针药结合思想在脾虚气滞型糖尿病胃轻瘫患者中的应用

Combination of Acupuncture and Medication Treating DGP of the Syndrome of Spleen Deficiency and Qi Stagnation

目的:通过观察针刺胃俞募穴联合健脾固本和胃方治疗脾虚气滞型2型糖尿病胃轻瘫患者的临床疗效,评价针药结合思想在治疗糖尿病胃轻瘫中的应用价值。方法:将108例符合纳入标准的脾虚气滞型2型糖尿病胃轻瘫患者随机分为针刺胃俞募穴联合健脾固本和胃方组、针刺胃俞募穴组、健脾固本和胃方组,观察各组患者治疗前后的临床症状积分、血浆胃动素、胃排空率变化。结果:各组临床有效率分别为针刺胃俞募穴组76. 47%(26/34),健脾固本和胃方组69. 44%(25/36),针刺胃俞募穴联合健脾固本和胃方组96. 97%(32/33),后者与前二者比较均有统计学差异(P <0. 01),而针刺胃俞募穴组与健脾固本和胃方组之间比较无统计学差异(P> 0. 05)。针刺胃俞募穴联合健脾固本和胃方组在改善血浆胃动素方面与针刺胃俞募穴组、健脾固本和胃方组比较有统计学差异(P <0. 05);在改善胃排空率方面,针刺胃俞募穴联合健脾固本和胃方组与针刺组相比有统计学差异(P <0. 05),余者相比无统计学差异(P> 0. 05)。结论:针刺胃俞募穴联合健脾固本和胃方是治疗糖尿病胃轻瘫(脾虚气滞型)的有效方法,针药结合在治疗糖尿病胃轻瘫中具有良好的应用价值。

Objective: To observe the clinical effect of needling back-shu and front-mu acupoints of Stomach combined with Jianpi Guben Hewei Decoction in the treatment of type 2 Diabetic Gastroparesis(DGP) of Spleen deficiency and qi stagnation pattern, thus to evaluate the value of the combination of acupuncture and medication for DGP. Methods: 108 DGP patients with Spleen deficiency and qi stagnation pattern were randomly divided into the combination group, the acupuncture group, and the medication group. The combination group was treated with needling back-shu and front-mu acupoints of Stomach combined with Jianpi Guben Hewei Decoction, the acupuncture group was treated with needling back-shu and front-mu acupoints of Stomach, and the medication group was treated with Jianpi Guben Hewei Decoction. The clinical symptoms, plasma motilin and gastric emptying rate were observed before and after the treatment. Results: The clinical effective rate was 76.47% in the acupuncture group, it was 69.44% in the medication group, and it was 96.97% in the combination group;of which, the combination group was statistically higher than the other two groups( P<0.01);however, there was no statistical difference between the acupuncture group and the medication group( P >0.05). The combination group was statistically different from the other two groups in terms of improving plasma motilin( P<0.05). There was statistical difference between the combination group and the acupuncture group in improving the gastric emptying rate( P<0.05). There were no statistical differences in other indexes( P >0.05). Conclusion: Needling back-shu and front-mu acupoints of Stomach combined with Jianpi Guben Hewei Decoction is an effective method for treating DGP of Spleen deficiency and qi stagnation pattern, which has a good application value in the treatment of DGP.