针药并用治疗肝胃郁热型反流性食管炎临床观察

Clinical Observation of Acupuncture plus Medication for Reflux Esophagitis Due to Stagnated Heat in Liver and Stomach

目的观察针药并用治疗肝胃郁热型反流性食管炎的临床疗效。方法根据患者入院先后顺序进行系统抽样,按1:1:1:1匹配均分为西药组、针刺组、中药组、针药组,每组47例。比较各组患者治疗前后5-羟色胺(5-HT)、舒血管肠肽(VIP)和内皮素(ET)、RDQ积分、内镜检查积分以及临床疗效的统计学差异。结果 4组治疗前5-HT比较差异无统计学意义(P>0.05),4组治疗后5-HT、VIP比较差异均有统计学意义(P<0.05);治疗后两两比较,5-HT(西药组与针刺组、针刺组与中药组、针刺组与针药组)、VIP(西药组与针刺组、西药组与中药组、西药组与针药组)指标差异均有统计学意义(P<0.05);4组治疗后胸骨后不适、食物反流、反酸指标比较差异均有统计学意义(P<0.05);治疗后与治疗前比较,4组内镜检查积分的差异均有统计学意义(P<0.05);治疗后内镜检查积分进行两两组间比较,西药组和针药组、针刺组和针药组、中药组和针药组之间的差异均有统计学意义(P<0.05);4组临床疗效、复发情况比较差异均有统计学意义(P<0.05)。结论单纯西药治疗、单纯针刺治疗、单纯中药治疗和针刺联合西药治疗对肝胃郁热型反流性食管炎有一定的疗效,但其中针刺联合西药治疗肝胃郁热型反流性食管炎的临床疗效更佳。

Objective To observe the clinical efficacy of acupuncture plus medication in treating reflux esophagitis due to stagnated heat in liver and stomach. Method Systematic sampling was performed according to the admission sequence, and the patients were allocated to a Western medication group, an acupuncture group, a Chinese medication group and an acupuncture-medication group at 1：1：1：1, with 47 cases in each group. The changes in 5-hydroxetryptine （5-HT）, vasoactive intestine peptide （VIP）, endothelin （ET）, Reflux Disease Questionnaire （RDQ） score and endoscopy score after the treatment and clinical efficacies were compared. Result There were no significant differences in the level of 5-HT among the four groups before the treatment （P〉0.05）; there were significant differences in the levels of 5-HT and VIP among the four groups after the treatment （P〈0.05）; the post-treatment paired comparisons showed significant differences in the levels of 5-HT （the Western medication group versus the acupuncture group, the acupuncture group versus the Chinese medication group, and the acupuncture group versus the acupuncture-medicationgroup） and VIP （the Western medication group versus the acupuncture group, the Western medication group versus the Chinese medication group, and the Western medication group versus the acupuncture-medication group）, （P〈0.05）; there were significant differences in the scores of retrosternal discomfort, food reflux and acid reflux among the four groups after the treatment （P〈0.05）; the endoscopy scores changed significantly in the four groups after the treatment （P〈0.05）; the post-treatment paired comparisons revealed significant differences in the endoscopy score between the Western medication group and the acupuncture-medication group, between the acupuncture group and theacupuncture- medication group, and between the Chinese medication group and the acupuncture-medication group （P〈0.05）; there were significant differences in the clinical efficacy and relapse among the four groups （P〈0.05）. Conclusion Western medication, acupuncture or Western medication used alone and acupuncture plus Western medication all can produce certain therapeutic efficacy in treating reflux esophagitis due to stagnated heat in liver and stomach, but acupuncture plus Western medication can produce the most significant efficacy.