本文選題：消化性潰瘍　切入點：五經(jīng)配伍　出處：《中國針灸》2017年08期

【摘要】：目的:比較基于湖湘五經(jīng)配伍理論針刺與常規(guī)西藥治療消化性潰瘍的療效差異。方法:將60例消化性潰瘍患者根據(jù)中醫(yī)辨證分為肝胃不和型及脾胃虛弱型兩個區(qū)組,然后將兩個區(qū)組內(nèi)的患者隨機分為觀察組與對照組,最終有效病例57例,觀察組28例(其中肝胃不和型17例,脾胃虛弱型11例),對照組29例(其中肝胃不和型18例,脾胃虛弱型11例)。觀察組按湖湘五經(jīng)配伍理論指導(dǎo)制定方案,予以毫針針刺治療,肝胃不和型選取中脘、太沖、行間、期門、足三里、公孫、少府、經(jīng)渠、內(nèi)關(guān)穴;脾胃虛弱型選取中脘、大都、太白、陰陵泉、足三里、少府、太沖、陰谷、太溪、太淵穴,辨證施予補瀉操作,每次留針30 min,每天1次,每周治療5 d,休息2 d。對照組采用西藥口服治療,其中幽門螺桿菌(Hp)陽性者予以常規(guī)三聯(lián)藥物奧美拉唑+阿莫西林+克拉霉素口服,Hp陰性者直接口服奧美拉唑。兩組均治療4周,觀察兩組患者治療前、治療后及治療后1個月臨床證候積分,比較兩組患者胃鏡下潰瘍愈合情況、抗Hp感染及轉(zhuǎn)陰率,并評定兩組總體療效。結(jié)果:在治療后及治療后1個月,兩組患者臨床證候積分與本組治療前比較均有下降(均P0.05),組間比較差異無統(tǒng)計學(xué)意義(均P0.05);組內(nèi)不同證型患者比較證候積分差異均無統(tǒng)計學(xué)意義(均P0.05)。兩組胃鏡下潰瘍愈合總有效率、抗Hp感染總有效率及臨床總有效率比較差異均無統(tǒng)計學(xué)意義(均P0.05);觀察組Hp轉(zhuǎn)陰率為22.2%(4/18),對照組為52.6%(10/19),觀察組轉(zhuǎn)陰率低于對照組(P0.05)。結(jié)論:基于湖湘五經(jīng)配伍理論體系針刺治療消化性潰瘍,能有效改善患者的臨床證候,促進潰瘍的愈合,有效抗Hp感染,其臨床總體療效與西醫(yī)常規(guī)藥物治療基本相當,但在Hp的轉(zhuǎn)陰率上不及西醫(yī)常規(guī)藥物治療。
[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.
【作者單位】： 湖南中醫(yī)藥大學(xué)第一附屬醫(yī)院;湖南中醫(yī)藥大學(xué)研究生院;
【基金】：國家中醫(yī)藥管理局湖湘五經(jīng)配伍針推學(xué)術(shù)流派傳承工作室建設(shè)項目:LP 0118041
【分類號】：R246.1

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