循按揣穴法进针对针刺治疗胃食管反流病进行随机对照研究的分析

观察循按揣穴法进针对针刺治疗胃食管反流病疗效的影响。方法 ?收集因食道反流接受针刺治疗的患者作为研究样本,并随机分为两组,即循揣组和对照组。两组在相同的取穴方案基础上采用了不同的进针方案:循揣组采用循按揣穴法确定进针点,对照组在腧穴标准定位进针。疗程4周,随访8周。采用耐信量表(RDQ)、焦虑、抑郁自评量表(SAS、SDS)、匹兹堡睡眠指数(PSQI)比较两组患者在开始接受治疗后第4周、第6周、第8周的疗效、反流症状、焦虑抑郁状态和睡眠质量。结果 在治疗后的各个观测时点中,与对照组相比,循揣组获得了更优的疗效;同时,循揣组测得更低的耐信量表评分、焦虑和抑郁评分、以及睡眠障碍评分。以上所述的组间差异均有显著性(P<0.05)。结论 循按揣穴进针法可以更准确的定位腧穴,提高针刺的临床疗效。

胃食管反流病证候分布及中医辨治思路的探讨

探讨胃食管反流病(GERD)证候分布及中医辨证治疗的思路。方法 选取本院2023年4月-2024年4月收治的94例GRED患者,随机分为A组和B组,两组均进行中医证候分型,A组给予常规治疗,B组给予中医辩证治疗,对比两组临床治疗效果。结果 经中医证候分型,GERD中有肝胃不和型21例(22.34%)、肝胃郁热型15例(15.96%)、脾胃湿热型14例(14.89%)、脾胃虚寒型11例(11.70%)、胃阴不足型10例(10.64%)、胆热犯胃型10例(10.64%)、中虚气逆型7例(7.45%)、痰气郁阻型6例(6.38%);证候分布中,肝胃不和型多为男性,脾胃虚寒型与胃阴不足型多为女性,不同证型的年龄分布无明显差异,中虚气逆型和痰气郁阻型多分布于肥胖患者群体;B组治疗有效率(93.62%)显著高于A组(82.98%),P<0.05。结论 在GERD临床治疗中,可进行具体的中医证候分型,根据其分布规律给予辩证治疗,能够有效提升疾病治疗效果。

针刺治疗难治性胃食管反流病30例

胃食管反流病（GERD）是指胃内容物反流人食管引起不适症状或食管黏膜损伤的疾病，主要表现为烧心、泛酸、胸骨后疼痛等反流相关症状。抑酸治疗是针对本病的首选治疗方法。临床上应用质子泵抑制剂（PPI）治疗一段时间效果较差的病例，称为难治性GERD。此型多见于非糜烂性反流病（NERD），常伴焦虑、抑郁等异常心理，往往增加患者就诊率，影响生活质量。笔者近年来应用针刺治疗难治性NERD患者30例，现报道如下。

Preliminary optimization of acupuncture regimen at Nèiguān(PC 6) for gastroesophageal reflux disease

Objective:To optimize preliminarily acupuncture regimen for gastroesophageal reflux disease(GERD).Methods:A total of 80 patients of GERD were taken as the subjects in observation.The reflux disease questionnaire(RDQ)was adopted to assess the relevant indicators.The orthogonal design method was used to observe the effects on GERD in acupuncture regimen with difference combinations among 5 factors and 2 levels at Nèiguān(内关 PC 6),including reinforcing-reducing technique by rotating needle(A),time of rotating needle(B),supplementary acupoint(C),time of needle retention(D)and treatment interval(E).The primary and secondary functions among 5 factors(variance analysis),advantages and disadvantages between 2 levels(multiplicity comparison)and superiority combination of 5 factors and 2 levels were determined preliminarily.Results:The reinforcing-reducing technique by rotating needle and the supplementary acupoint are the primary factors of therapeutic effects.The time of rotating needle,treatment interval and time of needle retention were the secondary factors.Conclusion:In the observation of five factors and two levels,the optimal regimen of acupuncture for GERD includes reducing technique by rotating needle at PC 6,the time of rotating needle for 60 s,Zúsānlǐ(足三里 ST 36)and Tàichōng(太冲 LR 3)as the supplementary acupoints,needle retention for 30 min and treatment interval of 24 h.

Jiāwèi Wǔbèizǐsǎn(Supplemented Galla Chinensis Powder) application on the navel for different syndromes of profuse sweating after tumor chemotherapy

Objective To observe the clinical efficacy of Jiāwèi Wǔbèizǐ sǎn（加味五倍子散,Supplemented Galla Chinensis Powder） application on the different syndromes of profuse sweating after tumor chemotherapy.Methods One hundred and sixty patients with profuse sweating after tumor chemotherapy were randomly divided into a control group（n=80） and a treatment group（n=80）.Placebo application was carried out in the control group,and traditional Chinese medicine application was conducted in the treatment group.Treatment for 7 days was considered as 1 course of treatment.Results In treatment group,48 patients were cured,improvement was found in25 cases,and ineffectiveness was seen in 7 cases.For the patients with lungwei insecurity syndrome,19 cases were cured,improvement was found in10 cases,and ineffectiveness was seen in 1 case;for the patients with deficiency of both qi and yin,27 cases were cured,improvement was found in 9 cases,and ineffectiveness was seen in 2 cases;for the patients with vigorous fire due to yin deficiency,3 cases were cured,improvement was found in5 cases,and ineffectiveness was seen in 4 cases.According to statistical analysis,the total efficacy of treatment group was superior to that of control group（P0.05）.The efficacy on lung-wei insecurity and deficiency of both qi and yin of treatment group was superior to that of control group（both P0.05）,but there was no obvious difference between treatment group and control group in the efficacy on vigorous fire due to yin deficiency（P0.05）.Conclusion Supplemented Galla Chinensis Powder application on the navel can effectively improve the profuse sweating syndrome of patients in the types of lung-wei insecurity and deficiency of both qi and yin after tumor chemotherapy,but the efficacy is not so good for the patients in the type of vigorous fire due to yin deficiency.