电针四肢腧穴为主治疗功能性消化不良临床对照研究

Controlled Clinical Study on Electroacupuncture at the Acupoints on Extremities Predominantly for Functional Dyspepsia

目的观察电针四肢部腧穴或腹部腧穴与口服莫沙比利治疗功能性消化不良(FD)的疗效及对生活质量的不同影响,以指导针灸治疗FD的临床选穴处方。方法将60例FD患者按就诊顺序随机分为四肢电针组、腹部电针组和西药组,每组20例。四肢电针组取穴足三里、三阴交、太冲、内关、公孙。在双侧足三里和三阴交分别连接G6805-2型电针仪,每次治疗30 min,隔日1次,共治疗10次。腹部电针组取穴中脘、天枢、气海,双侧天枢接电针仪,治疗时间、频率、次数同四肢电针组。西药组口服莫沙比利片,每次1片,每日3次,共服用20 d。3组患者均在治疗前、治疗后及治疗后1个月(随访)时进行尼平消化不良指数(NDI)评分,并在治疗后评价3种治疗方法的疗效。结果四肢电针组总有效率高于腹部电针组和西药组(P<0.05),腹部电针组和西药组有效率无明显差异(P>0.05)。治疗结束后,四肢电针组对症状指数(NDSI)的改善优于腹部电针组和西药组(P<0.05),腹部电针组和西药组无显著差异(P>0.05)。随访1个月后四肢电针组症状改善优于腹部电针组(P<0.05),腹部电针组优于西药组(P<0.05)。治疗结束后四肢电针组和腹部电针组对生活质量(NDLQI)的改善优于西药组(P<0.05),两电针组间无差异(P>0.05)。随访1个月后两电针组生活质量较治疗前仍有明显改善(P<0.05),但西药组改善不明显。结论四肢电针与腹部电针均较口服莫沙比利能够更有效且持续地改善FD患者的症状及生活质量。相比腹部电针,四肢部电针能够更好地改善FD患者的症状,但对生活质量影响无差异。

Objective To observe the therapeutic efficacy of electroacupuncture at the acupoints on extremities or abdominal acupoints and orally taking Mosapride in treating functional dyspepsia （FD） and the different effects on life style, for guiding the points selection in acupuncture-moxibustion treatment for FD. Method Sixty FD patients were randomized into an extremity-electroacupuncture group, an abdomen-electroacupuncture group, and a Western medication group by their visiting sequence, 20 cases in each group. In the extremity-electroacupuncture group, Zusanli （ST36）, Sanyinjiao （SP6）, Neiguan （PC6） and Gongsun （SP4） were selected. Bilateral Zusanli and Sanyinjiao were respectively connected to G6805-2 electroacupuncture apparatus, 30 min for each session, once every other day, 10 sessions in total. In the abdomen-electroacpuncture group, Zhongwan （CV12）, Tianshu （ST25）, and Qihai （CV6） were selected. Bilateral Tianshu were connected to electroacupuncture apparatus, with same treatment time, frequency and sessions. The Western medication group was intervened by oral administration of Mosapride, 1 tablet each time, 3 times a day, for 20 d in total. The three groups were evaluated by using Nepean Dyspepsia Index （NDI） prior to the treatment, after the treatment and 1 month after the treatment （follow-up study）, and the therapeutic efficacies were estimated after the treatment. Result The effective rate of the extremity-electroacupuncture group was higher than that of the abdomen-electroacupuncture group and Western medication group, while there was no significant difference between the abdomen-electroacupuncture group and Western medication group in comparing the effective rate. Aider the treatment, the improvement of Nepean Dyspepsia Symptom Index （NDSI） in the extremity-electroacupuncture group was more significant than that in the abdomen-electroacupuncture group and Western medication group （P〈0.05）, while there was no significant difference between the abdomen-electroacupuncture group and Western medication group （P 〉 0.05）. The 1-month follow-up showed that the improvement of symptoms in the extremity- electroacupuncture group was more significant than that in the abdomen-electroacupuncture group （P〈0.05）, and the improvement in the abdomen-electroacupuncture group was more significant than that in the Western medication group （P〈0.05）. After the treatment, the improvements of Nepean Dyspepsia Life Quality Index （NDLQI） in the extremity- electroacupuncture group and abdomen-electroacupuncture group were superior to the improvement in the Western medication group （P〈0.05）, while there was no significant difference between the two electroacupuncture groups （P〉 0.05）. The 1-month follow-up study showed that the quality of life in the extremity-electroacupuncture group was still significantly improved compared to that before the treatment, while the improvement in the Western medication group was insignificant. Conclusion Electroacupuncture at the acupoints on extremities and abdominal acupoints both can more effectively and consistently improve the symptoms and quality of life of FD patients compared to orally taking Mosapride. Compared to electroacupuncture at the abdominal acupoints, electroacupuncture at the extremity points works better in improving the symptoms of FD but doesn＇t show advantage in improving the quality of life.