至阳八阵穴隔附子饼灸治疗糖尿病胃轻瘫临床研究

Clinical Study of Aconite Cake-partitioned Moxibustion at Zhiyang Bazhen Points for Diabetic Gastroparesis

目的观察至阳八阵穴隔附子饼灸治疗脾胃气虚型糖尿病胃轻瘫的疗效及对胃泌素(GAS)、胃动素(MTL)和血管活性肠肽(VIP)水平的影响。方法86例脾胃气虚型糖尿病胃轻瘫患者随机分为对照组和治疗组,每组43例。治疗组给予至阳八阵穴隔附子饼灸;对照组口服枸橼酸莫沙必利片。治疗12周后观察胃轻瘫主要症状指数量表症状积分改善情况、胃排空率及血清GAS、MTL、VIP水平。结果治疗组治疗后在胃轻瘫主要症状指数量表症状积分及胃排空率方面明显高于对照组,差异均有统计学意义(P<0.05)。治疗组治疗后血清GAS、MTL水平明显高于对照组,血清VIP水平明显低于对照组,差异均有统计学意义(P<0.05)。治疗组总有效率为90.7%,明显高于对照组的72.1%(P<0.05)。结论采用至阳八阵穴隔附子饼灸能快速促进糖尿病胃轻瘫患者胃功能的恢复,改善症状和体征,其作用机制可能与升高患者血清GAS和MTL水平,降低VIP水平有关。

Objective To observe the efficacy of Aconite cake-partitioned moxibustion at Zhiyang Bazhen points[eight acupoints with Zhiyang(GV9)as the center]in treating diabetic gastroparesis due to spleen-stomach qi deficiency,and its effects on the levels of gastrin(GAS),motilin(MTL)and vasoactive intestinal peptide(VIP).Method Eighty-six patients with diabetic gastroparesis due to spleen-stomach qi deficiency were recruited and randomized into a control group and a treatment group,with 43 cases in each group.The treatment group was given Aconite cake-partitioned moxibustion at Zhiyang Bazhen points;the control group was intervened by oral administration of Mosapride citrate tablets.After 12-week treatment,the improvements in the symptom scores of Gastroparesis Cardinal Symptom Index(GCSI),gastric emptying rate and serum levels of GAS,MTL and VIP were observed.Result After treatment,the symptom scores of GCSI and gastric emptying rate were obviously higher in the treatment group than in the control group,and the differences were statistically significant(P<0.05).After treatment,the levels of GAS and MTL were obviously higher and the level of VIP was obviously lower in the treatment group than in the control group,and the differences were statistically significant(P<0.05).The total effective rate was 90.7%in the treatment group,notably higher than that in the control group(72.1%)(P<0.05).Conclusion Aconite cake-partitioned moxibustion at Zhiyang Bazhen points can efficiently boost the recovery of gastric function and improve the symptoms and signs in patients with diabetic gastroparesis,and the mechanism may be associated with the up-regulation of serum levels of GAS and MTL and the inhibition of the level of VIP.