经皮穴位电刺激治疗合并焦虑抑郁FD患者的临床研究

发布时间：2018-05-07 07:04

本文选题：功能性消化不良 + 焦虑抑郁　；参考：《华北理工大学》2017年硕士论文

【摘要】：目的本研究通过评价经皮穴位电刺激(Transcutaneous Electrical Acupoint Stimulation,TEAS)对合并焦虑抑郁的功能性消化不良(Functional dyspepsia,FD)患者的不同指标的疗效观察,从而为功能性消化不良的治疗提供不同参考。方法1选取2015年10月至2016年8月于华北理工大学附属医院就诊且符合罗马Ⅲ诊断标准、焦虑抑郁评分在50-72分的病人共43例。将病人分为实验组(经皮穴位电刺激)与对照组(氟哌噻吨美利曲辛片),实验组21例,对照组22例。2实验组使用电刺激仪刺激足三里及内关穴,每次30min,每天治疗1次,每周休息1天,治疗4周;对照组给予氟哌噻吨美利曲辛片口服,每日早午饭后半小时内口服,每次剂量为10.5mg,口服4周。3以临床症状积分、生活质量评分(SF-36)、精神心理状况评分(SAS\SDS)、饮水负荷试验(WLT)、血清胃泌素(GAS)为观察指标,治疗前及治疗后进行评估。4应用SPSS19.0对数据进行统计分析。计量资料采用均数±标准差((?)±s),组内及组间治疗前后相比,采用配对t检验或wilcoxon检验,若前后差值符合正态分布,则采用配对t检验,若不符合正态分布,则使用wilcoxon检验。以P0.05或P0.01为差异有统计学意义。结果1两组临床症状积分比较:实验组各项临床症状积分均有下降,差异具有统计学意义(P0.0l);对照组在恶心、呕吐、过度嗳气3个维度,积分较前没有下降,治疗前后不具有统计学意义(P0.05),在其余维度,积分均有下降,差异具有统计学意义(P0.0l或P0.05)。实验组总有效率为80.95%,对照组总有效率为50%,差异有统计学意义(P0.05)。2两组生活质量评分(SF-36)比较:两组生活质量评分较前均有提高,差异具有统计学意义(P0.0l或P0.05);治疗后,两组生活质量评分比较显示,在生理机能、生理职能、躯体疼痛、一般健康状况4个维度,两组提高无统计学差异(P0.05),在精力、社会功能、情感职能、精神健康4个维度,对照组分数提高较实验组提高明显,差异具有统计学意义(P0.0l)。实验组总有效率为47.62%,对照组总有效率为81.82%,差异有统计学意义(P0.05)。3两组精神心理状态评分(SAS\SDS)比较:两组患者SAS、SDS评分较前均有下降,差异具有统计学意义(P0.01);对照组焦虑抑郁评分较实验组焦虑抑郁评分下降明显,差异具有统计学意义(P0.01)。4两组饮水负荷试验比较:与治疗前相比,两组患者的饮水量较前均有上升,差异有统计学意义(P0.01);对照组较实验组饮水量上升量少,差异具有统计学意义(P0.01)。5两组血清胃泌素比较:与治疗前比,两组血清胃泌素含量较前均有下降,差异具有统计学意义(P0.05);实验组较对照组下降明显,差异有统计学意义(P0.05)。结论1经皮穴位电刺激与氟哌噻吨美利曲辛片均是治疗合并焦虑抑郁功能性消化不良患者的有效方法。2经皮穴位电刺激在改善患者临床症状方面优于氟哌噻吨美利曲辛片。3氟噻吨美利曲辛片在改善患者焦虑抑郁及生活质量方面优于经皮穴位电刺激。
[Abstract]:Objective to evaluate the efficacy of transcutaneous Electrical Acupoint stimulation (TEA) in patients with functional dyspepsia complicated with anxiety and depression, so as to provide different references for the treatment of functional dyspepsia. Methods from October 2015 to August 2016, 43 patients with anxiety and depression scores of 50-72 were selected from the affiliated Hospital of North China University of Technology. The patients were divided into two groups: experimental group (percutaneous acupoint electrical stimulation) and control group (droperazothioate metroxine tablets). The experimental group (21 cases) and the control group (22 cases) were treated with electric stimulator to stimulate Zusanli and Neiguan points for 30 minutes, once a day. The patients in the control group were treated with droperazothioate metroxine tablets for 4 weeks, and the control group with a dose of 10.5 mg within half an hour after early lunch. The clinical symptoms of the patients in the control group were scored with clinical symptoms for 4 weeks. Quality of life score (SF-36), psychosomatic score (SAS), drinking water load test (WLTT) and serum gastrin (gastrin) were used to evaluate the data before and after treatment. SPSS19.0 was used to analyze the data. The measurement data were measured by mean 卤standard deviation) 卤sg. The matched t test or wilcoxon test was used before and after treatment. If the difference before and after treatment was normal distribution, the paired t test was used, and if not, the wilcoxon test was used. P 0.05 or P 0.01 as the difference was statistically significant. Results 1 comparison of clinical symptom scores between the two groups: the scores of each clinical symptom in the experimental group were all decreased, the difference was statistically significant (P0.0l0. 01), in the control group, the scores of nausea, vomiting and excessive belching were not decreased. There was no statistical significance before and after treatment, but in the other dimensions, the scores were all decreased, and the difference was statistically significant (P 0.01 or P 0.05). The total effective rate of the experimental group was 80.955.The total effective rate of the control group was 50. The difference was statistically significant. The scores of quality of life in the two groups showed that there were four dimensions of physiological function, physiological function, physical pain, general health status, and there was no statistical difference between the two groups (P 0.05), and there were four dimensions of energy, social function, emotional function and mental health. The scores of the control group were significantly higher than that of the experimental group, and the difference was statistically significant (P 0.05). The total effective rate of the experimental group was 47.62 and the total effective rate of the control group was 81.82. The difference was statistically significant. The scores of anxiety and depression in the control group were significantly lower than those in the experimental group, and the difference was statistically significant in the drinking water load test between the two groups: compared with before treatment, the drinking water volume of the two groups was higher than that before treatment. There was a significant difference in serum gastrin between two groups: compared with before treatment, the content of serum gastrin in the control group was lower than that in the control group, and there was a significant difference between the control group and the experimental group in the quantity of drinking water, the difference was statistically significant (P 0.01), and the content of serum gastrin in the two groups was lower than that in the control group. The difference was statistically significant (P 0.05), and that of the experimental group was significantly lower than that of the control group (P 0.05). Conclusion 1 Percutaneous acupoint electrical stimulation and droperazothioate melitaxine tablets are effective methods for the treatment of patients with functional dyspepsia complicated with anxiety and depression. 2 Transcutaneous acupoint electrical stimulation is superior to droperazothioate in improving the clinical symptoms of patients. Ritroxine tablet .3 was superior to transcutaneous acupoint electrical stimulation in improving anxiety and depression and quality of life of patients.
【学位授予单位】：华北理工大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R57;R749

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