针刺督脉背段T3~T12棘突下治疗胃食管反流性胸痛临床研究

Clinical Study on the Therapeutic Effects of Gastroesophageal Reflux Related Chest Pain by Needling the Dorsal Segment of Governor Vessel from T3~T12

目的:研究胃食管反流性胸痛的患者针刺督脉背段T 3~T 12棘突下穴位及非穴位前后压痛变化规律,并观察其疗效。方法:根据纳入标准收集60例胃食管反流性胸痛患者,按照随机数字表法分为针刺组30例、西药组30例。针刺组予针刺督脉背段T 3~T 12棘突下穴位及非穴位治疗,隔日1次,西药组予雷贝拉唑钠肠溶胶囊口服,每次20 mg,1日两次,治疗疗程为8周。比较两组患者胃食管反流病问卷(RDQ)评分以及其中的胸痛评分在治疗前后的变化情况,比较T 3~T 12棘突下穴位及非穴位压痛阈值的变化情况,观察两组患者在治疗前后的临床疗效。结果:①治疗后针刺组与西药组RDQ评分以及其中的胸痛评分较治疗前均有明显改善(P<0.01),且针刺组较西药组改善更为明显(P<0.01);②西药组治疗后T 4、T 5、T 7、T 8、T 9棘突下的压痛阈值较治疗前降低(P<0.05或P<0.01),针刺组治疗后T 5~T 12棘突下的压痛阈值较治疗前明显提高(P<0.05或P<0.01),治疗后针刺组与西药组进行比较,针刺组在T 6~T 9棘突下的穴位压痛阈值高于西药组较明显(P<0.05);③针刺组愈显率为76.67%(23/30),西药组为30.00%(9/30),临床疗效针刺组优于西药组(P<0.01)。结论:针刺督脉背段T 3~T 12棘突下穴位及非穴位治疗胃食管反流性胸痛较西药雷贝拉唑钠肠溶胶囊更优,可以明显减轻胸痛程度。

Objective:To study the change of tenderness and the effects on gastroesophageal reflux related chest pain after needling the dorsal segment of Governor Vessel in the depressions of the spinous process from T 3 to T 12.Methods:According to the inclusion criteria,60 patients with gastroesophageal reflux related chest pain were randomly divided into the acupuncture group and the western medication group,with 30 cases in each group.The acupuncture group was treated with needling acupoints of the dorsal segment of Governor Vessel in the depressions of the spinous process from T 3~T 12,once every other day and 3 sessions a week.The western medication group was treated with Rabeprazole Sodium Enteric-coated Capsules,20 mg each time,twice a day.Both groups were treated for 8 weeks.The change of the scores of gastroesophageal reflux disease questionnaire RDQ and the chest pain were compared in the two groups before and after the treatment.The change of tenderness in the depression of spinous process from T 3 to T 12 were compared as well and the therapeutic effects were evaluated in the two groups.Results:The scores of RDQ and chest pain were significantly improved in the two groups after the treatment(P<0.01);the improvement was more significant in the acupuncture group(P<0.01).The tenderness threshold under T 3,T 4,T 5,T 7,T 8,T 9,T 10,and T 12 spinous processes was lower after the treatment than that before the treatment in the western medication group(P<0.05).The tenderness threshold from T 3 to T 12 spinous processes was lower after the treatment than that before the treatment in the acupuncture group(P<0.05).The tenderness threshold under the spinous process of T 6,T 7,T 8,and T 9 was significantly higher in the acupuncture group than that in the western medication group after the treatment(P<0.05).The marked effective rate was 76.67%(23/30)in the acupuncture group,which was significantly higher than 30.00%(9/30)in the western medication group(P<0.01).Conclusion:Needling acupoints and non-acupoints of T 3-T 12 in the dorsal segment of Governor Vessel is more effective than western medication Rabeprazole Sodium Enteric-coated Capsules,the needling can significantly relieve the chest pain caused by gastroesophageal reflux.