针刺督脉背段T_3～T_(12)棘突下治疗难治性胃食管反流病的临床观察

Clinical observation on acupuncture treatment of refractory gastroesophageal reflux disease by needling dorsal segment of Governor Vessel below spinous processes from T_3 to T_(12)

目的观察针刺督脉背段T_3～T_(12)棘突下治疗难治性胃食管反流病患者的临床疗效。方法将60例难治性胃食管反流病患者随机分为针刺组和西药组,每组30例。西药组予埃索美拉唑镁肠溶片口服,针刺组予针刺督脉背段T_3～T_(12)棘突下治疗。两组均治疗8周,观察临床疗效,比较胃食管反流病问卷(RDQ)评分、胃食管反流病健康相关生存质量量表(GERDHRQL)评分及T_3～T_(12)棘突下压痛阈值的变化情况。结果 (1)针刺组、西药组愈显率分别为60.0%、26.7%;两组临床疗效比较,针刺组优于西药组(P<0.05)。(2)治疗前后组内比较,两组RDQ、GERD-HRQL评分均较治疗前减少(P<0.05);组间治疗后比较,针刺组RDQ、GERD-HRQL评分均低于西药组(P<0.05)。(3)治疗前后组内比较,针刺组治疗后T_3～T_(12)各棘突下压痛阈值均较治疗前升高(P<0.05),西药组T_3～T_(12)各棘突下压痛阈值均较治疗前降低(P<0.05);组间治疗后比较,针刺组T_3～T_(12)各棘突下压痛阈值均高于西药组(P<0.05)。结论针刺督脉背段T_3～T_(12)棘突下治疗难治性胃食管反流病疗效满意,较埃索美拉唑镁肠溶片能更好地改善患者的临床症状,提高生活质量。

Objective To observe the clinical efficacy in acupuncture treatment of refractory gastroesophageal reflux disease( GERD) by needling the dorsal segment of Governor Vessel below the spinous processes from T3 to T12. Methods 60 patients with gastroesophageal reflux disease were randomly assigned into the acupuncture group and the medication group,30 patients in each group. Esomeprazole magnesium enteric-coated tablets were administrated to patients in the medication group and in the acupuncture group,the dorsal segment of Governor Vessel below the spinous processes from T3 to T12was punctured. Duration of treatment was 8 weeks in both groups. Clinical efficacy was observed,and the changes in scores of RDQ( Gerd Questionnaire) and GERD-HRQL and in the threshold of tenderness below the spinous processes from T3 to T12were compared. Results(1) The markedly effective rate was 60.0% and 26.7% in the medication group and the acupuncture group;and it was superior in the acupuncture group to that in the medication group( P<0.05).(2) The RDQ and GERD-HRQL scores decreased significantly in both groups after treatment compared to those before treatment( P<0.05);and the scores were lower in the acupuncture group than in the medication group after treatment( P<0.05).(3) In the acupuncture group,the threshold of tenderness below the spinous processes from T3 to T12increased significantly( P<0.05),while it decreased significantly in the medication group( P<0.05) after treatment compared to that before treatment;and there was significant difference in the threshold between the groups after treatment( P<0.05). Conclusion There is satisfactory clinical efficacy in acupuncture treatment for refractory gastroesophageal reflux disease by needling the dorsal segment of Governor Vessel below the spinous processes from T3 to T12,and acupuncture alleviates patients’ clinical symptoms and improves their quality of life more effectively than esomeprazole magnesium enteric-coated tablets.