电针腧穴治疗胃溃疡的疗效及对血清HSP70、TNF-α、IL-6水平的影响

Effect of Electro-acupuncture at Acupoints on Gastric Ulcer and Its Influence on Levels of Serum HSP70, TNF-α and IL-6

目的:观察电针腧穴联合四联疗法治疗胃溃疡的临床效果。方法:选取2016年10月~2018年10月116例胃溃疡患者为研究对象,按随机数字表法分为治疗组与对照组各58例,对照组采用埃索美拉唑(20mg/次,2次/日)+胶体果胶铋胶囊(100mg/次,3次/日)+阿莫西林(0.5g/次,3次/日)+克拉霉素(0.5g/次,2次/日)四联疗法,治疗组在对照组之上,给予电针腧穴(中脘、公孙、梁丘、内关、足三里)治疗,频率30Hz,留针时间30min,治疗1个月后,比较两组症状缓解时间,治疗前后血清核因子(NF-κB)、热休克蛋白70(HSP70)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)水平,评价两组临床疗效,并观察1年内Hp及溃疡复发情况。结果:治疗组上腹痛、上腹胀、食欲不振缓解时间显著短于对照组(P<0.05);治疗后,两组血清NF-κB、TNF-α、IL-6水平均显著低于治疗前、HSP70水平显著高于治疗前(P<0.05),且治疗组各指标降低或升高幅度大于对照组(P<0.05);两组临床疗效比较差异有统计学意义(P<0.05),且治疗组显效率86.21%,显著高于对照组的68.97%(P<0.05);治疗组Hp复发率5.17%,溃疡复发率3.45%,对照组Hp复发率10.34%,溃疡复发率8.62%,但比较差异均无统计学意义(P>0.05)。结论:胃溃疡患者在四联疗法基础上,辅以电针腧穴治疗,可以促进患者腹痛腹胀等症状缓解,调节炎症水平,提高临床疗效。

Objective:To observe the clinical effect of applying electro-acupuncture at acupoints combined with quadruple therapy in the treatment of gastric ulcer.Methods:A total of 116 patients with gastric ulcer from October 2016 to October 2018 were selected for the study.The patients were divided into treatment group and controlled group according to the random number table method, with 58 cases in each group.The controlled group was treated with quadruple therapy of Esomeprazole(20 mg/time, twice/d)+Colloidal Bismuth Pectin Capsules(100 mg/time, 3 times/d)+Amoxicillin(0.5 g/time, 3 times/d)+ Clarithromycin(0.5 g/time, twice/d), and the treatment group was given electro-acupuncture at acupoints(Zhongwan, Gongsun, Liangqiu,Neiguan, Zusanli) with frequency of 30 Hz and needle retention time of 30 min on the basis of the controlled group.After 1 month of treatment, the relief times of symptoms, and levels of serum nuclear factor(NF-κB), heat shock protein 70(HSP70), tumor necrosis factor-α(TNF-α) and interleukin-6(IL-6) before and after treatment were compared between the two groups, and the clinical efficacy was evaluated in the two groups, and the Hp and ulcer recurrence were observed within 1 year.Results:The relief times of upper abdominal pain, upper abdominal distension and loss of appetite in the treatment group were significantly shorter than those in the controlled group(P<0.05).After treatment, the levels of serum NF-κB, TNF-α and IL-6 in the two groups were significantly lower than those before treatment while the HSP70 level was significantly higher than that before treatment(P<0.05), and the decreases or increase of indexes in the treatment group were greater than those in the controlled group(P<0.05).There was a statistically significant difference in the clinical efficacy between the two groups(P<0.05), and the markedly effective rate in the treatment group was significantly higher than that in the controlled group(86.21% vs 68.97%)(P<0.05).The recurrence rate of Hp and the recurrence rate of ulcer were 5.17% and 3.45% in the treatment group, and were 10.34% and 8.62% in the controlled group(P>0.05).Conclusion:On the basis of quadruple therapy for patients with gastric ulcer, electroacupuncture at acupoints can promote the relief of abdominal pain and abdominal distension, regulate inflammation level and improve clinical efficacy.