体表电刺激联合电针治疗餐后不适综合征型FD的临床研究

发布时间：2018-04-06 05:20

本文选题：功能性消化不良　切入点：餐后不适综合征　出处：《湖北中医药大学》2016年硕士论文

【摘要】：目的观察体表电刺激(TEA)联合电针(EA)治疗餐后不适综合征型FD的临床疗效,建立一种科学有效的临床治疗FD的方法,并探索其可能的机制。方法根据已有的标准选取餐后不适综合征型FD患者共30例,分为三组,每组10例。EA组(A组)单用EA治疗,每周2次,每次30min;假性TEA联合EA组(B组)采用EA联合假性TEA治疗,即每周2次的EA治疗同时还需进行每天早晚各一次,每次45min的假性TEA治疗;TEA联合EA组(C组)采用EA联合TEA治疗,即每周2次的EA治疗同时还需进行每天早晚各一次,每次45min的TEA治疗。治疗总疗程为4周,研究期间共随访3次(分别为治疗开始前、治疗第2周末和治疗第4周末)。观测消化不良症状评分、生活质量问卷(SF-36)、Zung氏焦虑及抑郁评分量表等指标,通过液体营养餐试验评估胃容受性,通过胃电图(EGG)和心率变异性(HRV)检测分析胃电节律及迷走神经活性。结果1.消化不良症状评分分析:与治疗前相比,C组病例治疗2周后、治疗4周后的消化不良症状总积分及餐后饱胀、早饱、嗳气单项症状积分均有不同程度的下降,其差异均具有统计学意义(P0.05)。治疗4周后,各组间进行比较,与A、B两组相比,C组病例消化不良症状总积分及餐后饱胀、早饱、嗳气单项症状积分下降程度更为明显,差异具有显著性(P0.05)。2.生活质量量表与Zung氏焦虑及抑郁量表评分分析:三组患者治疗前、治疗2周后、治疗4周后焦虑抑郁量表评分无明显变化(P0.05)。与治疗前相比,A、B两组生活质量量表评分在经过4周治疗后,亦无明显改变(P0.05),而C组患者在治疗4周末的SF-36评分有一定程度的升高,其差异具有显著性(P0.05)。3.患者胃容受性分析:三组组内之间进行比较,相比于治疗前,治疗后患者的阈值饮入量有明显的增大(P0.05),最大饮入量变化没有统计学意义(P0.05)。三组组间进行比较,治疗4周后,C组的阈值饮入量较A、B两组有明显的增大(P0.05)。4.胃电图指标分析:与治疗前相比,治疗2周后三组患者的胃慢波比例无明显变化,餐后/餐前主功比有不同程度的上升,其中A、B两组的餐后/餐前主功比的差异无显著性(P0.05),而C组餐后/餐前主功比的差异却有显著性意义(P0.05);与治疗前比较,治疗4周后三组患者胃慢波比例仍无明显变化,但餐后/餐前主功比明显升高,其中A、B组P0.05,C组P0.01。5.心率变异性分析:与治疗前相比,C组患者治疗2周后HF有一定升高,LF/HF有所下降(P0.05),治疗4周后HF明显升高,LF/HF明显下降(P0.01)。结论TEA联合EA的治疗方法能减轻餐后不适综合征型FD患者的临床症状,改善其生活质量,通过刺激迷走神经活性,调节胃电节律,增加胃容受性而起到治疗FD的目的。
[Abstract]:Objective to observe the clinical efficacy of body surface electrical stimulation (tea) combined with electroacupuncture (EA) in the treatment of postprandial discomfort syndrome (FD), to establish a scientific and effective clinical method for FD, and to explore its possible mechanism.That is to say, EA treatment twice a week should also be performed once a day in the morning and evening, and every time the pseudo-#en0# therapy of 45min plus tea combined with EA group C) should be treated with EA combined with TEA, that is, EA treatment twice a week should also be performed once a day in the morning and evening at the same time.Each time 45min was treated with TEA.The total course of treatment was 4 weeks and the study was followed up for 3 times (before the beginning of treatment, at the 2nd week of treatment and at the end of 4th week respectively).The symptoms of dyspepsia, the quality of life questionnaire (QOL) and SF-36 / Zung's anxiety and depression scale were measured. The gastric receptivity was evaluated by the liquid feeding test, and the gastric electric rhythm and vagus nerve activity were analyzed by electrogastrogram (EGG) and heart rate variability (HRV).Result 1.After 2 weeks of treatment and 4 weeks of treatment, the total score of dyspepsia and the scores of fullness after meal, early satiety, and single symptom score of belching were all decreased in group C, compared with those before treatment.The differences were statistically significant (P 0.05).After 4 weeks of treatment, the total score of dyspeptic symptoms and the scores of post-meal fullness, early satiety and belching were more obvious in group C than those in group A and B, and the difference was significant (P0.05. 2).Quality of life scale and Zung's anxiety and depression scale score: before treatment, 2 weeks after treatment, and 4 weeks after treatment, the scores of anxiety and depression scale had no significant change (P 0.05).After 4 weeks of treatment, there was no significant change in the scores of quality of life scale (QOL) between group A and group B, while the SF-36 score of group C increased to some extent at the end of 4 weeks of treatment, and the difference was significant (P 0.05 / 3).Analysis of gastric receptivity: compared with before treatment, the threshold drinking volume of patients increased significantly after treatment (P 0.05), and the change of maximum intake was not statistically significant (P 0.05).After 4 weeks of treatment, the threshold drinking volume in group C was significantly higher than that in group A and B (P 0.05. 4).Analysis of electrogastrogram: compared with before treatment, there was no significant change in the proportion of slow wave in stomach of the three groups after 2 weeks of treatment, and the ratio of principal work to main work before meal increased to some extent.There was no significant difference in postprandial / preprandial principal work ratio between group A and B, but there was significant difference between group C and group C in postprandial / preprandial ratio.But the postprandial / preprandial principal work ratio was significantly increased, among which P0.05C group P0.01.5.Heart rate variability (HRV): compared with that before treatment, HF in group C increased after 2 weeks of treatment and decreased after 2 weeks of treatment. After 4 weeks of treatment, HF increased significantly and decreased significantly in group C (P 0.01).Conclusion TEA combined with EA can relieve the clinical symptoms and improve the quality of life of FD patients with postprandial discomfort syndrome. It can be used to treat FD by stimulating vagus nerve activity, regulating gastric electric rhythm and increasing gastric receptivity.
【学位授予单位】：湖北中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R259

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