Zhang Chao-xian, Guto Li-ke, Guo Bao-rui
Department of Gastroenterology, the First Affiliated Hospital of Xinxiang Medical College, Weihui 453100, Henan.
Zhongguo Zhen Jiu. 2012 Jun;32(6):491-8.
To observe the clinical efficacy and safety of electroacupuncture combined with Dalitong granule for gastroesophageal reflux disease and to explore the therapeutic mechanism.
Five hundred cases diagnosed as gastroesophageal reflux disease were randomly divided into a combination group, an electroacupuncture group, a Dalitong granule group, and a western medication group, 125 cases in each group. The electroacupuncture group was treated with acupuncture at Zusanli (ST 36), Zhongwan (CV 12), Neiguan (PC 6), Tai-chong (LR 3) and Gongsun (SP 4), once daily for 6 weeks; the Dalitong granule group was treated with oral administration of Dalitong granule 6 g, three times daily; the combination group was treated with above two methods; the western medication group was treated with oral administration of Mosapride 5 mg, three times daily, Omeprazole 20 mg, twice daily and Amitriptyline 25 mg, twice daily. The total refluxing times, times of long-term reflux, percentage of upright time, percentage of supine time, percentage of total time of the 24-hour intraesophageal pH < 4 or bilirubin absorbance value (Abs) > or = 0.14, symptom score, endoscopic score, life quality score and adverse reaction were observed before treatment, at the end of treatment and 48 weeks after treatment in four groups.
Compared with those before treatment, esophageal acid reflux, bile reflux, endoscopic score and symptom score were decreased significantly at the end of treatment in four groups (all P < 0.01), while score of life quality was increased significantly (all P < 0.01). The improvements of above indices in the combination group were superior to other groups (all P < 0.05). Compared with the end of treatment, changes of above indices were not obvious in both of combination group and electroacupuncture group 48 weeks after treatment (all P > 0.05), but these indices all recurred significantly in other two groups (all P < 0.5). The short and long-term total effective rates in the combination group were superior to other groups (P < 0.5, P < 0.1). No serious adverse reaction occurred in four groups.
Electroacupuncture and Dalitong granule can both inhibit esophageal acid reflux and bile reflux, decrease endoscopic score, alleviate the symptom of gastroesophageal reflux and improve life quality, but the effect of combination is much better with safety and long-term efficacy, which is correlated with their acid inhibition, gastrointestinal motility and antidepressant effects.
观察电针联合达立通颗粒治疗胃食管反流病的临床疗效及安全性，并探讨其治疗机制。
将500例诊断为胃食管反流病的患者随机分为联合组、电针组、达立通颗粒组和西药组，每组125例。电针组针刺足三里（ST 36）、中脘（CV 12）、内关（PC 6）、太冲（LR 3）和公孙（SP 4），每日1次，共治疗6周；达立通颗粒组口服达立通颗粒6 g，每日3次；联合组采用上述两种方法治疗；西药组口服莫沙必利5 mg，每日3次，奥美拉唑20 mg，每日2次，阿米替林25 mg，每日2次。观察四组患者治疗前、治疗结束时及治疗后48周的总反流次数、长时间反流次数、直立时间百分比、仰卧时间百分比、24小时食管内pH<4或胆红素吸光度值（Abs）≥0.14的总时间百分比、症状评分、内镜评分、生活质量评分及不良反应。
与治疗前相比，四组患者治疗结束时食管酸反流、胆汁反流、内镜评分及症状评分均显著降低（均P<0.01），生活质量评分显著提高（均P<0.01）。联合组上述指标的改善情况优于其他组（均P<0.05）。与治疗结束时相比，联合组和电针组治疗后48周上述指标变化不明显（均P>0.05），但其他两组上述指标均明显复发（均P<0.5）。联合组的短期和长期总有效率均优于其他组（P<0.5，P<0.1）。四组均未发生严重不良反应。
电针和达立通颗粒均可抑制食管酸反流和胆汁反流，降低内镜评分，缓解胃食管反流症状，提高生活质量，但联合应用效果更佳，且安全性好、疗效持久，这与其抑酸、促进胃肠动力及抗抑郁作用有关。
