针刺中脘联合旋覆代赭汤治疗糖皮质激素呃逆(胃虚痰阻气逆)随机平行对照研究

Acupuncture Zhongwan combined with Xuanfu Daizhe Decoction(旋覆代赭汤) in the Treatment of Glucocorticoid Hiccup(Weixu Tanzu Qini/胃虚痰阻气逆) Randomized Controlled Study

[目的]观察针刺中脘联合旋覆代赭汤治疗糖皮质激素呃逆(胃虚痰阻气逆)疗效。[方法]使用随机平行对照方法,将64例住院患者按病志号方法随机分为两组。对照组32例旋覆代赭汤(大枣8枚,旋覆花、半夏、生姜各15g,党参、甘草各20g,代赭石30g),胃寒去生姜,加干姜、柿蒂各10g;胃火上扰加黄连5g,陈皮15g;胃阴不足加石斛10g,麦冬15g;气机郁滞症,加郁金、沉香各15g;言语不利加远志15g,石菖蒲20g;肢体偏废,加桑寄生、牛膝各15g;血瘀较重,加莪术10g,鸡血藤20g,水煎400mL,1剂/d,2次/d。治疗组32例针刺中脘穴,患者仰卧位,穴位周围皮肤常规消毒,选30号1~1.5寸不锈钢毫针,针刺中脘,沿骨缘平刺1寸,留针30min,每10min行针1次,1次/d;旋覆代赭汤治疗同对照组。连续治疗5d为1疗程。观测临床症状、呃逆消失时间、不良反应。连续治疗2疗程(10d),判定疗效。[结果]治疗组痊愈25例,有效6例,无效1例,总有效率96.88%;对照组痊愈7例,有效18例,无效7例,总有效率78.13%;治疗组疗效优于对照组(P<0.05)。呃逆消失时间治疗组短于对照组(P<0.01)。[结论]针刺中脘联合旋覆代赭汤治疗糖皮质激素呃逆(胃虚痰阻气逆),疗效满意,无严重不良反应,值得推广。

[Objective] To observe the effects of acupuncture Zhongwan combined with Xuanfu Daizhe decoction in the treatment of glucocorticoid hiccup （Weixu Tanzu Qini）. [Methods] Randomized parallel control method was applied to divide 64 hospitalized patients into two groups according to their chronicles. In the control group, 32 cases of Xuanfu Daizhe decoction （Dazao 8, Xuanfuhua, Banxia, Shengjiang each 15g, Dangshen, Gancao each 20g, Daizheshi 30g）, stomach cold to ginger, and 10g of dried ginger and persimmon, 5g of coptis chinensis, 15g of orange peel, 10g of dendrobium, 15g of radix ophiopogon, Qi stagnation and 15g of Qi and calamus; ghassan parasitism, achyranthes each 15g; blood stasis is heavy, plus Ezhu 10g, Jixueteng 20g decoction 400mL, 1 doses/d, 2 times/d. In the treatment group, there were 32 cases of acupuncture at Zhongwan, supine position, routine disinfection of the skin around acupoint, 1～1.5 inch stainless steel needle in 1～1.5 inches, 1 inches of acupuncture at Zhongwan, 1 inches along the edge of bone, 1 times per 10min needle, 1 times/d, and the treatment of the same control group by Xuanfu Daizhe decoction. The continuous treatment of 5d was 1 courses. Observation of clinical symptoms, hiccup disappearance time and adverse reactions. 2 courses of continuous treatment （10d） were used to determine the curative effect. [Results] In the treatment group, 25 cases were cured, 6 cases were effective, 1 cases were invalid and the total effective rate was 96.88%. The control group recovered 7 cases, 18 cases were effective, 7 cases were invalid and the total effective rate was 78.13%. The curative effect of the treatment group was better than that of the control group （P〈0.05）. The hiccup disappeared time in the treatment group was shorter than that in the control group （P〈0.01）. [Conclusion] Acupuncture at Zhong wan point combined with Xuanfu Daizhe decoction has satisfactory effect on glucocorticoid hiccup （Weixu Tanzu Qini）, and no serious adverse reactions are observed. It is worth promoting.