旋覆代赭汤联合特定穴电针辅助治疗术后胃瘫(胃虚痰阻型)的疗效观察

Therapeutic Effect of Xuanfu Daizhe Decoction(旋覆代赭汤)Combined with Electroacupuncture at Specific Points in Treatment of Postsurgical Gastroparesis(Spleen Deficiency and Phlegm Obstruction)

目的观察并比较旋覆代赭汤联合特定穴电针与特定穴针刺辅助治疗术后胃瘫(胃虚痰阻型)的临床疗效。方法采取前瞻性研究方法,将40例外科术后发生胃瘫(胃虚痰阻型)的患者随机分为联合组20例和针刺组20例(针刺组因病情加重脱落1例)。所有患者均给予西医常规治疗。在此基础上,联合组辅助旋覆代赭汤联合特定穴(足三里、上巨虚)电针治疗,特定穴:内关、公孙、膻中、中脘、足三里、上巨虚、三阴交,1次/d。针刺组仅辅助特定穴针刺治疗,选穴同联合组(非电针),1次/d,均治疗14 d。观察并比较两组治疗前、后的胃瘫主要症状指数量表(GCSI)评分、日(24 h)胃液引流量及胃管留置时间、健康相关生活质量评分(SF-36)评分,评定两组的临床疗效。结果 (1)治疗后,两组患者的胃瘫主要症状指数量表(GCSI)评分、日(24 h)胃液引流量、健康相关生活质量评分(SF-36)均较治疗前改善(均P<0.05),且联合组的改善作用均优于针刺组(均P<0.05)。联合组胃管留置时间显著少于针刺组(P<0.05)。(2)联合组总有效率为100%(20/20),针刺组为84.21%(16/19)。联合组有效率高于针刺组(P<0.05)。结论旋覆代赭汤联合特定穴电针与特定穴针刺辅助治疗术后胃瘫均有效。而联合治疗在改善术后胃瘫(胃虚痰阻型)的恶心呕吐、腹饱胀、食欲不振等症状、减少胃液引出量、缩短胃管留置时间、提高患者的生活质量方面优于单纯针刺治疗。前者疗效优于后者。

Objective To observe and compare the clinical curative effects of Xuanfu Daizhe Decoction(旋覆代赭汤)combined with electroacupuncture at specific points and specific points acupuncture in the treatment of postsurgical gastroparesis(spleen deficiency and phlegm obstruction).Methods It was a prospective study.Forty cases of gastroparesis patients(spleen deficiency and phlegm obstruction) were randomized into combined group and acupuncture group, 20 patients in each group(1 case was dropped out due to aggravating illness in the acupuncture group).All the patients were given conventional Western medicine.On this basis, the patients were treated with Xuanfu Daizhe Decoction combined with electroacupuncture at specific point[Zusanli(ST36),Shangjuxu(ST37)] in combined group.And specific points acupuncture was adopted at Neiguan(PC6),Gongsun(SP4),Danzhong(RN17),Zhongwan(RN12),Zusanli(ST36),Shangjuxu(ST37) and Sanyinjiao(SP6),once a day.The acupuncture group was additionally treated with specific points acupuncture.The acupoints selection and manipulation were the same as that in the treatment group(with no electroacupuncture),once a day.All patients were treated for 14 days.The gastroparesis cardinal symptom index(GCSI),gastric juice drainage volume and gastric tube indwelling time and MOS36-Item Short-Form Health Survey(SF-36) of the two groups were observed and compared before and after treatment in both groups, and the clinical effects were assessed.Results(1)After treatment, the gastroparesis cardinal symptom index(GCSI)score, gastric juice drainage volume and the MOS36-Item Short-Form Health Survey(SF-36) score in the two groups were significantly improved(all P<0.05),and the improvements of the combined group were superior to that of the acupuncture group(all P<0.05).The gastric tube indwelling time in the combined group was less than that in the acupuncture group(P<0.05).(2)The total effective rate was 100%(20/20) in the combined group and 84.21%(16/19) in acupuncture group.The effective rate of the combined group was higher than that of the acupuncture group(P<0.05).Conclusion Both of the two methods(Xuanfu Daizhe Decoction combined with electroacupuncture at specific points and specific points acupuncture) have therapeutic effect on gastroparesis.But the combined therapy is better than specific points acupuncture in improving the symptoms of postoperative gastroparesis(spleen deficiency and phlegm obstruction),such as nausea, vomiting, fullness and anorexia, reducing the amount of gastric juice, shortening the time of gastric tube indwelling and improving life quality.The former has better curative effect than the latter.