中医“和法”结合针刺疗法治疗反流性食管炎肝胃不和型疗效及对胃肠激素的影响  

Therapeutic effect of traditional Chinese medicine“harmonization method”combined with acupuncture on reflux esophagitis of type of liver-stomach disharmony and its effect on gastrointestinal hormonesharmonize

作　　者：张丽丽[1] 李婉如 刘梦欢 李卉 赵志幸 任文静 孔晓琳 贾军峰[1] ZHANG Lili;LI Wanru;LIU Menghuan;LI Hui;ZHAO Zhixing;REN Wenjing;KONG Xiaolin;JIA Junfeng(Handan Hospital of Traditional Chinese Medicine, Handan 056001, Hebei, China)

机构地区：[1]邯郸市中医院,河北邯郸056001

出　　处：《现代中西医结合杂志》2022年第11期1492-1496,共5页Modern Journal of Integrated Traditional Chinese and Western Medicine

基　　金：河北省中医药管理局科研计划项目(2022653)。

摘　　要：目的观察中医“和法”结合针刺疗法治疗反流性食管炎肝胃不和型患者临床疗效及对血清胃泌素(GAS)、胃动素(MTL)的影响。方法选择2019年7月—2020年10月于邯郸市中医院治疗的肝胃不和型反流性食管炎患者87例,随机分为3组,每组29例。西药组给予奥美拉唑肠溶胶囊+多潘立酮片治疗,西药+中药组在西药组治疗基础上加用半夏泻心汤治疗,西药+中药+针刺组在西药+中药组基础上联合针刺治疗,3组疗程均为8周。观察3组患者治疗前后中医症状积分、血清GAS及MTL水平、生活质量GERD-HRQL量表评分变化,比较3组临床疗效、不良反应发生率及停药后6个月复发率。结果与治疗前比较,治疗后3组患者中医症状积分、GERD-HRQL评分均显著降低(P均<0.05),血清GAS、MOT水平均显著升高(P均<0.05),且西药+中药+针刺组患者上述指标改善情况均显著优于其他2组(P均<0.05)。治疗后,西药+中药+针刺组有效率为92.9%(27/29),显著高于西药组的69.0%(20/29)和西药+中药组的72.4%(21/29),差异均有统计学意义(P均<0.05)。3组均无不良反应发生。随访6个月,西药+中药+针刺组复发率为3.7%(1/27),显著低于西药组的25.0%(5/20)和西药+中药组的14.3%(3/21),差异均有统计学意义(P均<0.05)。结论中医“和法”结合针刺疗法可有效缓解反流性食管炎肝胃不和型患者的临床症状,提高患者生活质量,降低复发率,机制可能与促进GAS、MTL分泌,改善胃肠功能有关。Objective It is to observe the clinical efficacy of traditional Chinese medicine(TCM)“harmonization method”combined with acupuncture in the treatment of reflux esophagitis patients with liver-stomach disharmony syndrome and its effect on serum gastrin(GAS)and motilin(MTL).Methods A total of 87 patients with reflux esophagitis with liver and stomach disharmony syndrome treated in Handan Hospital of Traditional Chinese Medicine from July 2019 to October 2020 were selected and randomly divided into 3 groups,with 29 cases in each group.The western medicine group was treated with omeprazole enteric-coated capsules+domperidone tablets,the western medicine+TCM group was treated with Banxia Xiexin Decoction on the basis of the western medicine group,and the western medicine+TCM+acupuncture group was treated with acupuncture on the basis of the western medicine+TCM group.The three groups were treated for 8 weeks.The changes in TCM symptom scores,levels of serum GAS and MTL,and the scores of GERD-HRQL scale for quality of life were observed before and after treatment in the three groups.The clinical efficacy,incidence of adverse reactions and recurrence rate 6 months after drug withdrawal were compared among the three groups.Results Compared with before treatment,the TCM symptom scores and GERD-HRQL scores were significantly decreased in the three groups after treatment(all P<0.05),and the levels of serum GAS and MOT were significantly increased(all P<0.05),the improvement of the above indexes in the western medicine+TCM+acupuncture group was significantly better than that in the other two groups(P<0.05).After treatment,the effective rate of western medicine+TCM+acupuncture group was 92.9%(27/29),which was significantly higher than 69.0%(20/29)of western medicine group and 72.4%(21/29)of western medicine+TCM group,the differences were statistically significant(both P<0.05).There were no adverse reactions in the three groups.After 6 months of follow-up,the recurrence rate in the western medicine+TCM+acupuncture group wa

关 键 词：反流性食管炎 中医“和法” 针刺疗法 肝胃不和 胃肠激素 

分 类 号：R571[医药卫生—消化系统]