针刺四缝穴治疗儿童厌食症脾失健运证临床研究

Clinical Study on Acupuncture at Sifeng Point for Infantile Anorexia Nervosa with Spleen Failing in Transportation Syndrome

目的:观察针刺四缝穴治疗儿童厌食症脾失健运证的临床疗效。方法:选取儿童厌食症患者80例,随机分为2组各40例。对照组给予不换金正气散中药口服,针刺组给予针刺四缝穴治疗,2组均治疗8周后,观察2组临床疗效、治疗前后中医证候积分变化,体质量变化情况,以及血清胃泌素(GAS)、胃动素(MOT)及神经肽Y (NPY)的变化情况,并于治疗结束后随访3个月统计复发率。结果:治疗8周后,临床疗效总有效率针刺组92.5%,对照组72.5%,2组比较,差异有统计学意义(P<0.05)。与治疗前比较,2组治疗4周后、治疗8周后中医证候积分均有明显降低,且针刺组中医证候积分均低于同期对照组,差异均有统计学意义(P<0.05)。与治疗前比较,治疗4周后、治疗8周后2组GAS、MOT、NPY均明显高于治疗前,且针刺组GAS、MOT、NPY均高于同期对照组,差异均有统计学意义(P<0.05)。治疗8周后,2组体质量均有明显增长,且针刺组体质量高于对照组,差异均有统计学意义(P<0.05)。2组治疗期间经血尿粪常规、肝肾功能及心电图检查,未发现因治疗方案引起的严重不良反应。随访3个月,复发率针刺组5.4%,对照组27.6%,2组复发率比较,差异有统计学意义(P<0.05)。结论:采用针刺四缝穴治疗儿童厌食症脾失健运证疗效显著,可有效减少中医症状总积分,改善患儿厌食症状,提高患儿体内胃肠激素水平,促进体质量增长,降低复发率。

Objective:To observe the clinical effect of the therapy of acupuncture at Sifeng point(EXUE10) on infantile anorexia nervosa with spleen falling in transportation syndrome. Method: A total of80 cases of infantile anorexia nervosa were randomly divided into the two groups,with 40 cases in each group. The control group was given Buhuanjin Zhengqi Powder orally, the acupuncture group was given acupuncture at Sifeng point. Both groups were treated for 8 weeks. The clinical effects after treatment and the changes of traditional Chinese medicine(TCM) syndrome scores,body mass as well as serum gastrin(GAS),motilin(MOT) and neuropeptide Y(NPY) in the two groups were observed. After treatment,the recurrence rates were counted after 3 months of following up. Results:After eight weeks of treatment,the total clinical effective rate was 92.5% in the acupuncture group and 72.5% in the control group,the difference being significant(P<0.05). After 4 and 8 weeks of treatment,the TCM syndrome scores in the two groups were significantly decreased when compared with those before treatment respectively, and the TCM syndrome scores in the acupuncture group was lower than those in the control group at the same time,differences being significant(P<0.05). After 4 and 8 weeks of treatment,the GAS,MOT and NYP in the two groups were significantly higher than those before treatment respectively,and the above three indexes in the acupuncture group were higher than those in the control group at the same time,differences being significant(P<0.05). After 8 weeks of treatment,the body mass in the two groups were significantly increased when compared with those before treatment,and the body mass in the acupuncture group was higher than that in the control group,differences being significant(P<0.05). During treatment,no serious adverse reactions caused by the treatment plan was found in the two groups after performing the stool routine, liver and kidney function and electrocardiogram examination. Following up for 3 months, the recurrence rate was 5.4% in the acupuncture group and 27.6% in the control group,the difference being significant(P<0.05). Conclusion:The therapy of acupuncture at Sifeng point has a good curative effect on infantile anorexia nervosa with spleen falling in transportation syndrome,which can effectively reduce the TCM syndrome score, improve the symptoms of patients with infantile anorexia nervosa, enhance the levels of gastrointestinal hormones in the body,promote the increase of the body mass,and lower the recurrence rate.