循经点穴推拿联合经皮耳迷走神经刺激治疗产后功能性消化不良临床研究

Clinical Study on Point-Pressing Massage Along Meridians Combined with Transcuta⁃neous Vagal Nerve Stimulation for Postpartum Functional Dyspepsia

目的:观察循经点穴推拿联合经皮耳迷走神经刺激(taVNS)治疗产后功能性消化不良的效果及对胃肠功能的影响。方法:选取188例产后功能性消化不良的患者作为研究对象,按随机数字表法分为常规组、推拿组、taVNS组、联合组各47例。常规组给予常规治疗,推拿组在常规治疗基础上给予循经点穴推拿,taVNS组在常规治疗基础上给予taVNS治疗,联合组在常规治疗基础上给予循经点穴推拿联合taVNS治疗。比较4组临床疗效及不良反应发生情况,比较4组治疗前后中医症状评分、胃肠激素水平及胃电图参数值的变化。结果:治疗后,4组早饱感、餐后饱胀不适、上腹痛、上腹烧灼感中医症状评分均较治疗前下降(P<0.05),推拿组、taVNS组、联合组上述4项评分均低于常规组(P<0.05),联合组上述4项评分均低于常规组、推拿组、taVNS组(P<0.05)。联合组临床疗效总有效率高于常规组、推拿组、taVNS组,差异有统计学意义(P<0.05)。治疗后,4组血清胃泌素和胃动素水平均较治疗前升高(P<0.05),推拿组、taVNS组、联合组均高于常规组(P<0.05),联合组均高于常规组、推拿组、taVNS组(P<0.05)。治疗后,4组餐前、餐后的胃电频率、胃电紊乱百分比均较治疗前降低(P<0.05),正常慢波百分比均较治疗前升高(P<0.05);治疗后,联合组餐前、餐后的胃电频率、胃电紊乱百分比均低于其他3组(P<0.05),正常慢波百分比高于其他3组(P<0.05)。结论:循经点穴推拿联合taVNS治疗产后功能性消化不良有助于缓解症状,增强胃电活动,调节胃肠激素水平,提升疗效。

Objective:To observe the effect of point-pressing massage along meridians combined with transcutaneous vagal nerve stimulation(taVNS)on postpartum functional dyspepsia and its influence on gastrointestinal function.Methods:A total of 188 patients with postpartum functional dyspepsia were selected as the study objects,and were divided into the routine group,the massage group,the taVNS group and the combination group according to the random number table method,with 47 cases in each group.The routine group was given routine treatment;the massage group was given point-pressing massage along meridians based on routine treatment;the taVNS group was treated with taVNS based on routine treatment,and the combination group was given point-pressing massage along meridians combined with taVNS based on routine treatment.The clinical effects and adverse reactions in the four groups were compared,and the changes of traditional Chinese medicine symptom scores,gastrointestinal hormone levels and electrogastrogram parameters were compared before and after treatment.Results:After treatment,the traditional Chinese medicine symptom scores of early satiety,postprandial fullness and discomfort,upper abdominal pain and upper abdominal burning in the four groups were decreased when compared with those before treatment(P<0.05),and the above four scores in the massage group,the taVNS group and the combination group were lower than those in the routine group(P<0.05);the above four scores in the combination group were lower than those in the routine group,the massage group and the taVNS group(P<0.05).The total effective rate in the combination group was higher than that in the conventional group,the massage group,the taVNS group(P<0.05).After treatment,the levels of serum gastrin and motilin in the four groups were increased(P<0.05),and the above two levels in the massage group,the taVNS group and the combination group were higher than those in the conventional group(P<0.05),and the levels in the combination group were higher than those in the massage group and the taVNS group(P<0.05).After treatment,the pre-meal and post-meal gastric electrical frequency and the percentage of gastric electrical disorders in the four groups were decreased when compared with those before treatment(P<0.05),and the percentage of normal slow wave was increased when compared with that before treatment(P<0.05).After treatment,the pre-meal and post-meal gastric electrical frequency and the percentage of gastric electrical disorders in the combination group were lower than those in the other three groups(P<0.05),and the percentage of normal slow wave was higher than that in the other three groups(P<0.05).Conclusion:The point-pressing massage along meridians combined with taVNS is helpful to relieve symptoms of postpartum functional dyspepsia,enhance gastric electrical activity,regulate gastrointestinal hormone levels,and improve the therapeutic effect.