经络诊察取穴法针刺治疗慢性萎缩性胃炎疗效观察

Acupuncture based on meridian diagnosis for chronic atrophic gastritis

目的:比较经络诊察取穴法与常规取穴法针刺治疗慢性萎缩性胃炎的疗效。方法:将70例慢性萎缩性胃炎患者随机分为观察组(35例,脱落5例)与对照组(35例,脱落5例)。观察组根据手察经络法及八十道经络能量测定仪检测结果综合辨经选穴,按照实则泻其子、虚则补其母的原则,实证选择加络穴、背俞穴,虚证选择加原穴、募穴、足经的合穴,奇经八脉穴根据穴性原则加减。对照组主穴取中脘、内关、足三里、公孙,并根据辨证配穴。两组均每周治疗2次(周二、周四各1次),连续治疗6个月,并于治疗后6个月随访。比较两组治疗前后及随访时临床症状评分、胃肠病患者报告的结局指标(PRO)量表评分及治疗前后胃黏膜病理组织变化评分。结果:治疗后、随访时,两组患者临床症状评分、胃肠病PRO量表评分均降低(P<0.01,P<0.001);随访时,观察组胃肠病PRO量表评分低于对照组(P<0.01)。治疗后,两组患者胃黏膜病理组织变化评分均降低(P<0.01),观察组低于对照组(P<0.05)。结论:经络诊察取穴法针刺治疗慢性萎缩性胃炎的疗效较常规取穴法更佳,对胃黏膜病理改善作用更显著,且远期疗效稳定。

Objective To compare the efficacy between acupoint selection of meridian diagnosis and regular acupoint selection for chronic atrophic gastritis(CAG).Methods A total of 70 cases of CAG were randomly divided into an observation group(35 cases,5 cases dropped off)and a control group(35 cases,5 dropped off).In the observation group,according to the hand diagnosis of meridians and the results of 80-channels energy determinator,based on the principle of child-mother relation acupoint combination,the luo-connecting point and back-shu points were added for excess syndrome,and the yuan-primary point,front-mu points and he-sea point of foot meridians were added for deficiency syndrome;in addition,the acupoints of the eight extraordinary meridians were added based on the nature of acupoints.In the control group,Zhongwan(CV 12),Neiguan(PC 6),Zusanli(ST 36)and Gongsun(SP 4)were selected as the primary acupoints,and additional acupoints were added according to syndrome differentiation.The two groups were treated twice a week(Tuesday and Thursday,respectively),totally for 6 months.Six months after treatment,the follow-up was conducted.The clinical symptom score,gastroenteropathy patient reported outcomes(PRO)scale score before treatment,after treatment and during follow-up as well as the score of pathological changes of gastric mucosa before and after treatment were compared between the two groups.Results After treatment and during follow-up,the clinical symptom scores and gastroenteropathy PRO scale scores were decreased in the two groups(P<0.01,P<0.001);at the follow-up,the gastroenteropathy PRO scale score in the observation group was lower than that in the control group(P<0.01).After treatment,the scores of pathological changes of gastric mucosa in the two groups were decreased(P<0.01),and the score in the observation group was lower than that in the control group(P<0.05).Conclusion The acupoint selection of meridian diagnosis is superior to regular acupoint selection for CAG,which has better efficacy,more significant improvement on gastric mucosa pathology,and more stable long-term effect.