运用“脾胃升降协调论”针药结合法治疗非糜烂性反流病疗效及对食管动力的影响  

Study on Curative Effect and Influence on Esophageal Motility of Non-erosive Reflux Disease Treated by Combination of Acupuncture and Medicine Therapy Based on“Coordination of Spleen and Stomach Ascending and Descending Theory”

作　　者：刘凡 张书 舒磊[1,2] 万曌 时昭红[1,2] LIU Fan;ZHANG Shu;SHU Lei;WAN Zhao;SHI Zhaohong(Wuhan Hospital of Integrated Traditional and Western Medicine,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,Hubei,China;No.1 Hospital of Wuhan,Wuhan 430030,Hubei,China;Hubei University of Chinese Medicine,Wuhan 430065,Hubei,China)

机构地区：[1]华中科技大学同济医学院附属武汉市中西医结合医院,湖北武汉430030 [2]武汉市第一医院,湖北武汉430030 [3]湖北中医药大学,湖北武汉430065

出　　处：《辽宁中医杂志》2023年第6期183-187,共5页Liaoning Journal of Traditional Chinese Medicine

基　　金：国家重点研发计划中医药现代化研究专项(2019YFC1709601);国家重点研发计划中医药现代化研究专项(2019YFC1709604);国家中医临床基地拓展病种临床研究项目(JDZX2019001);武汉市卫生健康委员会科研项目(WZ20C03)。

摘　　要：目的观察“脾胃升降协调论”针药结合疗法干预非糜烂性反流病(non-erosive reflux disease,NERD)寒热错杂证的临床疗效及对食管动力的影响。方法选择80例2020年9月—2021年9月武汉市中西医结合医院消化内科门诊及住院NERD寒热错杂证患者,随机分为试验组与对照组各40例。试验组予以半夏调中颗粒10 g/次,3次/d,并配合背俞针刺,每次30 min,每两天治疗1次,3次/周;对照组予以泮托拉唑肠溶片20 mg,2次/d;疗程均为4周。比较两组治疗后反流、烧心症状疼痛视觉模拟(VAS)评分、中医证候积分与高分辨率食管测压结果。结果与治疗前相比,两组治疗后的反流、烧心VAS评分、中医证候总积分均降低,差异有统计学意义(P<0.05,P<0.01);组间比较显示,治疗后试验组的反流VAS评分、中医证候总积分均低于对照组(P<0.01),且试验组总有效率高于对照组(P<0.05)。高分辨率食管测压结果显示,试验组治疗后下食管括约肌(LES)静息压、食管远端蠕动收缩波幅和蠕动波传导速度均较治疗前增高(P<0.01),且与对照组比较差异有统计学意义(P<0.01)。结论“脾胃升降协调论”针药结合疗法对NERD寒热错杂证患者的临床症状有明显缓解作用,同时可改善食管动力障碍,且无明显不良反应,安全有效。Objective To observe the efficacy and effect on esophageal motility of the combination of acupuncture and medicine therapy based on“coordination of spleen and stomach ascending and descending theory”in the treatment of cold-heat complicated syndrome of non-erosive reflux disease(NERD).Methods A total of 80 patients with NERD syndrome were enrolled from September 2020 to September 2021 in Department of Gastroenterology,Wuhan Hospital of Traditional Chinese and Western Medicine,and were randomly divided into experimental group and control group(40 cases in each).The experimental group was given Banxia Tiaozhong Granule(半夏调中颗粒)10 g/time,3 times/day,and acupuncture at back Shu acupoints,30 min for each time,once every two days,3 times a week.The control group was given pantoprazole enteric-coated tablet 20 mg twice a day.The treatment course was 4 weeks.The visual analogue scale(VAS)score of reflux,heartburn symptom,TCM syndrome score and high resolution esophageal manometry were compared between the two groups after treatment.Results Compared with those before treatment,reflux,heartburn VAS score and TCM syndrome total score were decreased after treatment in two groups,and the differences were statistically significant(P<0.05,P<0.01).Comparison between the two groups showed that VAS score and total score of TCM syndromes in the experimental group were lower than those in the control group after treatment(P<0.01),and the total effective rate in the experimental group was higher than that in the control group(P<0.05).The results of high resolution esophageal manometry showed that lower esophageal sphincter(LES)resting pressure,peristaltic contraction amplitude and peristaltic wave conduction velocity in the distal esophagus of the experimental group increased after treatment compared with those before treatment(P<0.01),and the differences were statistically significant compared with those of the control group(P<0.01).Conclusion The combination of acupuncture and medicine with the theory of“coordinati

关 键 词：脾胃升降协调论 针药结合 非糜烂性反流病 背俞针刺 高分辨率食管测压 随机对照 

分 类 号：R573[医药卫生—消化系统]