摘要
目的:观察电针联合枳术宽中胶囊治疗功能性消化不良的远期疗效及其安全性,并探讨其作用机制。方法:将320例确诊为功能性消化不良患者随机分为4组:电针组、枳术宽中胶囊组、联合治疗组及西药组,每组80例。电针组针刺足三里、中脘、内关、太冲、公孙,每日2次,每周连续5日;枳术宽中胶囊组予枳术宽中胶囊1.29g口服,每日3次;联合治疗组予上述针刺及枳术宽中胶囊治疗;西药组口服莫沙比利5mg,每日3次,奥美拉唑20mg,每日2次,阿米替林25mg,每日2次。4组均治疗6周。观察4组患者治疗前、治疗后及治疗后4周症状积分、症状指数(NDSI)和生活质量指数(NDLQI)、健康相关生活质量评分(SF-36)、胃电图、血浆胃动素水平、B超胃排空变化和不良反应。结果:与治疗前比较,治疗后各组症状积分、NDSI均明显下降(均P<0.01),NDLQI、SF-36、胃电频率、血浆胃动素水平、胃排空明显上升(均P<0.01),联合治疗组上述指标优于其他组(均P<0.05);与治疗结束时比较,治疗后4周上述指标在电针组和联合治疗组无明显反复(均P>0.05),在枳术宽中胶囊组和西药组则明显反复(均P<0.05),联合治疗组近期和远期总有效率均显著高于其他组的总有效率(P<0.05,P<0.01),各组均无严重不良反应发生。结论:电针和枳术宽中胶囊均提高血浆胃动素水平及胃电频率,促进胃排空,缓解消化不良症状,提高生活质量指数,但联合用药效果更好,并具有较好的安全性和远期疗效。
Objective To observe the long-term efficacy and safety on functional dyspepsia treated with electroacu puncture and Zhizhu Kuanzhong capsule and explore the therapeutic mechanism. Methods Three hundreds and twenty patients with confirmed diagnosis as functional dyspepsia were randomly divided into 4 groups： an electroacupuncture group, a Zhizhu Kuanzhong capsule group, a combined therapy group and a western medication group, 80 cases in each group. In electroacupuncture group, acupuncture was applied to Zusanli （ST 36）, Zhongwan （CV 12）, Neiguan （PC 6）, Taichong （LR 3） and Gongsun （SP 4）, twice per day, continuously for ,5 days each week. In Zkizhu Kuanzhong capsule group, ZhizhuKuanzhong capsule, 1.29 g was administered for oral application, three times each day. In comhined therapy group, the therapeutic programs in the ahove mentioned groups were applied in combination. In western medication group, Mosapride 5 mg, three times per day; Omeprazole 20 mg, twice per day and Amitriptyline 25 mg, twice per day were administered for oral application. Six weeks treatment was re quired in each group. The symptoms score, the Nepean Dyspepsia Symptom Index （NDS1）, the Nepean Dyspepsia I.ife Quality Index （NI）LQI）, Medical Outcomes Study 36 Item Short Form Health Survey（SF-36）, electrogas- trography, plasma motilin, gastric emptying by B-sonography and adverse reactions were observed before and after treatment, as well as 4 weeks after treatment separately. Results Compared with those before treatment, the symptom score and NDSI decreased apparently after treatment （all P（0.01 ）, NDLQI, SF 36, electrogastrographic frequency, plasnm motilin and gastric emptying were up-regulated apparently （all P〈0. 01） after treatment in each group. The results of the above-mentioned indices in combined therapy group were superior to the other groups （all P〈0.05）.As compared with the condition at the end of treatment, in 4 weeks after treatment, the above indices were not rehound apparently in electroacupuncture group and combined therapy group （all P〉0.05）. But they were rebound obviously in Zhizhu Kuanzhong capsule group and western medication group （all P〈0.05）. The short-term and long-term efficacies in combined therapy group were significantly higher than the total effective rates in the other groups （P〈0.05, P〈0.01）. No serious adverse reaction was reported in each group. Conclusion Electroacupuncture and Zhizhu Kuanzhong capsule all up-regulate plasma motilin and electrogastrographic frequency, promote gastric emptying, alleviate the symptom of functional dyspepsia and improve NDLQI. But the combined medication achieves much better efficacy and presents better safety and long-term therapeutic effect.
出处
《中国针灸》
CAS
CSCD
北大核心
2011年第12期1071-1077,共7页
Chinese Acupuncture & Moxibustion
作者简介
通讯作者：张超贤（1974－），男，副主任医师。研究方向：中西医结合治疗功能性胃肠病。E—mail：g75zh@yahoo．com．cn
