盐酸甲氧氯普胺穴位注射治疗手术后胃瘫综合征随机对照观察

Observation on Therapeutic Effects of Acupoint Injection of Metoclopramide for Postsurgical Gastroparesis Syndrome

目的:通过观察盐酸甲氧氯普胺穴位注射对术后胃瘫综合征(PGS)患者临床症状及疗效的影响,探索中西医结合治疗该病的新途径。方法:选择临床确诊的腹部PGS患者46例,按接受治疗的顺序将患者随机分为穴位注射组及肌肉注射组,每组23例。两组患者除常规治疗外,穴位注射组交替选取双侧足三里穴和胃俞穴,每穴注射盐酸甲氧氯普胺5mg,肌肉注射组采用上臂三角肌或臀大肌肌肉注射盐酸甲氧氯普胺10mg,均为每日1次,共14次。观察两组治疗后临床症状评分及疗效。结果:治疗后两组患者临床症状评分均较治疗前明显降低,且穴位注射组低于肌肉注射组(均P<0.05);两组间总有效率比较差异有统计学意义(P<0.05),穴位注射组高于肌肉注射组。结论:常规治疗配合盐酸甲氧氯普胺穴位注射能显著改善PGS的临床症状。

Objective To observe the clinical effects of acupoint injection of metoclopramide for postsurgical gastroparesis syndrome（PGS）.Methods A total of 46 patients with PGS（from abdominal surgery）were randomly divided into control and acupoint injection groups（n=23in each group）.Patients of the acupoint injection group were treated by injection of Metoclopramide（5mg＋ normal saline）into bilateral Zusanli（ST 36）and Weishu（BL 21）alternatively,while patients of the control group treated by injection of 10 mg of Metoclopramide into the deltoid muscle and gluteus maximus muscle alternatively.The treatment of both groups was conducted once daily for 14 days.A 3-point scale of clinical symptoms（abdominal distension,belching,nausea-vomiting,upper-abdominal distending pain,sour regurgitation and gastric burning sensation）was used to evaluate the therapeutic effect.Results There were no statistical differences between two groups in clinical symptom scores before the treatment（P0.05）.Following treatment,the clinical symptom scores of both groups were significantly decreased in comparison with pre-treatment（P0.05）and the scores of the acupoint injection group were significantly lower than those of the control group（P0.05）.Of the 23 PGS patients in the control group and acupoint injection group,0and 2were cured,5and 10 were significantly improved,10 and 9were improved,8and 2failed,with the effective rates being 65.22%and 91.30%,respectively.Conclusion Acupoint injection of Metoclopramide is effective for improving clinical symptoms of PGS patients.