超声引导下针刺足三里穴对胃窦收缩功能的影响:随机对照研究

Effect of Acupuncture at Zusanli(ST36) on Antral Contraction Function under Ultrasound Guidance: A Randomized Controlled Trial

目的观察超声引导下针刺足三里穴得气与不得气对胃窦收缩功能的影响。方法将符合纳入标准的72例健康受试者,按照1∶1随机分配到观察组和对照组,每组36例。在超声引导下针刺受试者右侧足三里穴,观察组针刺深度到达小腿骨间膜处,施以提插捻转手法使之得气,对照组针刺深度到达浅筋膜处,不运针,不要求得气,应用受试者针感临床评价量表、胃脘部热红外成像与胃窦运动超声数据进行评估,比较两组针刺前后胃窦收缩频率的变化。结果观察组完成35例,脱落1例;对照组完成34例,脱落2例。两组间比较,受试者针感临床评价量表评分、胃窦收缩频率、胃窦收缩幅度与胃窦运动指数在针刺得气后差异具有统计学意义(P <0.05);观察组针刺前后胃窦收缩频率、胃窦收缩幅度与胃窦运动指数比较差异具有统计学意义(P <0.05),以胃窦收缩频率增加、收缩幅度增大及运动指数增加为主要表现;对照组针刺前后胃窦收缩频率、胃窦运动幅度与胃窦收缩指数比较差异均无统计学意义(P> 0.05);观察组与对照组针刺前后胃脘部皮肤温度变化差异无统计学意义(P> 0.05)。结论针刺足三里穴得气可一定程度改变胃窦运动功能,超声成像技术能有效引导针刺操作并实时观察记录胃窦运动变化,安全高效,值得临床推广与应用。

Objective To observe the effect of deqi and not deqi on antral contraction function by acupuncture at Zusanli(ST36) under ultrasonic guidance. Methods A total of 72 healthy subjects who met the inclusion criteria were randomly assigned to the observation group(36 cases) and the control group(36 cases) with the 1∶1 ratio. Acupuncturing the subjects at the right Zusanli(ST36) guided by ultrasound. The needling depth in the observation group reached the crural interosseous membrane with lifting-thrusting and twirling-rotating manipulation to make the subjects produce deqi sensations. While needling depth in the control group just reached the superficial fascia without any manipulation and deqi sensations obtained. The clinical evaluation scale of acupuncture sensation, epigastric thermal infrared imaging and antral motility ultrasound data were used to evaluate the changes of antral contraction frequency before and after acupuncture in the two groups. Results Totally three participants dropped out, two in control group and one in observation group respectively. The rest 69 subjects were analyzed. Compared with those before acupuncture, there were statistically significant differences between the two groups in the scores of acupuncture clinical evaluation scale, antral contraction frequency,antral contraction amplitude and antral motility index after acupuncture(P < 0.05). The main manifestations were the increase of antral contraction frequency, antral contraction amplitude and antral motility index.Compared with the control group, there was statistical difference in the observation group of antral contraction frequency,antral contraction amplitude and antral motility index(P < 0.05). However, there was no statistical significance in epigastric thermal infrared imaging between 2 groups or both of two groups before and after acupuncture(P > 0.05).Conclusion Acupuncture at Zusanli(ST36) with deqi sensations can change the motility function of gastric antrum to some extent. Acupuncture manipulation and the motility changes of gastric antrum can be observed and recorded by ultrasonic imaging technology effectively in real time, which is has highly safety and efficiency and worthy of clinical application.