针灸结合整脊治疗非糜烂性反流病的临床研究

发布时间：2018-08-11 13:28

【摘要】：目的:观察针灸结合整脊治疗非糜烂性反流病(Non-erosive Relux Disease,NERD)的临床有效性,探讨其理论依据,以便更好地在临床上推广。方法:将60例非糜烂性反流病患者随机分为治疗组、对照组,每组各患者30例。治疗组采用针灸配合整脊治疗,对照组使用单纯针灸治疗。两组治疗取穴:督脉经阳性反应点,至阳,灵台,神道,大椎,百会,每2天治疗一次,一周3次,每次留针30min,观察周期为6周。以RDQ、胃食管反流病生活质量自评量表、SAS、SDS、GerdQ量表为评价指标,进行治疗前与治疗后、组间与组内临床疗效的比较。结果:1.经治疗后,两组患者RDQ、GerdQ积分均较前降低,其烧心、反酸、胸痛及反食的发作频次在治疗前后有显著差异(P0.05),说明两组治疗NERD均有疗效;治疗组治疗后量表评分与对照组相比有明显差异(P0.05),说明治疗组更优于对照组。2.治疗后,两组SAS、SDS、GERD-HRQL量表评分均显著降低(P0.05),治疗组治疗后量表评分明显低于对照组(P0.05),说明针灸结合整脊与单纯针灸相比,更能改善NERD患者的焦虑、抑郁状态和生活质量的影响。3.经治疗后,治疗组总有效率为93.33%,对照组总有效率为83.33%,P=0.2280.05,两组无统计学差异;治疗组愈显率56.67%,对照组愈显率26.67%,P=0.0090.05,有显著差别。说明两组在治疗NERD有效率方面无明显差别,但治疗组愈显率优于对照组4.疗程结束1月后随访,两组复发率相比P=0.0150.05,差异有统计学意义,说明针灸结合整脊治疗NERD远期疗效优于单纯针灸。结论:针灸结合整脊治疗非糜烂性反流病疗效确切,优于单纯针刺治疗。针刺结合整脊能激发督脉阳气,不仅对NERD患者的反酸、烧心、非心源性胸痛、反食等临床症状有很好的疗效,而且对于改善患者的焦虑,抑郁状态以及生活质量也有明显作用。值得在临床上推广和应用。
[Abstract]:Objective: to observe the clinical efficacy of acupuncture and moxibustion combined with chiropractic in the treatment of non erosive reflux disease (Non-erosive Relux disease). Methods: 60 patients with non erosive reflux disease were randomly divided into treatment group and control group with 30 cases in each group. The treatment group was treated with acupuncture plus chiropractic therapy, while the control group was treated with simple acupuncture and moxibustion. Two groups of treatment points: du meridian positive reaction point, to Yang, Lingtai, Shinto, Dazhui, Baihui, once every 2 days, 3 times a week, 30 mins each time, observation period is 6 weeks. The quality of life (QOL) of gastroesophageal reflux disease (GERD) was compared with that of the group before and after the treatment. The result is 1: 1. After treatment, the scores of RDQN GerdQ in the two groups were lower than those in the previous group. The frequency of heartburn, acid regurgitation, chest pain and food regurgitation were significantly different between the two groups before and after treatment (P0.05), indicating that the two groups were effective in the treatment of NERD. There was significant difference in the scale scores between the treatment group and the control group (P0.05), indicating that the treatment group is better than the control group. 2. After treatment, the scores of GERD-HRQL in both groups were significantly decreased (P0.05), and the scores of GERD-HRQL in the treatment group were significantly lower than those in the control group (P0.05), indicating that acupuncture combined with chiropractic could improve the anxiety, depression and quality of life of NERD patients better than that of acupuncture alone (P0.05). After treatment, the total effective rate of the treatment group was 93.33 and the total effective rate of the control group was 83.33. The total effective rate of the treatment group was 83.33 and the total effective rate of the control group was 83.33. There was no statistical difference between the two groups, and there was significant difference between the treatment group and the control group. The results showed that there was no significant difference in the effective rate of NERD between the two groups, but the curative effect rate of the treatment group was better than that of the control group. At the end of one month follow-up, the recurrence rate of the two groups was 0.0150.05, the difference was statistically significant, indicating that the long-term effect of acupuncture combined with chiropractic therapy on NERD was better than that of pure acupuncture. Conclusion: acupuncture combined with chiropractic therapy is more effective than acupuncture alone in the treatment of non-erosive reflux disease. Acupuncture combined with chiropractic can stimulate the Yangqi of du pulse. It not only has a good effect on the clinical symptoms of NERD patients, such as acid regurgitation, heart-burning, non-cardiogenic chest pain and reverse eating, but also has obvious effect on improving the anxiety, depression and quality of life of the patients. It is worth popularizing and applying in clinic.
【学位授予单位】：南京中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R246.1

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