针灸配合当归四逆汤治疗慢性萎缩性胃炎疗效观察

Therapeutic Observation of Acupuncture-moxibustion Combined with Danggui Sini Decoction for Chronic Atrophic Gastritis

目的观察针灸配合当归四逆汤治疗脾胃虚寒型慢性萎缩性胃炎(CAG)的疗效。方法选择150例脾胃虚寒型CAG患者,按照密封信封法随机均分为对照组与联合组,每组75例,对照组给予当归四逆汤治疗,联合组给予针灸配合当归四逆汤治疗,治疗28 d。比较两组临床疗效与不良反应发生率,中医症候评分,胃镜下糜烂愈合疗效以及血清炎症因子水平的变化。结果两组临床总有效率比较差异有统计学意义(P<0.05),治疗过程未发生明显不良反应;两组治疗后胃脘隐痛、喜按喜暖、食后胀满、纳呆少食、大便稀溏以及倦怠无力评分明显降低(P<0.05),联合组上述评分低于对照组(P<0.05);两组治疗后胃镜下糜烂愈合显著改善(P<0.05),联合组优于对照组(P<0.05);两组治疗后血清IL-6水平显著降低(P<0.05),联合组低于对照组(P<0.05)。结论针灸配合当归四逆汤治疗脾胃虚寒型CAG患者,能够明显提升临床治疗效果,降低中医症候评分,改善患者胃镜下糜烂愈合情况,抑制血清炎症因子水平。

Objective To observe the therapeutic efficacy of acupuncture-moxibustion plus Danggui Sini decoction in treating chronic atrophic gastritis(CAG)due to deficient cold of spleen and stomach.Method A total of 150 patients with CAG due to deficient cold of spleen and stomach were recruited and randomized into a control group and a joint group using the sealed envelope method,with 75 cases in each group.The control group was given Danggui Sini decoction,and the joint group was given acupuncture-moxibustion plus Danggui Sini decoction,both lasting for 28 d.The clinical efficacy,the incidence rate of adverse reactions,and the changes in the symptoms scores of traditional Chinese medicine(TCM),erosion healing efficacy based on gastroscopy and the level of serum inflammatory factor were compared between the two groups.Result There was a significant difference in the clinical total effective rate between the two groups(P<0.05),and there did not occur any notable adverse reactions during intervention;after treatment,the scores of gastric dull pain,preference to pressing and warmth,bloating and fullness after having food,poor appetite and reduced intake,loose stool and lassitude and weakness dropped significantly in both groups(P<0.05),and were lower in the joint group than in the control group(P<0.05);the erosion showed significant improvement in both groups after treatment according to gastroscopy(P<0.05),and the joint group was superior to the control group(P<0.05);the level of serum interleukin(IL)-6 declined significantly after treatment in both groups(P<0.05),and was lower in the joint group than in the control group(P<0.05).Conclusion Acupuncture-moxibustion plus Danggui Sini decoction can notably promote the clinical treatment result,reduce the TCM symptoms scores,improve the healing of erosion under gastroscope and inhibit the level of serum inflammatory factor in the treatment of CAG due to deficient cold of spleen and stomach.