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[足阳明经特定穴与非特定穴针刺治疗功能性消化不良的疗效对比研究]

[Comparative study on therapeutic effect between acupuncture at special acupoints and non-specific acupoints in foot yangming meridian for functional dyspepsia].

作者信息

Wang De-Jun, Chang Xiao-Rong, Yan Jie, Wang Xiao-Juan, Wang Ting, Liu Jue, Diao Li-Hong, Xie Hui

机构信息

College of Acupuncture-Moxibustion and Massage, Hunan University of CM, Key Laboratory of Correlativity Between Meridian Point and Viscera of State Administration of TCM, Key Laboratory of Biological Information Analysis for Acupuncture and Moxibustion of the Department of Education of Hunan Province, Changsha 410007, China.

出版信息

Zhongguo Zhen Jiu. 2012 Aug;32(8):703-8.

Abstract

OBJECTIVE

To compare the clinical efficacy differences among acupuncture at special acupoints, nonspecific acupoints and non acupoints in Foot Yangming Meridian for functional dyspepsia (FD) at different time points.

METHODS

One hundred and sixteen FD patients were randomly divided into a special acupoints in Foot Yangming Meridian group (group A, n = 36), a non-specific acupoints in Foot Yangming Meridian group (group B, n 39) and a non acupoints group (group C, n = 41). Group A was treated with acupuncture at Chongyang (ST 42), Fenglong (ST 40), Zusanli (ST 36) and Liangqiu (ST 34), and group B was treated with acupuncture at Tiaokou (ST 38), Yinshi (ST 33), Futu (ST 32) and Dubi (ST 35), and the assisted acupoints were setting up at 2 mm apart from selected acupoints in meridian of proximal part. Group C was treated with 4 non acupoints: (1) medial elbow, middle point on the line between olecranon and armpit; (2) middle point on the line between condylus medialis humeri and wrist of elbow-bone; (3) the junction of deltoid and biceps inside the arm; (4) 1-2 cm horizontally away from Zusanli (ST 36), lateral border of shin bone, and the assisted acupoints were setting up at 2 mm away from selected non acupoints along limb longitudinal axis of proximal part. All acupoints and assisted acupoints were connected to the HANS nerve stimulator and they were all treated for 4 courses. The FD Symptom Index (FDI) and MOS 36-Item Short-Form Health Survey (SF-36) after treatment, 1 month and 3 months after treatment were observed and the clinical efficacy was assessed.

RESULTS

After treatment, the total effective rate of abdominal fullness after meal, early satiation, upper abdominal pain and upper abdominal burning sensation were 84.8% (28/33), 67.7% (21/31), 76.9% (20/26) and 56.3% (9/16), respectively, in group A, and 45.9% (17/37), 38.7% (12/31), 42.9% (12/28) and 38.5% (5/13), respectively, in group B, and 15.8% (6/38), 18.4% (7/38), 46.1% (12/26) and 16.7% (4/24), respectively, in group C. The total effective rate of abdominal fullness after meal, early satiation and upper abdominal pain in group A were superior to those in group B (all P < 0.05), and the total effective rate of abdominal fullness after meal, early satiation, upper abdominal pain and upper abdominal burning sensation in group A were all superior to those in group C (all P < 0.05), and the total effective rate of abdominal fullness after meal in group B was superior to that in group C (P < 0.05). The score of FDI and SF-36 after treatment, 1 month and 3 months after treatment in all the groups were better than those before treatment (all P < 0.05), and above indices in group A were the most significant (all P < 0.05), and the scores of FDI and SF-36 after treatment in group B were better than those in group C (both P < 0.05).

CONCLUSION

All the treatment of acupuncture at special acupoints, non-specific acupoints in Foot Yangming Meridian and non acupoints have therapeutic effect on FD, but acupuncture at special acupoints has better short and long term therapeutic effects, which confirm the existence of acupoints specificity.

摘要

目的

比较足阳明经特定穴、非特定穴及非经穴针刺治疗功能性消化不良(FD)不同时间点的临床疗效差异。

方法

将116例FD患者随机分为足阳明经特定穴组(A组,n = 36)、足阳明经非特定穴组(B组,n = 39)和非经穴组(C组,n = 41)。A组针刺冲阳(ST42)、丰隆(ST40)、足三里(ST36)、梁丘(ST34);B组针刺条口(ST38)、阴市(ST33)、伏兔(ST32)、犊鼻(ST35),辅穴在本经近端所选穴位旁开2mm处。C组针刺4个非经穴:(1)肘内侧,尺骨鹰嘴与腋窝连线中点;(2)肱骨内侧髁与尺骨小头腕横纹连线中点;(3)上臂三角肌与肱二头肌交界处内侧;(4)足三里(ST36)水平旁开1 - 2cm,胫骨外侧缘,辅穴在近端肢体纵轴上距所选非经穴2mm处。所有穴位及辅穴均连接HANS神经刺激仪,均治疗4个疗程。观察治疗后、治疗后1个月及3个月的FD症状指数(FDI)和MOS 36项简短健康调查量表(SF - 36),并评估临床疗效。

结果

治疗后,A组餐后腹胀、早饱、上腹痛、上腹部烧灼感的总有效率分别为84.8%(28/33)、67.7%(21/31)、76.9%(20/26)、56.3%(9/16);B组分别为45.9%(17/37)、38.7%(12/31)、42.9%(12/28)、38.5%(5/13);C组分别为15.8%(6/38)、18.4%(7/38)、46.1%(12/26)、16.7%(4/24)。A组餐后腹胀、早饱、上腹痛的总有效率均优于B组(均P < 0.05);A组餐后腹胀、早饱、上腹痛、上腹部烧灼感的总有效率均优于C组(均P < 0.05);B组餐后腹胀的总有效率优于C组(P < 0.05)。各组治疗后、治疗后1个月及3个月的FDI和SF - 36评分均优于治疗前(均P < 0.05),且A组上述指标改善最显著(均P < 0.05),B组治疗后FDI和SF - 36评分优于C组(均P < 0.05)。

结论

足阳明经特定穴、非特定穴及非经穴针刺治疗FD均有疗效,但特定穴针刺的近期及远期疗效更佳,证实了穴位特异性的存在。

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