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针刺治疗胃食管反流的临床研究。

Clinical study on the treatment of gastroesophageal reflux by acupuncture.

机构信息

Department of Gastroenterology, First Hospital Affiliated to Xinxiang Medical College, Henan 453100, China.

出版信息

Chin J Integr Med. 2010 Aug;16(4):298-303. doi: 10.1007/s11655-010-0516-y. Epub 2010 Aug 10.

Abstract

OBJECTIVE

To explore the clinical efficacy and safety of acupuncture in treating gastroesophageal reflux (GER).

METHODS

Sixty patients with confirmed diagnosis of GER were randomly assigned to two groups. The 30 patients in the treatment group were treated with acupuncture at acupoints Zhongwan (CV 12), bilateral Zusanli (ST36), Sanyinjiao (SP6), and Neiguan (PC6), once a day, for 1 week as a therapeutic course, with interval of 2-3 days between courses; the 30 patients in the control group were administered orally with omeprazole 20 mg twice a day and 20 mg mosapride thrice a day. The treatment in both group lasted 6 weeks. Patients' symptoms and times of reflux attacking were recorded, the 24-h intraesophageal acid/bile reflux were monitored, and the endoscopic feature of esophageal mucous membrane was graded and scored at three time points, i.e., pre-treatment (T0), immediately after ending the treatment course (T1) and 4 weeks after it (T2). Besides, the adverse reactions were also observed.

RESULTS

Compared with those detected at T0, 24-h intraesophageal pH and bile reflux, endoscopic grading score and symptom score were all decreased significantly at T1 in both groups similarly (P<0.01), showing insignificant difference between groups (P>0.05). These indices were reversed at T2 to high level in the control group (P<0.05), but the reversion did not occur in the treatment group (P>0.05). No serious adverse reaction was found during the therapeutic period.

CONCLUSION

Acupuncture can effectively inhibit the intraesophageal acid and bile reflux in GER patients to alleviate patients' symptoms with good safety and is well accepted by patients.

摘要

目的

探讨针刺治疗胃食管反流病(GER)的临床疗效和安全性。

方法

将 60 例确诊为 GER 的患者随机分为两组。治疗组 30 例患者采用针刺中脘(CV 12)、双侧足三里(ST36)、三阴交(SP6)和内关(PC6),每日 1 次,每周 1 个疗程,疗程之间间隔 2-3 天;对照组 30 例患者给予奥美拉唑 20mg,每日 2 次,莫沙必利 20mg,每日 3 次口服。两组治疗均持续 6 周。记录患者症状及反流发作次数,监测 24 小时食管内酸/胆汁反流,在三个时间点(治疗前(T0)、治疗结束后即刻(T1)和结束后 4 周(T2))对食管黏膜内镜特征进行分级和评分,并观察不良反应。

结果

与 T0 时相比,两组患者的 24 小时食管内 pH 值和胆汁反流、内镜分级评分和症状评分在 T1 时均明显下降(P<0.01),两组间无显著性差异(P>0.05)。对照组在 T2 时各项指标均恢复高水平(P<0.05),但治疗组未出现逆转(P>0.05)。治疗期间未发现严重不良反应。

结论

针刺可有效抑制 GER 患者食管内酸和胆汁反流,缓解患者症状,安全性好,患者接受度高。

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