芒针治疗中风后消化不良疗效观察

Elongated needle for post-stroke indigestion

目的:观察芒针、毫针、药物治疗中风后消化不良的疗效差异。方法:将60例中风后消化不良患者随机分为芒针组、毫针组与药物组,每组20例。3组患者均予"醒脑开窍"针刺法及内科常规治疗。芒针组接受125 mm长芒针直刺深刺中脘、梁门、天枢穴;毫针组直刺中脘、梁门、天枢穴20~30 mm,每日1次,每周针刺6次,共4周;药物组口服多潘立酮(吗丁啉),10 mg/次,3次/日,共4周。使用消化不良中医症状积分、利兹消化不良问卷(LDQ)、尼平消化不良指数生活质量(NDLQI)、抑郁自评量表(SDS)、不良反应量表(TESS)作为评价指标,并比较各组消化不良症状的临床疗效。结果:与治疗前相比,各组治疗7、14、28 d消化不良中医症状积分、LDQ、SDS积分均明显下降(P<0.05,P<0.01),NDLQI积分明显增加(均P<0.05)。治疗28 d,芒针组消化不良中医症状积分、LDQ积分低于毫针组和药物组(P<0.05,P<0.01);药物组SDS积分低于芒针组和毫针组(均P<0.05),3组NDLQI积分差异无统计学意义(P>0.05)。芒针组总有效率为90%(18/20),毫针组、药物组总有效率分别为70%(14/20)、75%(15/20),3组疗效差异有统计学意义(P<0.01)。结论:芒针深刺能改善中风后消化不良中医症状,疗效优于毫针组、西药组。

Objective To observe the clinical efficacy difference among elongated needle, filiform needle and medication for post-stroke indigestion. Methods Sixty cases of post-stroke indigestion were randomly assigned into an elongated needle group, a filiform needle group and a medication group, 20 cases in each one. Acupuncture of restoring consciousness and inducing resuscitation and conventional medical treatment were applied in the three groups. 125 mm elongated needles were perpendicularly inserted at Zhongwan（CV 12）, Liangmen（ST 21） and Tianshu（ST 25） in the elongated needle group; 20 to 30 mm perpendicular filiform at the same points in the filiform needle group. All the treatment was given for 4 weeks, 6 times a week, 1 time a day. Domperidone was prescribed orally in the medication group for 4 weeks, 3 times a day and once 10 mg. The indexes were dyspepsia TCM symptom score, Liz dyspepsia questionnaire（LDQ）, Nepean Dyspepsia Index of quality of life（NDLQI）, Safety Data Sheet（SDS） self rating scale and side effect scale（TESS）. The effects were evaluated. Results The scores of TCM symptom, LDQ, SDS scores in the three groups decreased and NDLQI increased after 7-day, 14-day, and 28-day treatment as compared with those before treatment（P0.05, P0.01）. The TCM symptom score and LDQ score in the elongated needle group after 28-day treatment were lower than those in the filiform needle and medication groups（P0.05, P0.01）. The SDS score in the medication group was lower than that in the elongated needle and filiform needle group（both P0.05）. There were no significant statistical difference for NDLQI score in the three groups（P0.05）. The total effective rate was 90%（18/20） in the elongated needle group; those in the filiform needle group and medication group were 70%（14/20） and 75%（15/20） respectively, indicating statistical significance（P 0.01）. Conclusion Acupuncture with elongated needle can obviously improve symptoms in the patients with post-stroke indigestion, which is better than filiform needle and medication.