Acupuncture therapy with point selection based on syndrome differentiation along the meridians for functional dyspepsia:a randomized controlled trial

循经辨证取穴针刺治疗功能性消化不良:随机对照试验

Objective:To observe the difference in clinical efficacy between acupuncture with point selection based on syndrome differentiation along the meridians and acupuncture at non-meridian and non-acupoint points for functional dyspepsia(FD).Methods:A total of 74 FD patients were randomized into an observation group and a control group,with 37 cases in each group.Both groups received acupuncture treatment.Zusanli(ST 36)and Neiguan(PC 6)were selected in the observation group,with Taichong(LR 3)and Neiting(ST 44)added for excess syndrome,and Gongsun(SP 4)and Yinlingquan(SP 9)added for deficiency syndrome.Four non-meridian and non-acupoint points were selected in the control group.The treatments in both groups were performed once a day with a 2-day break after 5 consecutive treatments,which constituted one treatment course.A total of 4 courses were performed.The scores of Nepean dyspepsia index(NDI)and Leeds dyspepsia questionnaire(LDQ)were recorded before and after treatment,and during follow-up(8,12,16,20 and 24 weeks after recruitment)to assess the clinical efficacy.Results:The NDI scores in the two groups after treatment and at each time point during follow-up were higher than those before treatment(all P<0.05),and the LDQ scores were lower than those before treatment(all P<0.05).The NDI scores after treatment and at each time point during follow-up in the observation group were higher than those in the control group(all P<0.01);the total LDQ score and scores of upper abdominal pain,postprandial satiety and upper abdominal burning sensation after treatment and at each time point during follow-up in the observation group were significantly lower than those in the control group(P<0.01 or P<0.05)..Conclusion:Acupuncture with point selection based on syndrome differentiation along the meridians has a better curative effect than acupuncture at non meridian and non-acupoint points in the treatment of FD.

目的:观察循经辨证取穴针刺与非经非穴针刺治疗功能性消化不良(FD)的临床疗效差异.方法:将74例FD患者随机分为观察组和对照组,每组37例.两组均予以针刺治疗,观察组取足三里和内关,实证加太冲和内庭,虚证加公孙和阴陵泉.对照组取4个非经非穴刺激点.两组均每日治疗1次,连续5次后休息2 d,为1个疗程,共治疗4个疗程.分别于治疗前、治疗后以及随访时(入组8周、12周、16周、20周和24周)进行尼平消化不良指数(NDI)与利兹消化不良问卷(LDQ)评分,评估临床疗效.结果:两组治疗后及随访各个时间点的NDI评分均高于同组治疗前(均P<0.05),LDQ评分均低于同组治疗前(均P<0.05);观察组治疗结束时以及5个随访时间点的NDI评分均高于同时间点对照组(均P<0.01);观察组治疗后及每个随访时间点的LDQ总分及上腹痛、餐后饱胀感和上腹烧灼感评分均显著低于同时间点对照组(P<0.01 or P<0.05).结论:循经辨证取穴针刺治疗FD的疗效优于非经非穴点针刺治疗.