Lima Flávia Altaf da Rocha, Ferreira Lincoln Eduardo Villela Vieira de Castro, Pace Fábio Heleno de Lima
Universidade Federal de Juiz de Fora, Hospital Universitário, Departamento de Gastroenterologia e Endoscopia Digestiva, MG, Brasil.
Arq Gastroenterol. 2013 Jul-Sep;50(3):202-7. doi: 10.1590/S0004-28032013000200036.
Functional dyspepsia represents a frequent gastrointestinal disorder in clinical practice. According to the Roma III criteria, functional dyspepsia can be classified into two types as the predominant symptom: epigastric pain and postprandial discomfort. Even though the pathophysiology is still uncertain, the functional dyspepsia seems to be related to multiple mechanisms, among them visceral hypersensitivity, changes in the gastroduodenal motility and gastric accommodation and psychological factors.
Evaluate the effectiveness of acupuncture as a complementary to conventional treatment in functional dyspepsia patients.
Randomized clinical trial in which were enrolled patients with functional dyspepsia patients in according with Rome III criteria. One group was submitted to drug therapy and specific acupuncture (GI) and the other to drug therapy and non-specific acupuncture (GII). The gastrointestinal symptoms, presence of psychiatric disorders and quality of life were evaluated, at the end and three months after treatment.
After 4 weeks of treatment there was improvement of gastrointestinal symptoms in Group I (55 ± 12 vs 29 ± 8.8; P = 0.001) and Group II (50.5 ± 10.2 vs 46 ± 10.5; P = 0.001). Quality of life was significantly better in Group I than group II (93.4 ± 7.3 vs 102.4 ± 5.1; P = 0.001). Anxiety (93.3% vs 0%; P = 0.001) and depression (46.7% vs 0%; P = 0.004) were significantly lower in Group I than group II. When comparing the two groups after 4 weeks of treatment, gastrointestinal symptoms (29 ± 8.8 vs 46 ± 10.5; P<0.001) and quality of life (102.4 ± 5.1 vs 96 ± 6.1; P = 0.021) were significantly better in Group I than group II. Three months after the treatment, gastrointestinal symptoms remained better only in Group I, when compared to the pre-treatment values (38 ± 11.3 vs 55 ± 12; P = 0.001).
In patients with functional dyspepsia the complementary acupuncture treatment is superior to conventional treatment. Further studies with more patients are needed to confirm these findings.
功能性消化不良是临床实践中常见的胃肠道疾病。根据罗马III标准，功能性消化不良可根据主要症状分为两种类型：上腹部疼痛和餐后不适。尽管其病理生理学仍不确定，但功能性消化不良似乎与多种机制有关，其中包括内脏高敏感性、胃十二指肠动力和胃容纳功能的改变以及心理因素。
评估针刺作为功能性消化不良患者常规治疗补充手段的有效性。
一项随机临床试验，纳入符合罗马III标准的功能性消化不良患者。一组接受药物治疗和特定穴位针刺（GI组），另一组接受药物治疗和非特定穴位针刺（GII组）。在治疗结束时和治疗后三个月评估胃肠道症状、精神障碍的存在情况和生活质量。
治疗4周后，I组（55±12对29±8.8；P = 0.001）和II组（50.5±10.2对46±10.5；P = 0.001）的胃肠道症状均有改善。I组的生活质量明显优于II组（93.4±7.3对102.4±5.1；P = 0.001）。I组的焦虑（93.3%对0%；P = 0.001）和抑郁（46.7%对0%；P = 0.004）明显低于II组。治疗4周后比较两组时，I组的胃肠道症状（29±8.8对46±10.5；P<0.001）和生活质量（102.4±5.1对96±6.1；P = 0.021）明显优于II组。治疗三个月后，与治疗前值相比，仅I组的胃肠道症状仍较好（38±11.３对55±12；P = 0.001）。
在功能性消化不良患者中，针刺辅助治疗优于常规治疗。需要更多患者参与的进一步研究来证实这些发现。
