基于湖湘五经配伍理论针刺治疗消化性溃疡的临床观察

发布时间：2018-03-31 20:48

本文选题：消化性溃疡　切入点：五经配伍　出处：《中国针灸》2017年08期

【摘要】：目的:比较基于湖湘五经配伍理论针刺与常规西药治疗消化性溃疡的疗效差异。方法:将60例消化性溃疡患者根据中医辨证分为肝胃不和型及脾胃虚弱型两个区组,然后将两个区组内的患者随机分为观察组与对照组,最终有效病例57例,观察组28例(其中肝胃不和型17例,脾胃虚弱型11例),对照组29例(其中肝胃不和型18例,脾胃虚弱型11例)。观察组按湖湘五经配伍理论指导制定方案,予以毫针针刺治疗,肝胃不和型选取中脘、太冲、行间、期门、足三里、公孙、少府、经渠、内关穴;脾胃虚弱型选取中脘、大都、太白、阴陵泉、足三里、少府、太冲、阴谷、太溪、太渊穴,辨证施予补泻操作,每次留针30 min,每天1次,每周治疗5 d,休息2 d。对照组采用西药口服治疗,其中幽门螺杆菌(Hp)阳性者予以常规三联药物奥美拉唑+阿莫西林+克拉霉素口服,Hp阴性者直接口服奥美拉唑。两组均治疗4周,观察两组患者治疗前、治疗后及治疗后1个月临床证候积分,比较两组患者胃镜下溃疡愈合情况、抗Hp感染及转阴率,并评定两组总体疗效。结果:在治疗后及治疗后1个月,两组患者临床证候积分与本组治疗前比较均有下降(均P0.05),组间比较差异无统计学意义(均P0.05);组内不同证型患者比较证候积分差异均无统计学意义(均P0.05)。两组胃镜下溃疡愈合总有效率、抗Hp感染总有效率及临床总有效率比较差异均无统计学意义(均P0.05);观察组Hp转阴率为22.2%(4/18),对照组为52.6%(10/19),观察组转阴率低于对照组(P0.05)。结论:基于湖湘五经配伍理论体系针刺治疗消化性溃疡,能有效改善患者的临床证候,促进溃疡的愈合,有效抗Hp感染,其临床总体疗效与西医常规药物治疗基本相当,但在Hp的转阴率上不及西医常规药物治疗。
[Abstract]:Objective: to compare the therapeutic effects of acupuncture on peptic ulcer based on the combination theory of Huxiang five meridians and routine western medicine. Methods: sixty patients with peptic ulcer were divided into two groups according to TCM syndrome differentiation: liver and stomach disharmony type and spleen and stomach weakness type. Then the patients were randomly divided into observation group and control group. There were 57 effective cases, 28 cases in observation group (17 cases of liver and stomach disharmony, 11 cases of deficiency of spleen and stomach), 29 cases of control group (18 cases of disharmony of liver and stomach). According to the theory of compatibility of Huxiang five meridians, the observation group was given the treatment of acupuncture with filiform acupuncture, and the type of disharmony of liver and stomach was selected as Zhongwan, Taichong, interline, Shimen, Zusanli, Gongsun, Shaofu, Jing qu and Neiguan points; Spleen and stomach asthenia type selected Zhongwan, mostly, Taibai, Yin Lingquan, Zusanli, Shaofu, Taichong, Yinku, Taixi, Taiyuan, Dialectic application of reinforcing diarrhea operation, every time to keep needle 30 minutes, once a day, Five days a week and two days rest. The control group was treated by oral administration of western medicine. The patients who were positive for Helicobacter pylori were treated with omeprazole and amoxicillin clarithromycin. The patients in both groups were treated with omeprazole for 4 weeks. After treatment and 1 month after treatment, the clinical syndromes scores of the two groups were compared, the healing of ulcer under gastroscope, the rate of anti-HP infection and negative conversion were compared, and the overall curative effect of the two groups was evaluated. Results: after treatment and 1 month after treatment, the healing rate of ulcer was compared between the two groups. The clinical syndromes scores of the two groups were decreased compared with those of the patients before treatment (all P 0.05), but there was no significant difference between the two groups (all P 0.05), and there was no significant difference in the comparison of syndromes between the two groups (P 0.05). Total effective rate of healing of lower ulcer, There was no significant difference in the total effective rate of anti-HP infection and the total clinical effective rate (all P 0.05), the negative conversion rate of HP in the observation group was 22.22 / 18%, and that in the control group was 52.6% 10 / 19%. The negative conversion rate in the observation group was lower than that in the control group (P 0.05). Conclusion: based on the theoretical system of compatibility of Huxiang five meridians, the negative rate of the observation group is lower than that of the control group. Acupuncture for peptic ulcer, It can effectively improve the clinical syndromes, promote the healing of ulcers, and effectively resist HP infection. The overall clinical efficacy is basically the same as that of western medicine, but the negative rate of HP is not as good as that of western medicine.
【作者单位】：湖南中医药大学第一附属医院;湖南中医药大学研究生院;
【基金】：国家中医药管理局湖湘五经配伍针推学术流派传承工作室建设项目:LP 0118041
【分类号】：R246.1

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