穴位贴敷联合腹式呼吸训练治疗胃食管反流病患者的疗效观察

Clinical Effect of Acupoint Application Combined with Abdominal Breathing Training in Treatment of Patients with Gastroesophageal Reflux Disease

目的探讨穴位贴敷联合腹式呼吸训练治疗胃食管反流病患者的疗效观察。方法选取2019年9月—2021年1月期间在张家港市中医医院接受诊治的肝胃郁热证型胃食管反流病患者90例,按照随机数字表法分为对照组和观察组,各45例。对照组给予常规护理联合埃索美拉唑治疗,观察组在对照组治疗基础上给予穴位贴敷联合腹式呼吸训练治疗。治疗4周后,观察比较两组患者临床疗效、治疗前后中医症状(反酸、烧心、胸骨后疼痛、暧气、胃脘灼痛)积分、生活质量、内镜积分、食管下括约肌(Low esophageal sphincter,LES)静息压力、食管pH值检测结果。结果治疗后观察组治疗总有效率95.56%(43/45)明显高于对照组82.22%(37/45),差异有统计学意义(P<0.05)。治疗后两组患者中医症状评分均明显低于治疗前,差异有统计学意义(P<0.05);且观察组明显低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者心理健康、治疗情况、饮食情况、日常活动评分均明显高于治疗前,差异有统计学意义(P<0.05);且观察组评分均明显高于对照组,差异有统计学意义(P<0.05)。治疗后两组患者内镜积分明显低于治疗前,LES静息压明显高于治疗前,差异有统计学意义(P<0.05);且观察组内镜积分明显低于对照组,LES静息压明显高于对照组,差异有统计学意义(P<0.05)。治疗后反流持续时间≥5 min次数、两组pH值<4的时间、DeMeester评分均明显低于治疗前,差异有统计学意义(P<0.05);且观察组明显低于对照组,差异有统计学意义(P<0.05)。结论采用穴位贴敷联合腹式呼吸训练治疗胃食管反流病患者疗效显著,可显著提高LES静息压力,改善患者食管胃内容物反流情况,缓解临床症状,提高患者生活质量。

Objective To explore the clinical effect of acupoint application combined with abdominal breathing training in the treatment of patients with gastroesophageal reflux disease,in order to provide reference for the selection of clinical treatment methods.Methods A total of 90 patients with gastroesophageal reflux disease of liver and stomach stagnation-heat syndrome who were diagnosed and treated in Zhangjiagang Hospital of Traditional Chinese Medicine from September 2019 to January 2021 were selected and divided into a control group and an observation group according to a random number table,with 45 in each group.Patients in the control group were given conventional nursing care combined with esomeprazole,and those in the observation group received acupoint application combined with abdominal breathing training on the basis of the treatment in the control group.After 4 weeks of treatment,the clinical effect of the two groups was compared.In addition,the traditional Chinese medicine(TCM)syndrome(acid regurgitation,heartburn,retrosternal pain,belching,and epigastric pain)score,quality of life,endoscopic score,lower esophageal sphincter(LES)resting pressure,and esophageal pH were compared between the two groups before and after treatment.Results The total effective rate in the observation group was 95.56%(43/45),which was higher than 82.22%(37/45)in the control group(P<0.05).After treatment,the TCM symptom score,endoscopic score,number of reflux duration≥5 min,time of pH<4 and DeMeester score of the two groups were lower than those before treatment(all P<0.05),with the observation group having more obvious decrease than the control group(P<0.05).Moreover,the scores of mental health,treatment,diet,and daily activityas well as LES resting pressure in the two groups were higher than those before treatment(all P<0.05),with the observation group having more obvious increase than the control group(P<0.05).Conclusion Acupoint application combined with abdominal breathing training achieved a significant effect in treating patients with gastroesophageal reflux disease,which could markedly increase the LES resting pressure,reduce the reflux of esophageal and gastric contents in patients,alleviate clinical symptoms and improve the quality of life of patients.