艾司奥美拉唑联合穴位针灸治疗中虚气逆型胃食管反流病的临床观察  

Clinical Observation of Esomeprazole Combined with Acupoint Acupuncture in Treating Gastroesophageal Reflux Disease of Deficiency of Qi and Inversion

作　　者：何婧[1] 王毅[1] 周竞 马桂芝 张静静 董烨卿 胡智海[1] HE Jing;WANG Yi;ZHOU Jing;MA Gui-zhi;ZHANG Jing-jing;DONG Ye-qing;HU Zhi-hai(Shanghai Hospital of Integrated Traditional Chinese and Western Medicine,Shanghai 201203;Shanghai University of Traditional Chinese Medicine,Shanghai College of Integrated Traditional Chinese and Western Medicine,Shanghai 200082)

机构地区：[1]上海市中西医结合医院,上海201203 [2]上海中医药大学中西医结合临床医学院,上海200082

出　　处：《世界中西医结合杂志》2021年第6期1079-1083,1088,共6页World Journal of Integrated Traditional and Western Medicine

基　　金：上海市卫生健康委员会科研课题青年项目(20184Y0355);上海市中医专科培育项目(201918)。

摘　　要：目的探讨艾司奥美拉唑联合穴位针灸对中虚气逆型胃食管反流病(GERD)的临床疗效及对炎症因子、脑肠肽的影响。方法选取2018年6月—2020年1月期间上海市中西医结合医院收治的GERD且中医辨证属中虚气逆型患者86例,根据随机数字表法分为对照组43例和治疗组43例。对照组给予艾司奥美拉唑治疗,治疗组在对照组基础上加以穴位针灸治疗。治疗8周后,观察两组临床疗效,治疗前后中医证候积分,胃食管反流诊断问卷(GERDQ)评分,食管测压[食管上括约肌(upper esophageal sphincter,UES)静息压、食管下括约肌(low esophageal sphincter,LES)静息压]水平,相关炎症因子[C反应蛋白(CRP)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)]及脑肠肽[胃泌素(GAS)、胃动素(MTL)、血清血管活性肠肽(VIP)]水平,并观察两组不良反应及随访6个月复发情况。结果治疗后治疗组总有效率90.70%(39/43)高于对照组72.09%(31/43),两组比较,差异有统计学意义(χ2=4.914,P=0.027,P<0.05)。治疗后两组患者反酸嗳气、嘈杂、胸骨后灼痛、胃脘胀满、食欲不振、大便溏薄中医证候积分均低于治疗前,差异有统计学意义(P<0.05),且治疗组患者反酸嗳气、嘈杂、胸骨后灼痛、胃脘胀满、食欲不振、大便溏薄中医证候积分均低于对照组,两组比较,差异有统计学意义(P<0.05)。治疗后两组患者GERDQ评分均低于治疗前,差异有统计学意义(P<0.05),且治疗组患者GERDQ评分低于对照组,两组比较,差异有统计学意义(P<0.05);两组患者UES静息压、LES静息压均高于治疗前,差异有统计学意义(P<0.05),且治疗组患者UES静息压、LES静息压均高于对照组,两组比较,差异有统计学意义(P<0.05)。治疗后两组患者血清CRP、IL-6、TNF-α水平均低于治疗前,差异有统计学意义(P<0.05),且治疗组患者血清CRP、IL-6、TNF-α水平均低于对照组,两组比较,差异有统计学意义(P<0.05)。治疗后两组�Objective To explore the clinical efficacy of esomeprazole combined with acupoint acupuncture on gastroesophageal reflux disease(GERD)of deficiency of qi and inversion and its influence on inflammatory factors and brain-gut peptides.Methods Eighty-six patients with GERD who were admitted to Shanghai Hospital of Integrated Traditional Chinese and Western Medicine from June 2018 to January 2020 and were treated by TCM syndromes were middle-deficiency-qi inverse type.According to the random number table method,they were divided into control group 43 cases and treatment group 43 cases.The control group was treated with esomeprazole,and the treatment group was treatedwith acupuncture points on the basis of the control group.After 8 weeks of treatment,observe the clinical efficacy of the two groups,the scores of TCM syndromes before and after treatment,the Gastroesophageal Reflux Diagnostic Questionnaire(GERDQ)score,esophageal pressure measurement[upper esophageal sphincter(UES)resting pressure,lower esophageal sphincter(LES)resting pressure]level,related inflammatory factors[C-reactive protein(CRP),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)]and brain-gut peptide[Gastrin(GAS),motilin(MTL),serum vasoactive intestinal peptide(VIP)]levels,adverse reactions and recurrence in 6 months of follow-up of the two groups were observed.ResultsAfter treatment,the total effective rate of the treatment group was 90.70%(39/43)higher than that of the control group 72.09%(31/43).The difference between the two groups was statistically significant(χ2=4.914,P=0.027,P<0.05).After treatment,the two groups of patients with acid reflux belching,noisy,retrosternal burning pain,gastric fullness,loss of appetite,loose stools,TCM syndrome scores were lower than before treatment(P<0.05),and the treatment group patients with acid reflux,belching,The scores of TCM syndromes of noisy,retrosternal burning,full stomach,loss of appetite,and loose stools were lower than those of the control group(P<0.05).After treatment,the GERDQ scores of the

关 键 词：胃食管反流病 中虚气逆 艾司奥美拉唑 针灸 

分 类 号：R573[医药卫生—消化系统] R655.4[医药卫生—内科学]