in different swallowing（all P〈0.05）,the distal contractile integral in all type bolus swallow were increased with acupuncture treatment（all P〈0.05）,the contractile front velocity of peristaltic wave in different bolus were no difference between before and after therapy.（4）The achievement ratio of water and solid swallows were higher than baseline（all P〈0.05）.Conclusion The symptoms related with gastroesphageal refluxare improved after 4-weeks acupuncture therapy,and esophageal dysmotility is normalized in some paremeters in the patients

关 键 词：针灸疗法 非糜烂性反流病 高分辨食管测压 

分 类 号：R246.1[医药卫生—针灸推拿学]